Fortune | FORTUNE 09月06日
优化处方药定价:DTC模式的机遇与挑战
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美国正迎来处方药定价的关键时刻,MFN行政命令和DTC定价呼吁凸显了创新的必要性。长期以来,药品价格的不透明给患者带来困扰,导致大量处方被放弃。直接面向消费者(DTC)的定价模式,通过提供简单、可预测的现金价格,有望扩大药物可及性,并减轻医护人员的行政负担。GoodRx近15年的经验表明,透明且负担得起的现金折扣价对消费者极具吸引力。然而,成功的DTC策略需要制造商、药房和PBM的深度协作,以及无缝的用户体验、跨药房的可及性,和强大的平台支持。尽管DTC模式潜力巨大,但需注意并非所有降价政策都能惠及所有患者,部分患者可能面临新的支付障碍。最终,DTC定价应作为一种补充,而非替代保险,以期为更多美国人带来负担得起的药物。

💡 **DTC定价模式为解决处方药价格不透明问题提供了新途径**:长期以来,患者在药房面临高昂且难以预测的费用,导致大量处方被放弃。DTC模式通过提供简单、透明的现金价格,让患者在无需经历保险复杂流程的情况下获得药物,从而扩大了药物的可及性,并为医护人员减轻了行政负担。GoodRx的实践表明,当患者能够以负担得起且透明的价格购买品牌药物时,他们倾向于选择现金折扣价。

🚀 **构建成功的DTC策略需要多方协作和强大的平台支持**:一个真正有效的DTC定价模式,不仅需要提供较低的价格,更需要制造商、药房和PBM(药品福利管理机构)之间的深度协作。关键要素包括:提供无缝、直观的用户体验,确保患者无需花费过多时间和精力就能找到并使用优惠;实现跨药房的广泛可及性,让患者能在任何选择的药房使用现金折扣价,无论大小药房;以及与具备规模化能力的平台合作,如GoodRx,该平台拥有广泛的用户基础和成熟的基础设施,能够帮助制造商高效地将DTC策略推向市场。

⚠️ **DTC模式虽潜力巨大,但需审慎评估其风险与局限**:尽管DTC解决方案在降低昂贵药物成本方面具有强大潜力,但并非所有旨在降低药价的政策都无风险。某些政策可能降低药品标价,但并非所有患者都能从中受益。例如,采用百分比共同保险的患者可能会看到自付费用降低,而固定金额共同支付的患者可能变化不大。此外,若政策变动导致患者失去保险覆盖,即使有新的DTC价格,他们每月仍可能面临数百甚至数千美元的费用。因此,政策制定者和行业领导者必须共同努力,以现实可行的方式推进DTC愿景,使其成为保险的补充,而非颠覆。

The national conversation around prescription drug pricing is back in full force. From the recent Most Favored Nation (MFN) executive order to President Trump’s letter urging pharmaceutical companies to offer direct-to-consumer (DTC) pricing for brand medications, it’s clear we’re at a pivotal moment for American healthcare. It’s a moment that demands more than just rhetoric; it demands innovation, pragmatism, and above all, deep collaboration across the industry.

For too long, the cost of prescriptions has been shrouded in mystery. Patients show up at the pharmacy counter only to be blindsided by costs they never saw coming, confused by copays, high deductibles, and opaque coverage rules. It’s no wonder almost a billion prescriptions are left at the pharmacy counter each year.

A well-structured DTC pricing model offers a way forward. By allowing patients to pay a simple, predictable cash price without having to navigate insurance hurdles, it can expand access to critical treatments. This isn’t just beneficial for consumers. It also reduces the administrative burden on healthcare professionals who spend countless hours helping their patients overcome these insurance barriers. 

To be clear, this isn’t a radical new idea. At GoodRx, we’ve been offering cash discount prices for nearly 15 years and have an unmatched presence at more than 70,000 pharmacies nationwide. In this time, we’ve processed billions of prescriptions and seen firsthand that when patients are offered an affordable, transparent price (particularly for expensive brand medications) they often choose to pay a cash discount price over using their insurance. Doing this at scale offers real potential. 

But designing a DTC strategy that truly works for patients, and for the larger healthcare ecosystem, requires more than simply announcing a lower price. Drug pricing is complex and deeply interconnected. It requires the right infrastructure and collaboration between manufacturers, pharmacies and PBMs to create scalable solutions. 

At GoodRx, we believe the reach and scale of our trusted platform is unrivaled in the industry. With over 300 million site visits in 2024 alone, we enable pharma manufacturers to put savings directly in the hands of the patients who need them. Currently, we have more than 80 point-of-sale cash prices on our platform where the manufacturer buys down the price of a brand medication via GoodRx so it’s more affordable for the consumer. 

Based on our experience, here’s what we’ve learned are three essential elements for getting DTC pricing models right:

    A frictionless user experience: Patients don’t want to spend time hunting down savings across multiple sites or enrolling in complicated programs. They want one simple platform that shows them an accessible price upfront and is easy to use. If working in this industry for almost 30 years has taught me anything, it’s that most people don’t have the time or patience to navigate complicated healthcare processes. Creating something intuitive is critical. Seamless access across pharmacies: Patients want to be able to use cash discount prices at any pharmacy of their choosing. Providing a narrow network or mail-order-only option defeats the purpose. A viable strategy needs to integrate both large retail pharmacies along with independent pharmacies, so patients can fill wherever it’s most convenient. That’s why GoodRx has partnered with over 70,000 pharmacies nationwide, from national chains to regional grocers, and recently launched its Community Link program for independent pharmacies. Our network enables manufacturers to launch DTC programs that are truly accessible.Strategic collaboration with platforms built for scale: DTC pricing can’t succeed in a vacuum. It demands coordination across manufacturers, pharmacies and technology platforms. The right partners bring the infrastructure and consumer trust needed to operationalize complex programs quickly. GoodRx has spent years building that foundation with nearly 30 million consumers and over one million healthcare professionals using us annually, established pharmacy partners, and a platform designed to deliver affordability at scale. We’re ready to help manufacturers bring DTC strategies to market efficiently and with maximum impact.

At the same time, while a DTC strategy has the power to improve the healthcare system, it’s important to acknowledge that not every proposed policy aimed at reducing drug costs is without risk. The order might reduce list prices for certain drugs, but not all patients will benefit equally. Those with percentage-based coinsurance could see reduced out-of-pocket costs, but patients with fixed-dollar copays may see little to no change in what they pay. Patients who stand to lose coverage due to policy changes could pay prices in the hundreds or thousands per month even with the new lower DTC prices from manufacturers.  

Overall, the power of direct-to-consumer solutions for expensive drugs is real. But policymakers and industry leaders must work together to make this vision a reality in a realistic way. It’s not about dismantling the system, it’s about evolving it. Direct-to-consumer pricing, if done right, can complement insurance and unlock new pathways to access for millions of Americans. At GoodRx, we are actively advocating for policies that will expand access to affordable medications.

It’s time for a smarter, more transparent approach that meets patients where they are and puts affordability within reach for everyone.

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处方药定价 DTC GoodRx 药品可及性 医疗改革 Prescription Drug Pricing DTC GoodRx Drug Accessibility Healthcare Reform
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