Helpful tips for using GoodRX.com
Disclaimer – I don’t have any relationship with GoodRx.com whatsoever, nor to any pharmaceutical company, lobbying group, pharmacy, big box store, warehouse store, etc. I’m just a big fan of the benefits of this website to my patients and wish more people knew about it. – Dr. Patel
This is a lengthy and detailed post. If you like to save money and decrease hassle in regards to your prescription medication, though, it’s worth your while.
Goodrx.com has helped many a patient/family of mine afford medications and get around limitations imposed by insurance, pharmacy benefit managers, and/or pharmacies. Here are some of the ways I recommend that people use it:
- To get a 90 day supply of a (non-controlled*) medication, when your insurance would normally force you to break that up into a 30 day supply with two refills
- To get medication in a form that your insurance might not prefer
- To get medication sooner than expected
- Related to the above reasons for non-coverage, using GoodRx coupons or cards can help you and your doctor avoid having to get a prior authorization
- To check whether the copay amount you were asked to pay for a medication at the pharmacy seems reasonable
I’ll give examples and context for each of these, but first, some caveats and basic principles.
This is generally most useful for medications that have a generic and are relatively old and inexpensive
For example, in our work, there’s no reason you should ever pay more than a few dollars a week for Prozac. It is an old and inexpensive medication.
See?
If you tried that with the related compound Trintellix, which does not have a generic available, you’d see a very different picture:
You will still need a prescription
After all, this is a coupon website, not a prescription one.
Generally, the major retail pharmacies will be more expensive
The other places tend to be places where you will get groceries and home goods, so you’re likely to frequent at least one of them.
The generic will be the cheapest option, and the brand name price may not vary much between pharmacies
It’s important, therefore, to make sure that it is okay for you to take the generic for a given medication. That’s usually the default assumed by doctors, pharmacists, and insurance companies. Still, there are situations in which your doctor may want you to take the brand name medication over one of its generic alternatives.
You will need to make sure that the details of the coupon match that of the prescription
You’ll need to know the name, form (tab or capsule? Extended release or delayed release? Liquid or patch? Etc.), dosage, and quantity. If you’re not sure about this, ask your doctor, your doctor’s office staff, or the pharmacy staff.
Don’t forget to put in your zip code so you’re seeing local results!
You may need to move the prescription to the pharmacy with the best price
For non-controlled substances, it’s not a big deal. You can call either the new or the old pharmacy, and say that you want it transferred, and where to. You can show up to the preferred pharmacy and tell them from where you want it transferred. You may have to wait a while, and you’ll need some identifying information, but that’s it. Note: you cannot do this for psychostimulants in Illinois, and probably can’t for other controlled substances either. I.e. if it’s one of those medications, your doctor will have to call the prescription in to the preferred pharmacy.
Give the pharmacy staff the details of your coupon
Here’s an example of a coupon:
Note that it has information on it that is very similar to your insurance card. This is essentially taking the place of your insurance. You might want to clarify that to the staff (e.g. “I know my insurance doesn’t cover this, so I don’t want you to run it through my insurance, and to use this coupon instead”), in case they’re not familiar (which is unlikely, but people do make mistakes in how they run these). You don’t have to print out the coupon. You can just pull it up on your smartphone and show it to the pharmacy staff. Once they take it down and put it into their system, they’re not likely to need this information again. Still, it was easy enough to get in case you have to in the future.
Deductibles
For those of you with high deductible insurance, you may find it worth it to pay the full price, as everything ends up being cheaper once you meet that deductible. I also believe that the coupon price that you pay does not get applied to your deductible. These are certainly factors worth considering, based on your circumstances.
Okay, now on to examples and explanations of the perks of using this service.
1 – 90 day supplies. This should be self-explanatory, especially if you’re the head of a household of people taking various medications. The fewer trips to the pharmacy, the better.
2 – To get medication in a form that insurance might not prefer. For example, Prozac, though inexpensive, is slightly pricier in tablet form than in capsule form. When I’m prescribing it for the first time for a patient, I often prefer to use Prozac tablets, as I’ll often have patients take a smaller than full pill amount. I think it’s generally easier to break a tab into a smaller piece and swallow it than to open up a capsule, sprinkle out the contents, put some to the side, and ingest the remainder. This convenience is not so great that I’d want to jump through the hoops of a prior authorization, though, so one of these coupons is an easy and quick workaround.
See? Pricier than the capsules, but still far cheaper than the $99 retail price that was quoted in my search.
3 – Earlier fills. Say you lost a bottle of medication, or spilled it into the sink. Or say that you’re due for a refill in a week or two, but are leaving the country in the next day. Your insurance isn’t expecting you to have run out by now, and won’t want to cover the bulk of the medication’s cost, leaving you to pay the full cash price. You can instead use a coupon to bypass insurance, usually with a fee that is on par with your typical copay. Note: there may be other limitations to getting early fills for controlled substances.
4 – Prior authorizations are the bane of my existence, and likely worthy of a separate post. Sometimes, they’re unavoidable – e.g. for a specific medication that’s only available in the brand name formulation. If I can avoid them and the hours to days that it takes to resolve them, I will.
5 – Any time you’re at the register at a pharmacy and you get a price for a medication that seems higher than it ought to be, you can use this website to double check. If you get a result like this next one, that’s not such a surprise. But if you’re paying more for the medication than you would have to using a coupon at, say, the pharmacy across the street, you might choose to do that instead. Or you might inquire about the price and find out that something was entered incorrectly in applying insurance, a manufacturer’s copay card, etc.
So that’s how it’s done! Did any of this not make sense? Have you used GoodRx.com and run into problems that I didn’t address? Have you used other prescription coupons that you’d recommend? Let us know!
*Scheduled/”controlled” substances in psychiatry include psychostimulants (Adderall, Ritalin, etc.), benzodiazepines (Xanax, Ativan, Valium, etc.), and opioids (Suboxone, Methadone, etc.). They have legitimate uses as treatment, but also the potential for abuse. As a result, there are greater security measures in how they are prescribed and filled, including limits to how many days’ supply can be provided at one time. The rules can vary from state to state and medication to medication.
-Birju Patel, M.D.