Affordable medication access remains a significant challenge in dermatology. In 2021, 17% of older US adults could not afford their prescriptions.¹ Programs like GoodRx and Cost Plus Drugs aim to enhance patient medication access. These digital platforms build on established models, such as the usual and customary pricing models, the Walmart $4 formulary, and discount cards. It is critical to scrutinize these discount platforms鈥� operations and impact.² We aimed to inform readers about prescription cost-saving platforms and raise questions about their consequences for clinical practice and quality of care.

GoodRx is a digital health platform providing prescription discounts and subscription services like telehealth.³ The company partners with pharmacy benefit managers (PBMs) for negotiated prices.⁴ GoodRx鈥檚 model extends these discounts to all patients and benefits those facing high out-of-pocket expenses or without insurance. These programs, in effect, are workarounds allowing dermatology patients to access treatments, like topical retinoids, at lower rates without insurance. Pharmacies must honor these deals to remain within their insurance networks, which may lead to reduced profit margins. After accounting for the fees paid to PBMs and GoodRx, pharmacies retain roughly 80% of their lowest reimbursement.⁵ In this arrangement, pharmacies may be reimbursed below their acquisition cost for the medication, effectively operating at a loss.⁶ GoodRx, in turn, takes a share of the savings as revenue, functioning as an intermediary in a complex system. Ultimately, the question remains whether these discounts create sustainable models. While they may provide temporary relief, their long-term sustainability and consequences for the broader health care system and patient access to medications require careful consideration. It is important to analyze how these platforms integrate with existing health care structures and whether they can contribute to a stable and equitable system without compromising financial viability or patient care quality.