The news: Epic is launching a tool that lets patients compare cash drug prices across pharmacies before doctors send prescriptions. The product, called Prescription Marketplace, will compare what a pharmacy charges someone paying out of pocket against what they’d pay through their insurance plan. According to Epic, any pharmacy will be able to share its cash prices with health systems using Epic’s EHR next year.

Why it matters: Many doctors' offices already use digital tools like Epic’s to estimate prescription costs based on insurance and preferred pharmacy. But the growing cash-pay prescription drug market gives consumers more opportunities to compare prices with and without insurance. Depending on the drug, pharmacy, and insurance plan, paying cash can sometimes be cheaper due to opaque pricing negotiations by pharma middlemen and complex insurance rules.

Broadly, pharmacies, prescription drug marketplaces, and drugmakers are expanding lower-cost cash-pay options to reach patients facing insurance coverage restrictions or high deductibles. GLP-1 weight loss drugs are a prime example. As more health plans restrict obesity drug coverage, Eli Lilly and Novo have significantly lowered cash-pay prices through their direct-to-consumer platforms and pharmacy partnerships.

Epic’s Prescription Marketplace reflects this shift. Pharmacy players in the cash-pay market, including Lilly, Costco, Amazon Pharmacy, and Mark Cuban Cost Plus Drugs, either helped develop Epic’s new tool or have expressed early support for it.

Greater prescription price transparency could help reduce medication abandonment due to cost:

• Just 24% of US adults ages 25+ always know what a prescription will cost before reaching the pharmacy, per a recent Model N survey.
• Meanwhile, 23% said upfront price uncertainty caused them to delay pickup, and 17% said it led them to leave the pharmacy without filling their prescription.

Point-of-care price transparency could reveal lower-cost options that existing tools miss, making patients more likely to fill prescriptions. Epic also noted that the solution will notify providers when the patient fills their prescription and if a script goes unfilled for too long, which should help address abandonment before it disrupts treatment.

Implications for drugmakers and pharmacies: Comparing prescription prices across cash-pay and insurance options will likely always remain somewhat cumbersome, but new tools are improving the process.

Discount services like GoodRx and SingleCare have long offered alternatives to insurance pricing, though they aren’t always integrated into doctors’ workflows or EHRs. For companies with a strong cash-pay presence, like Lilly, Novo, and Cost Plus Drugs, integrating up-to-date pricing into EHRs will help reach patients, especially as physicians field more questions about drug costs and cash-pay options.

But whether tools like Epic’s become a go-to resource for comparing prescription prices will depend on how comprehensively they capture available, real-time pricing across drugmakers, pharmacies, and discount programs.