Making Prescription Medications More Affordable with New Marketplaces

Mark Thierer

With the beginning of every new year Americans can count on one thing – prescription drug price increases! These price hikes are surpassing inflation, reaching as high as 10% annually over the last 10-15 years. Consumers are fed up with paying more and more for their medications every year – they are demanding change!  

Consumer dissatisfaction with sky-rocketing drug costs is driving price transparency into the spotlight. Federal regulators and lawmakers are pressure-testing every part of the Rx ecosystem to make significant changes to drug plans, ranging from changes in coverage, plan designs, member portals and much more. Drug price increases have created the “Perfect Storm” … Never before have we witnessed more significant policy initiatives both nationally and at the state level aimed at remedying the problem. Taken together, these legislative efforts and political saber-rattling are putting immense pressure on every player in the prescription drug ecosystem. 

At Waltz, we do not believe government-mandated price controls are the answer. Some recent efforts have managed to put a band-aid on price issues for popular medications, but true industry reform won’t come from policy makers or Washington DC. Only the industry participants themselves – the drug manufacturers, pharmacies, PBMs, and payers – can fix the system. Waltz Health’s mission from the start has been to rewire the system, to be that accelerant, to help drive a free-market answer system and allow technology-enabled expertise to help unlock more competition.

We believe new marketplaces that drive price competition are the only durable answer for the long term. We’ve seen the power that true marketplaces have on costs in other industries from travel, to housing, to ridesharing, and everything in between. The same potential exists in healthcare! Marketplace platforms have become ubiquitous for consumers of all sorts to save money and have more choice. They also create business growth opportunities on the supply side, spawning valuable new businesses for both existing players and new entrants.  

Too often in our U.S. healthcare system, we have seen huge resistance to the transformational power that comes with marketplace platform adoption. The established market leaders have strong economic motivations to maintain old models, working hard to “protect the house” and shield their businesses from increased competition. The good news is there are market leaders who are poised to take new approaches, recognizing this unique moment as a chance to lead.

The other good news – we’re witnessing new entrants come forward and to deliver consumers lower prices on their prescription medications – Mark Cuban Cost Plus Drug Company as a good example. But what’s missing is the alignment of interests of all constituents across the ecosystem: payers, PBMs, pharmacies, drug manufacturers, and most importantly, consumers. We all know our industry is a complex web of systems and contracts stitched together to ultimately deliver a price to a member. At Waltz, we are using marketplace technology to ingest big data and drive competition – coupled with newly configured supply chain contracts to unlock price. We see a world where both existing players and new entrants increase prescription access and affordability, working together in new marketplaces. This is a big idea whose time has come! 

With the right information, partnerships, and technology, marketplaces can deliver amazing value: 

  1. Payers improve their ability to compete and deliver better pricing and clinical service differentiation. In addition, health plans can build trust with their members that their benefit is working on their behalf to find them savings. 
  2. Pharmacies can offer an enhanced service offering for their customers while alleviating today’s operational challenges that exist at the pharmacy counter. 
  3. Consumers are the ultimate beneficiary – they receive lower prices with better choice.  They enjoy direct access to lower prices through D2C products that educate and shine a bright light on options available in the market.

There’s no doubt – the industry has reached a tipping point. From public policy to new pharmacy market entrants, there is great hope on the horizon! We’ll say it again – we believe government should play a limited role in regulating the pharmacy market. It’s the free market that holds the most potential for a better ecosystem, and “green shoots of change” surround us. Incumbents will have no choice but to respond to the pressure and marketplace demands to lower the cost of prescription drugs. 

At Waltz, we’re introducing technology-enabled toolsets that create marketplaces to focus on the consumer. We combine new-to-the-world technology and deep domain expertise, all aimed at rewiring the Rx market. Our goal: Reduce the cost of prescription medications for every American! We’re in the early innings, but our strategy is working! Our integrated savings platform – Marketplace Search Platform for Payers – is now installed in large health plans and is saving insured members serious money, while simultaneously closing the Rx data gap. We recently announced a partnership with SCAN Health Plan to bring down Medicare beneficiaries’ prescription drug costs while experiencing coverage gaps. At the pharmacy counter, our custom, white-labeled Marketplace Search Platform for Pharmacies empowers consumers with lower prices at their preferred pharmacy location. Finally, our Intelligent Specialty Engine – new-to-the-world technology aimed at unlocking huge value in the specialty space – is just a few short months from launch. We are well on our way to “rewire the supply chain!”

Want to learn more about how Waltz Health is creating marketplaces across the supply chain? We’d love to hear from you! Contact us here.

Mark Thierer

Co-Founder and CEO