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OOP Costs Often Exceed Discount Card Pricing for Select Generics

Medically reviewed by Drugs.com.

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Sept. 6, 2023 -- For select generic medications, out-of-pocket (OOP) payments frequently exceed discount card pricing for two discount drug programs, according to a research letter published online Sept. 5 in the Annals of Internal Medicine.

Pranav M. Patel, Pharm.D., from the University of Toledo College of Pharmacy and Pharmaceutical Sciences in Ohio, and colleagues estimated the proportion and extent of OOP payments exceeding Amazon Prime and GoodRx Gold discount card pricing for commonly prescribed generic medications using data from the 2020 Medical Expenditure Panel Survey. The analysis focused on the 20 most prescribed generic medications in this dataset.

The researchers found that for about 20 and 43 percent of the prescriptions included in the analysis, OOP payments exceeded Amazon and GoodRx prices, respectively. For 40 and 79 percent of the prescriptions assumed to be in the deductible phase, OOP payments exceeded Amazon and GoodRx prices, respectively. Assuming patients obtained their medications using Amazon and GoodRx discount cards, the estimated cumulative OOP cost savings amounted to about $969 million and $1.83 million, respectively. Of the cumulative savings, most were generated from 90-day prescriptions.

"Although some discount card programs may provide temporary relief for patients' OOP costs on select generic medications, their dependence on pharmacy benefit managers for claims adjudication and access to contracted pharmacies hinders long-term solutions," the authors write.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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Posted September 2023

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