GoodRx’s Data-driven Insights into Rx Abandonment
Our healthcare system has a persistent challenge: patients abandoning prescriptions at the pharmacy counter. While several factors contribute to this, none are as influential—or possibly as solvable—as patient out-of-pocket (OOP) costs. New data from pharma-sponsored cash buydown programs with GoodRx show a wide range of OOPs at prices well above a historical “walk-away” price of $50 (range is $65 - $231) significantly reduced reversal rates across specialties including asthma, birth control, diabetes, and high cholesterol (Figure 1).
The $50 threshold: A historical patient tipping point
A study published in the Annals of Internal Medicine analyzed 2008 prescription data and found that prescriptions with copays above $50 were 4.68 times more likely to be abandoned than those with no copay at all. This insight has remained remarkably durable over time, with new data reinforcing cost as the primary barrier to medication adherence.
That was fifteen years ago, and price elasticity has since changed. So, what is the walk-away price today?
Updating beliefs about what patients are willing to pay out of pocket
In 2025 the $50 figure is no longer true. One reason is high-deductible health plans (HDHPs) have redefined patient cost exposure. From 2006 to 2016, the average payments by enrollees towards deductibles rose 176% from $151 to $417, and total OOP spending rose 54%. A growing portion of consumers now assume a larger portion of their healthcare costs, including prescription medications.
According to a 2024 IQVIA report, “patients starting new therapy abandoned 98 million prescriptions at pharmacies with increasing frequency as costs rise” even as the use of copay programs, ecoupons, and cash-pay increased. For patients without insurance, paying out of pocket can still be viable—if the price is reasonable.
However, in many cases it’s not.
Changing context: WAC, specialty, formularies, and prices
Today’s drug pricing environment is vastly different than it was even five years ago, let alone fifteen. The wholesale acquisition cost (WAC) of many prescription medications is out of sync with patient affordability, especially as more specialty drugs enter the retail space. Formulary designs continuously evolve and formulary exclusions and other restrictions increase each year, increasing patients’ cost burden. GoodRx research shows an average 39% list price increase for all prescription medications since 2014, placing further strain on patients and increasing the likelihood of abandonment.
Despite increased investment from pharmaceutical manufacturers into copay assistance and patient support programs (PSPs), their impact has been limited. A 2021 study showed that although pharma spent billions on patient support, roughly 3% of patients used the manufacturer-provided PSPs available to them. GoodRx research in 2024 showed that only 7% of the U.S. population used a manufacturer’s savings card or PSP. Compounding the problem, healthcare professionals (HCPs) approve switches from branded drugs to similar generics for 9 out of 10 call backs—even when the generic is not AB rated—according to Blue Fin Group's proprietary research.
GoodRx insights illustrate nuances of OOP costs and abandonment
Amid this change and complexity, GoodRx has emerged as a leading provider of Rx abandonment solutions through its insights into millions of claims of generic, retail, and specialty medications and over 200 brands with copay and/or cash offerings. Not only can GoodRx reduce patients’ OOP costs, our platform provides insights into cash pricing and conversion for specific brands and therapeutic categories (Figure 1).
Unlike traditional industry averages, abandonment curves on GoodRx look markedly different—and often show that patients are more willing to pay cash for their prescription when prices are transparent and competitive. This is a crucial capability for brands at the pharmacy counter to help ensure that prescriptions written are prescriptions filled. By leveraging real-world abandonment data from cash markets, manufacturers can optimize OOP cost strategies, allocate copay support more effectively, and ultimately improve adherence and outcomes.
Walkaway prices vary by category, by brand, and by patient
Prescription abandonment is a solvable problem—but only if the industry aligns with patients on affordability. Fifty dollars as the abandonment threshold is outdated, but the concept remains relevant today: There is always a price at which many patients walk away. The challenge for the industry is not only identifying that threshold and working to stay below it but also setting an optimal price that increases their net revenue.
As we’ve seen, market dynamics can create an imperative for a brand to offer a “patient pay” price. These include patients assuming more of the Rx cost burden, brand switches, formulary pressures, and pharmacies facing reimbursement challenges. To overcome these challenges, brands in different lifecycle stages work with GoodRx to deliver a custom cash price that enables them to drive incremental prescriptions without negatively impacting their gross-to-net margin, build market share, and reduce friction in helping patients get and stay on therapy.
To learn about GoodRx’s prescription abandonment solutions, download Reduce RX Abandonment at the Pharmacy
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