Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health.
This week on the podcast I had the pleasure of sitting down with Dr. Vinay Patel, a brilliant PharmD who’s making waves with his company MakoRx. Dr. Patel and I deep dive into the absurd pricing disparities that are all too common in the pharmaceutical world. We share some jaw dropping stories and discuss why it’s more important than ever to support our local mom and pop pharmacies over the big chains.
Dr. Patel's mission with MakoRx is to make medications more affordable for the everyday person through a cost-plus pharmacy benefit solution. It’s a model that could bring much needed transparency and fairness to the industry. If you’re tired of outrageous drug prices and impersonal care, you won’t want to miss this episode!
PODCAST NOTES
Recently, I had a patient who had driven 100 miles to see me for narcolepsy. I prescribed him Modafinil, a medication I’ve had success with in treating such cases. When he got back home to Knoxville and went to his local CVS, he found out that the medicine would cost him $750/month. I was astounded and had my nurses call around. We found out through GoodRx, that at Food City he could get the exact same medication for just $35/ month. This kind of pricing disparity is exactly why this issue with pharmaceutical costs bothers me so much.
Vinay Patel is a doctor of pharmacy who’s been in the field for nearly two decades. He’s spent his career working in various pharmacy settings and has now co-founded MakoRx, a company designed to tackle the high cost of medications. MakoRx operates on a cost-plus pharmacy benefit model, particularly targeted at employer groups, aiming to ensure that hardworking Americans can afford their medications without being crippled by the costs - a remarkable and much-needed initiative.
What I love about MakoRx’s approach is its transparency. Their cost-plus model means you know exactly what you’re paying for - it’s the cost of the medication plus a fixed fee. This agreement ensures that local pharmacies, which are often strangled by the current system, get paid fairly for their services without hidden costs. This straightforward approach not only helps patients get their medications at a reasonable price but also supports these small businesses economically.
One significantly problematic area we discussed is the role of Pharmacy Benefit Managers (PBMs). PBMs were initially intended to help negotiate better prices for medications, but what’s happened instead is that they’re soaking up a substantial share of the profits. They’re harming both pharmacies and pharmaceutical companies. There are legislative efforts underway, spearheaded by individuals like Congresswoman Diana Harshbarger, a fellow pharmacist, to address these manipulated profit pathways and seek to potentially shut them down (or at least reconfigure their practices to ensure fair play).
GoodRx for example. While it does provide patients with heavily discounted drug prices compared to standard offerings, it has a backend dealing with big PBMs like Caremark and Express Scripts who still find ways to make money off these transactions. In some cases, the discounts offered by GoodRx can deeply hurt local pharmacies financially by reducing their profit margins significantly or even causing them to take a loss on some medications.
Supporting local independent pharmacies is crucial. Dr. Patel and I both agree that they provide far more personalized and knowledgeable care compared to big chain pharmacies. These small pharmacies offer an invaluable service where they know your medical history and can offer tailored advice. Unlike the corporate chains, local pharmacies can create strong patient relationships and deliver customer-focused care, vital for any meaningful healthcare system.
The overarching issue we’re tackling here are monopolies and how they’ve grown to dominate the healthcare and pharmaceutical landscapes. Just three major PBMs control about 80% of all drug prescriptions in the U.S., restricting competition and innovation. This consolidation hurts patients, pharmacies, and the healthcare system as a whole. We need a more equitable system where smaller entities can compete fairly and patients’ lives and affordability are put first.
Dr. Patel and his team at MakoRx are showing that there is a different way forward. Although they currently don’t work with Medicare plans due to the heavy regulations and financial prerequisites, they aim to eventually bring their cost-plus model into the government space. By focusing on the employer market and prioritizing local pharmacies, they’re setting a precedent for transparent pricing and better care. This kind of innovative, patient-focused approach could truly revolutionize how we think about and manage the cost of healthcare in this country.
During our discussion we touched on how the current system forces both doctors and pharmacists into roles that prevent us from providing the best possible care. As a doctor, I’m aware that rushed, impersonal consultations driven by insurance demands are detrimental. Pharmacists in chain stores face similar pressure, dealing with high prescription volumes that compromise the quality of the patient interactions. Dr. Patel's company, MakoRx, aims to reverse this trend by fostering environments where pharmacists can spend adequate time on patient care and ensuring that medications are not just accessible but also accompanied by expert advice and individualized attention.
Dr. Patel also emphasized the importance of viewing healthcare as a collaborative effort involving pharmacists, doctors, and patients. He pointed out that many patients don’t realize how invaluable their pharmacists can be as part of their healthcare team. Building relationships between doctors and local pharmacists is essential for holistic patient care. This alignment enables better communication, trust, and overall better health outcomes. Encouraging patients to see their pharmacists as advocates rather than mere storefront dispensers could be transformative in managing and optimizing their treatment plans efficiently.
MakoRx is doing something truly innovative by promoting transparency and affordability through their cost plus model. They focus on supporting local pharmacies, creating a more personal and trustworthy approach to getting your medications. I love that! We all should become advocates for better healthcare.
Thank you Dr. Patel for educating us.
Stay educated. Stay healthy.
Till next week.
