FDA Enforcement on Copycat GLP-1's Could Reshape Retail Pharmacy Economics: Q&A with David Graziano

David Graziano, head of retail network, GoodRx, discusses the impact of the FDA's enforcement on non-approved GLP-1 drugs, emphasizing the importance of FDA-approved medications and GoodRx's role in providing affordable access. In a conversation with Pharmaceutical Executive, Graziano highlighted GoodRx's value proposition in filling prescription gaps and ensuring predictable reimbursement for independent pharmacies.

A transcript of his conversation with Pharmaceutical Executive can be found below.

Pharmaceutical Executive: How do you expect enforcement of FDA’s recent move against non-approved or “copycat” GLP-1’s to impact retail pharmacies and platforms like GoodRx?
David Graziano: I believe, that the ability to gain access to FDA approved medications is wildly important. The opportunity for pharmacies to be able to deliver it to patients and dispense it to patients is important as well, and we want to be able to provide value and access to those FDA approved medications. So, the push and the opportunity that we've been involved in is to bring those medications at a price that patients can afford.

PE: If compounded GLP-1’s becomes more restricted, what changes do you anticipate in prescription demand, pricing pressure, and retail pharmacy operations?
Graziano: The ability for us to bring affordable GLP-1’s, or more affordable GLP-1’s to market on behalf of our pharma manufacturers that we partner with directly is really the value proposition that's available for patients.

We're bringing a price point that is competitive in the marketplace, allows patients to pick up at retail, so whatever was being done to fill gaps in the past, we believe now we're actually playing a role in filling whatever gap may happen in the future by being in partnership across the value chain, whether it's pharma providing an affordability solution and ultimately having retail access, ubiquitous, almost ubiquitous retail access across the board.

PE: How does GoodRx address struggles with below-cost reimbursement on high-demand brand drugs, and why is predictable reimbursement becoming essential for pharmacy sustainability?
Graziano: We see independence as a cornerstone of the marketplace and the healthcare journey for patients and in communities, and being able to navigate that having predictable economics associated with the dispensing of medications is important for those independent pharmacies to stay in business.

When I think about the direct contracting relationship that we have through community link, it actually provides value for that independent pharmacist to know that when they dispense a brand medication through GoodRx on behalf of a pharma manufacturer, they actually know what they're going to be paid.

So those predictable economics ensure that they can make payroll in a given week or month. They can ensure that they're staffing appropriately, and they can also procure the medication, actually get it in hand, and not have to tell the patient that they don't have access to it and send them off to another pharmacy, potentially losing that entire pharmacy basket.

PE: What strategies should independent pharmacies adopt to remain competitive and retain patients who might otherwise migrate to online platforms?
Graziano: Retail pharmacy is still the fastest way to pick up your medication. So, ensuring that you have the product in stock and on hand, or the prescription in stock and on hand is clearly important.

But again, for an independent or broader chain pharmacy, sometimes getting access to it has been a challenge. So, when we know that we can deliver the value, by that, I mean patients coming in the door to pick up the prescription, ultimately, that should lead to the patient picking up their prescription when they leave their doctor.

In other words, you gain prescription in hand for the patient. Later on that same day, being able to pick up that prescription versus having to go through the platform waiting for it to come in the mail, not sure about cold chain storage and how it's going to get to them. Let's keep it as simple and effective as possible.

PE: How is the shift in insurance design changing the role of retail pharmacies, and what does it mean for how patients discover and afford therapies like GLP-1s moving forward?
Graziano: It is increasingly complex, both the reimbursement model and what's on and off formulary, as patients don’t understand it and they show up to the counter, and it's a something went bump in the night moment and it turns out it's not covered.

What do I do? Having a solution like GoodRx and having access helps ensure it brings awareness to the patient that there is a solution that can solve that bump in the night moment. This is a great way, and it's not just GLP-1’s.You can think about a whole host of brand medications. We have over 100 brand medications that have buy down offerings that is supported by pharma and ultimately leads to positive reimbursement for the for the retail pharmacy.

So, I think about that sort of broader scope of the landscape, as it allows a pharmacy to bring a solution for those instances where insurance fails and we play a role in filling that gap and filling that hole.