As pharma companies and President Trump tout initiatives to sell branded medications directly to cash-paying consumers, some entrepreneurs have seized on a potential business opportunity — pitching a new model for employers to help their workers pay for medications without using insurance. …
Take the blockbuster obesity treatments Wegovy and Zepbound, for example. Many employers don’t cover them, since they find them too expensive to add to their health plans. But now that the drug manufacturers Eli Lilly and Novo Nordisk have started selling the products directly to patients at about $500 a month, employers are being incentivized by startups to subsidize part of the cash price for their workers…. [end quote]
A direct-to-consumer (DTC) model by the big drug manufacturers is the ultimate in wholesale-to-retail marketing. It only makes sense for very expensive drugs. It bypasses the huge pharmacy benefit managers that add so much to the cost of drugs.
Time will tell how widespread DTC drug marketing will become and whether employers will subsidize their employees’ drug purchases because they are cheaper than going through insurance.
While not “direct”, we have a couple of scripts sent to Cost Plus (Mark Cuban). The cheapest I can get my script at a regular pharmacy is about $130, last I checked. Cost Plus (which operates through True Pill) costs me about $32, and that includes their “processing fee”.
I know a pharmacist. He explained at least some of the shenanigans in the pharmaceutical industry. The WAC is a “list price”, but nobody actually pays that (so why do they have it?). Prices can vary widely among pharmacies, with the same script costing -in my case- almost 4x what I can get it for when I shop around. And that was with insurance (Cost Plus doesn’t do insurance).
This is not an ad for Cost Plus. But I would recommend to anyone that if they are taking a regular prescription, at least check them out to see if you could save. The prices you find often have no basis in reality. Somehow Mark Cuban cut through all the BS with his company.
We get our meds at a Wegmans Pharmacy. I compared everything we take to Cost Plus and Wegmans is always cheaper.
But I think I cracked the code.
We walk into Wegmans to pick up a prescription and they say it will be ready in 10-15 minutes. We could just sit there, but instead we take our basket and do food shopping.
Problem solved for Wegmans, but not my wallet nor waistline.
All the big drug company stocks went up after ][rumpRx was announced. Very few people with health insurance will use it, so the drug companies won’t lose much revenue from it. DTC drugs is a way for the drug companies to say they are lowering prices while having very few people actually use the service.
