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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

May 25, 2021 - Health

New Alzheimer's drug could enter the market soon

Illustration: Eniola Odetunde/Axios

A new drug to treat Alzheimer's disease may soon enter the market, but getting it to patients could be challenging, Bloomberg reports.

Why it matters: The drug, which is called aducanumab and made by Biogen, is the first Alzheimer's treatment thought to slow the progression of the disease in people who show early signs of cognitive impairment.

Updated 15 mins ago - Sports

Olympics dashboard

Team USA's Caeleb Dressel celebrates winning gold in the final of the men's 50m freestyle swimming event at the Tokyo 2020 Olympic Gameson Sunday. Photo: Odd Andersen/AFP via Getty Images

🚨: Simone Biles won't compete in Olympic floor finals, individual vault or uneven bars

🏊: U.S. wins gold in men's 4x100-meter medley relay, earning Caeleb Dressel fifth gold — American Bobby Finke wins gold in men's 1,500-meter freestyle

🏊‍♀️: Katie Ledecky wins gold in women's 800m freestyle

🇬🇧: Britain wins gold in first-ever Olympic mixed 4x100m medley relay

💻: Japan tests teleporting games and "remote cheering"

🏳️‍⚧️: Axios at the Olympics: Games grapple with trans athletes — Trans athletes see the Tokyo Games as a watershed moment

Go deeper: Full Axios coverage

Updated 21 mins ago - Sports

U.S. wins gold in men's 4x100-meter medley relay

USA's Ryan Murphy (L) and USA's Caeleb Dressel celebrate winning the final of the men's 4x100m medley relay swimming event during the Tokyo 2020 Olympic Games at the Tokyo Aquatics Centre in Tokyo on Sunday. Photo: Odd Andersen/AFP via Getty Images

Team USA win the gold medal in the men's 4x100-meter medley relay, setting a new world record in the process on Sunday morning local time.

Of note: Caeleb Dressel won his fifth Tokyo Games gold medal during the event— becoming the fifth American to do so after speedskater Eric Heiden and the swimmers Mark Spitz, Matt Biondi and Michael Phelps, who achieved the feat three times.