Recently, GoodRx partnered with healthcare media agency Publicis Health Media (PHM) at its 2024 HealthFront event. One of the highlights on the main stage was a GoodRx-sponsored session that featured new research and a candid discussion between two physicians about the daily challenges they face in caring for patients. Dr. Preeti Parikh, VP, executive medical director at GoodRx and practicing pediatrician, and Dr. Minisha Sood, an endocrinologist and cofounder and co-owner of Fifth Avenue Endocrinology, reviewed highlights of new GoodRx research into medication affordability and the issues HCPs face in the diagnosis and treatment of diabetes and obesity.
Specialists are a high-value and sometimes elusive audience for pharma marketers and media strategists. This conversation exposed key insights about the everyday hassles and barriers to treating patients; key considerations for making treatment decisions; and the evolving role of HCPs in discussing medication affordability with patients.
What follows is an edited transcript of their conversation.
Parikh: I’ve been practicing for over 15 years. When I started, cost conversations weren’t always top of mind. But now, in every patient encounter I have, we talk about cost. It has also become a bigger factor in my decisions about treatment plans. And I’ve seen a dramatic increase in the amount of time and energy my staff puts into prior authorization, pharmacy calls, calls between my colleagues and patients about other medications when they can’t afford them.
Sood: I have patients who really rely on GoodRx to get savings for their medications, and it’s very helpful to me as an HCP. When I send prescriptions, I look up GoodRx coupons myself and include that information in the prescription to just make it easier for the patients at the pharmacy, to decrease phone calls on either side of that equation.
Parikh: New site-intercept research from GoodRx mirrors what I’m seeing in my practice. Eighty percent of consumers visiting GoodRx are insured, 35% have incomes over $100,000 a year, and 37% are looking for discounts on drugs their insurance won’t cover. It’s surprising that even people with insurance and higher incomes still have issues affording their prescriptions.
Sood: I have three full-time staff to deal just with insurance prior authorizations, field phone calls from upset patients and pharmacies, and review forms, sign them and send them in. And this goes on day after day.
Parikh: Here’s a recent example in my practice. A generic of one of the inhaled corticosteroids used in pediatrics became available. Most clinicians would think, “That’s great news, more of my patients will be able to afford it now.” But the opposite happened. My office was inundated with phone calls from pharmacies and from parents saying, “My insurance plans aren’t covering my child’s asthma medication.”
Sood: With the rise in type 2 diabetes and advancements in therapy, it’s been frustrating to see many patients not staying in their recommended blood glucose range. Part of the reason is that these drugs remain exorbitantly expensive for those who also need testing supplies, and possibly insulin. It’s an added level of stress and frustration and can lead to some of them avoiding medical care due to additive costs.
The ADA guidelines expanded first-line therapy to include some of these newer medications. And yet, clinicians are not able to always use these medications because of their high out-of-pocket (OOP) costs. Add to that the supply shortages of injectable diabetes medications such as the GLP-1s, and patients are scrambling month-to-month to find a supply — and the finances — to support their need for these medications.
Parikh: We’ve seen the headlines about the effectiveness of the new weight loss medications, but do they create new challenges for you?
Sood: Before 2021 clinicians were able to quietly prescribe GLP-1s off-label for obesity and they were on many insurance formularies. These could have been for patients with a range of conditions on the spectrum of metabolic syndrome. The results were robust and helped patients avert progression, which had huge implications for extending their healthspan and lifespan.
Around 2022 the greatly expanded use of GLP-1s caused supply to dwindle, and insurance companies realized they were spending more on these medications and therefore became much more stringent about patients meeting clinical criteria for obesity. So, patients who may have been pre-diabetic and using a GLP-1 off-label no longer had it covered by insurance. That’s where GoodRx coupons can help.
Parikh: Some GLP-1s have or are being studied for other indications. How has that impacted your practice?
Dr. Sood: Expanded indications for GLP-1s will exacerbate the shortages. Combine that with other obesity medications having manufacturing issues, plus the newer meds not being covered by Medicare. That can leave many patients in a precarious treatment gap.
We know from clinical studies that when these medications are stopped, patients regain up to two-thirds of their body weight, often over a short period. Unfortunately, pharma companies don’t always give doctors and their staff the information they need, so it’s difficult to forecast drug availability for our patients.
Parikh: In addition to supply challenges, I agree that patient affordability and access is definitely an issue. And these situations prompt a lot of HCPs and their patients to look for a platform such as GoodRx where they can find — in one place — medication copay and cash solutions across both retail and specialty. For example, over 150 prescription brands have leveraged the GoodRx platform to help eligible patients access their copay programs, and more than 30 brands use GoodRx to offer cash-pay programs for their treatments.
I’ve talked to many colleagues about where they go at the point of diagnosis to determine which medications to prescribe, which medications their patients can afford, and also which medications will decrease the back and forth for their office staff in dealing with prior auth or other issues. They consistently say that GoodRx addresses these recurring pain points, and as a physician who also uses GoodRx I would have to agree.
Click here to watch the full “HCP Perspectives” video with Parikh and Sood.
