The Heart of Healthcare | A Digital Health Podcast

The Chaos Of Drug Pricing in the US | GoodRx CEO Wendy Barnes

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Apr 20, 2026

Wendy Barnes, President and CEO of GoodRx with 30+ years in pharmacy and benefits leadership, breaks down the chaos of U.S. drug pricing. She unpacks why prices vary wildly across pharmacies. She explores PBM reform, offshoring rebates, and why pharmacies lag in online adoption. She highlights direct-to-patient pharma moves and the push for real-time price transparency.

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INSIGHT

GoodRx Shifted From PBMs To Direct Pharmacy And Pharma Deals

GoodRx evolved from a PBM-powered discount marketplace to direct contracts with nine of the top 10 pharmacies and direct pharma partnerships.
Direct contracts let GoodRx offer more aggressive pricing and buy-downs on brand drugs integrated at point of sale.

INSIGHT

Drug Pricing Is A Cascade Of Manufacturers Payers And Pharmacy Contracts

Drug prices vary because manufacturers set list prices, payers negotiate rebates, and payers then contract diverse reimbursement rates with pharmacies.
That creates hundreds of contract tables and regional differences so the same drug can have many consumer prices.

ADVICE

Show Cash Prices Side By Side With Funded Coverage

Integrate cash prices alongside funded coverage so patients can choose the lower option without hunting.
GoodRx built integrated savings rails with top PBMs, but payers don't always surface the cheaper cash option.

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Nearly one billion prescriptions are abandoned at the pharmacy counter every year, often because patients are blindsided by the cost.

This week, co-host Halle Tecco is joined by Wendy Barnes, President and CEO of GoodRx, to discuss the chaos of prescription drug pricing, the murky world of Pharmacy Benefit Managers (PBMs), and how digital tools are changing patient affordability. They break down the layered system of manufacturers, payers, and pharmacies that creates inconsistent pricing, and explore the current push for greater transparency.

We cover:

The cascade of drug pricing: from initial manufacturer costs and rebates to payer and pharmacy contracts, which results in vast price variability for consumers
What it would take to get to price transparency in drug pricing
The current pressures on PBMs, including efforts to ban "spread" and the practice of offshoring rebate contracting for tax advantages
Why pharmacies haven’t gone online like other areas of consumer goods
The future of medication access, including the growth of pharma’s direct-to-patient programs and the low current adoption of home delivery despite widespread retail pharmacy closures

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About our guest:

Wendy Barnes is the President and CEO of GoodRx. She has over 30 years of leadership experience across the pharmacy and medical benefit industry. Most recently, Wendy served as CEO of RxBenefits, where she led the company in providing pharmacy benefit support to more than 2,000 self-insured clients, representing over 3 million lives. Prior to that, she served as President of Express Scripts Pharmacy, overseeing operations for 100 million beneficiaries. Her leadership spans roles at Rite Aid, Premier Inc., and the U.S. Air Force, where she served as a Medical Service Corps Officer. She holds a B.S. degree in Biochemistry from the United States Air Force Academy and an M.B.A. degree from the University of Alaska Anchorage.

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