Discount cards...worth what you paid for it

I have a couple patients a week come in and ask if we take pharmacy discount cards. The answer is almost always no. I like to ask the patient how much they paid for the card. As they are given away for free, patients always say something like “it just showed up in the mail” or “it was on the desk at the doctor’s office.” I like to reply that those cards are worth what you paid for it.

These cards are not the same as insurance…because you actually pay for insurance. Every discount card out there says something on it (in small print of course) that the card is not insurance. How these things work is as follows (this is from a great article in the Pittsburgh Post-Gazette ):

The card issuer then takes a cut of that sale in the form of a service fee. Often, companies issuing the cards have nothing to do with medicine or health care, despite names like "Healthcare Alliance" (which is essentially a consumer marketing company).

Why do the pharmacies agree to sell a $100 prescription for $50 when a customer hands over a savings card issued by a marketing firm?

"One, they're still making money," said Rich Sagall, founder of NeedyMeds, one of the many card issuers. His organization is a nonprofit, meaning, he said, that its service charge fees are cheaper than most.

Another reason, he said, is "peer pressure" -- if all of the other pharmacies are part of a particular "discount" network, it's bad business to be the only one that doesn't accept the card.

In exchange for the discounts, card users should know that many of the issuers are getting to know you and your medical history fairly intimately.

"Marketers can get all sorts of information from the prescriptions, [information] that can be resold," he said. Even if your name appears nowhere on the card, the minute you use the card to buy a prescription, the pharmacy -- and the card issuer -- has your name.

There are a couple key problems with this system:

  1. If you are a cash-paying customer (one without insurance) and your pharmacy can afford to take a $50 cut on the prescription cost then you are getting screwed over. But if you think about it, all those $4 prescriptions create a loss for those companies…they have to make money somewhere right? So they do it by sticking it to patients who take drugs not on their discount lists.

  2. Giving this information away to marketing companies is likely legal but of questionable ethics. The Health Insurance Portability and Accounting Act (HIPAA) protects people’s health information. Your health information is being sold and used by other companies when you use those discount cards. I am sure that in the fine print of the card it says that you agree to this use but is it really an informed consent? Do you want marketers knowing that you had a yeast infection last week or that you have sexual dysfunction? How would you like it if they know you are diabetic and have problems with your eyesight?

This is why our pharmacy has taken a stand and will not accept “discount cards” to be used at our pharmacy. We have an in house discount program that keeps your health information private and beats the cash price of the big box stores on over 75% of drugs. Heck, in our experience, our discount program even beats the discounts offered by those cards 9 out of 10 times. Call us to check a price of a prescription that you take. If it is on a $4 list, we probably won’t beat it. But if your drug isn’t on a discount program at the big box stores then I am very confident that we can beat that price.

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