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Photo: Lindsey Nicholson/Education Images/Universal Images Group via Getty Images

Buying prescription drugs through GoodRx, Amazon and other alternative avenues does not guarantee patients are getting a good deal.

The big picture: More people are purchasing their drugs with cash instead of using their health insurance, in large part because they are getting sizable discounts. But discounted prices often still have no relation to a drug's actual cost.

How it works: The amount people pay out of pocket for their medication is tied to secretive contracts among pharmacy benefit managers, health insurers, distributors, pharmaceutical companies, pharmacies and other entities.

  • When people decide to use discount programs like GoodRx (now a publicly traded company) or go to cash-only pharmacies, they are no longer using their insurance — and thus any amount they pay doesn't go toward deductibles and out-of-pocket limits.
  • People do this because those discounted prices still could be lower than if they were using insurance.

Yes, but: Generic versions of the HIV pill Truvada have significantly brought down the drug's price, but not for everyone, according to new research from analysts at drug-pricing firm 46brooklyn.

Here's what a monthly supply of generic Truvada costs someone through a cash-paying program, according to 46brooklyn:

  • $1,567 at Amazon, which uses a discount card program owned by Cigna and its PBM Express Scripts.
  • $112 at GoodRx, which generates most of its revenue from PBMs.
  • $25 at Blueberry, a small, cash-only pharmacy in Pittsburgh that eschews the entire supply chain.

Between the lines: All of these prices are cheaper than the $1,800 per-month cash price of brand-name Truvada, but most drug-discount programs are tethered to the broken drug-pricing system.

  • At $25, Blueberry is still making a profit. So at more than four times Blueberry's rate, the GoodRx price "isn't even close to the real cost of the drug," 46brooklyn's analysts write.

The bottom line: The existence of so many drug-discount programs is an indictment of both America's insurance and pharmaceutical systems.

Go deeper

Aug 11, 2021 - Health

VA won't cover Biogen's Alzheimer's drug

The VA hospital in Phoenix. Photo: Caitlin O'Hara/Bloomberg via Getty Images

The Department of Veterans Affairs has excluded Aduhelm, the $56,000-per-year Alzheimer's drug made by Biogen and Eisai, from its list of approved drugs due to the drug's "lack of evidence of a robust and meaningful clinical benefit and the known safety signal," Endpoints News reports.

Why it matters: Some hospitals and health insurers have said they will not provide or cover Aduhelm, but the VA is the largest entity yet to spurn the drug.

Felix Salmon, author of Capital
1 hour ago - Economy & Business

Investors pour millions into immersive, interactive art experiences

Photo Illustration: Megan Robinson/Axios. Photo: Martin Bureau/AFP via Getty Images

How much would you pay for "a sleek, if pleasantly confusing, package of moods" or "a confusing tangle of disjointed installations" or even "the total erosion of meaning itself"? The answer, according to the current market-clearing price, seems to be about $35.

Why it matters: Investors are pouring hundreds of millions of dollars into ticketed experiences — immersive, interactive museum-like spaces that don't have the d0-not-touch stuffiness of traditional museums.

Special Envoy for Haiti resigns over Biden deportations

Daniel Foote testifies during a Senate Foreign Relations Committee hearing on May 26, 2016. Photo: Drew Angerer/Getty Images

The Special Envoy for Haiti on Wednesday resigned from his position, writing in his resignation letter obtained by PBS that he "will not be associated with the United States inhumane, counterproductive decision to deport thousands of Haitian refugees."

Why it matters: Ambassador Daniel Foote's resignation comes amid heightened anger over the treatment of Haitian migrants and asylum-seekers living in a temporary encampment in Del Rio, Texas — especially after images surfaced of Border Patrol agents whipping at the migrants from horseback.