If GoodRX Can Deliver Affordable Drug Prices, Why Can't The Federal Government— Does It Want To?

Ten years ago, a side effect of my chemo treatment was neuropathy. One of the drugs prescribed was Vimpat which would have cost me tens of thousands of dollars annually. Medicare refused to cover it for cancer patients, only for neuropathy patents with diabetes. It made no sense but after a few years I gave up arguing with them. I started traveling abroad and smuggling 6-month supplies from Thailand and other countries where it cost a tenth of what it did in the U.S.— still not cheap but a lot cheaper. And then I discovered Good RX, where the cost is negligible, pocket change. I don’t really understand how that works beyond the fact that GoodRx works for me because it leverages competitive pricing and PBM discounts to offer Vimpat at a fraction of its U.S. retail cost, bypassing Medicare’s coverage denial. While it’s a lifesaver, it’s also a symptom of a broken system where patients must navigate complex workarounds to afford essential medications.

I haven’t seen Congress trying to address this broken system and I can’t really imagine I’ll ever see that. Two senators, Josh Hawley (R-MO) and Peter Welch (D-VT) are introducing a bipartisan plan to lower drug costs that I don’t expect much from. Yesterday, Ben Leonard and Jordain Carney reported that their bill aims to lower drug prices “by barring drug companies in the U.S. from charging higher prices than the international average.”

GoodRX is a lot better than any international averages. Hawley said that they are trying “to end a drug market that favors Big Pharma, make prescriptions affordable again, and empower Americans to get the care they need.”

“Where congressional Republicans ultimately end up on drug pricing,” wrote Leonard and Carney, “as part of their yet-to-be-finalized policy package remains to be seen. While the White House is pushing what it is calling a ‘most favored nation’ plan, Speaker Mike Johnson poured cold water on the idea during an interview last week.”

Hawley, meanwhile, is a key vote to watch on the Republicans’ sweeping party-line bill— and as part of the Senate’s debate on that measure, lawmakers will be able to offer unlimited amendments on nearly any proposal. He said that “if Republicans want to save money on health care costs in reconciliation, this is where to start.”

In addition to prohibiting pharmaceutical companies from selling drugs within the United States at a higher price than the international average, it also would impose a penalty if companies violate the prohibition.

“Big Pharma’s price gouging has made that a reality for many Americans, forcing them to pay four or five times more for the same lifesaving medications as folks in other countries — it’s unacceptable,” said Welch, a Vermont Democrat.

The legislation would go after the list price of drugs, but most Americans don’t pay the list price when getting prescriptions filled. That’s because health insurers and pharmacy benefit managers are able to negotiate lower costs.

The pharmaceutical industry is expected to fiercely oppose such a move, having previously argued that so-called international reference pricing and other similar “government price controls” would lead to significant barriers to accessing treatments for patients, including longer wait times for medications.

The Congressional Budget Office found last year that an international reference pricing policy based on prices in several other high income countries, including Canada, France and the United Kingdom, would reduce average drug prices in 2031 by more than 5 percent.