CEO Wants Cheap Drugs! Pricing Transparency API Gives Patients Back Their Power - Miriam Paramore

Where can I get cheap drugs? That's the question that Miriam Paramore was asking everyone at the Vive event as founder and CEO of RX Utility, Miriam's passionate about one thing: helping patients get cheap drugs. We shouldn't have to pay this much or jump through so many hoops to get quality care that we can afford. And that's what RX Utility is all about solving. Miriam is obsessed with fixing how much consumers are paying out of pocket and wants to give choice and agency back to people like you and me. This was an outstanding conversation and a really cool dive into the value of data and transparent, open source data sets. It is a fantastic episode that shows how unlocking data can democratize care and give people choice back in their healthcare equations. I really enjoyed this conversation with Miriam Paramore of RX Utility. Listen in on the tech Glow Up from the Vive event. if there were one thing that we should absolutely touch on in this conversation, what is that most important topic?

We help people save money on medicine.

Alright, that's gonna be an easy one to get into.

That's our, that's our mission. And we, you know, otherwise, you know mm-hmm.

cheap drugs,

and where do I get'em?

Oh my gosh. it's a question I've been asking for years.

Yes. Like, spend a lot of time. Yes, exactly.

Awesome. So, Miriam, the first thing that we do is we clap in to sync the sound and the video. Okay. So we're gonna make alligator hands toward the camera. Nice. And then on three, we're gonna clap'em. Ready Uhhuh 1, 2, 3.

Oh, that's so fun.

Hello and welcome to the Tech Glow Up from Vive. Today I'm here with Miriam Paramore, CEO, and founder of RX Utility. Yes, Miriam, it is so great to meet you. we've already been having some spicy opinions passing back and forth. I can't wait to get into it. The same on The Tech Glow Up.

It's delightful to meet you. I just love. Your vibe.

Amazing. Great. Well, VIVE is a vibe and

vibe. It is. That's

true. So

yeah, it's a vibe.

It is. So, can you start us off and by introducing yourself and the work that you do at RX Utility?

I have been in healthcare for a really long time. Mm-hmm. And I started out as a programmer, so I'm definitely a nerd. Mm-hmm. And so I've built a lot of systems and a lot of companies that are in health tech or health it, or what we call digital health now. So, and in this incarnation and this phase of my life, I really wanted to use those skills and experience to do something that directly tangibly helps humans

mm-hmm.

And we do live in a, a society where, we have healthcare that is, capitalism driven. Mm-hmm. And so we talk about, being patient centered, but we, we don't operate that way as an industry. Yeah. We just flat out do not. So, I started RX Utility to focus on affordability of medications for consumers, specifically what we pay out of our pocket when we go to the pharmacy. Yeah. And so there's a lot of opacity. We know a, but basically we don't ever tell consumers how much the medicines cost for what we just prescribed for them. Mm-hmm. From the doctor or hospital they just went to. And there are literally millions of price points out there.

Yeah.

So we wanted to create a tool that makes it easy for consumers to see the price options

Yep.

And choose the best price for them for that drug.

there's a lot of approaches to helping consumers find, these kinds of deals. how do you approach the problem space and how do you put customers first, as you do that?

When you look at the various folks that are on the floor here, you think about the healthcare industry.

Yeah.

There are those who serve health systems. There are our health plans. We've heard a lot about PBMs. We've had PBM recent reform, which is a good thing. Yeah. But there, there's some good things out of that. but what you don't see is what is focused strictly on the consumer's out of pocket affordability experience. So we've got a couple of things that have happened over the years. We have the rise of high deductible health plans, which means we're gonna have more out of pocket spend. Mm-hmm. At the same time, drugs have been getting more and more expensive at the same time. They take up more, share of the total spend. Yeah. And then we've had this explosion last year of direct to consumer prices from pharma, which goes around the retail experience in PBM reform. So what I wanted to do was build a company that said you as a consumer don't have to care about inside baseball. Okay. You don't have to care. You don't have to know.

Yeah.

Just

give, we are cheap drugs. Just gimme some cheap, we are going to make pricing consumer drug pricing available to everyone.

Yeah.

So what, the way we did it.

Mm-hmm.

The first step was we said there's these things called pharma copay coupons. Yep. That's for when you use your insurance. For a branded drug.

Mm-hmm.

sometimes there's a coupon. Oftentimes there is. So, those exist for 1200 brands. And most of them do not have a generic equivalent. So it's not like you're overpaying.

Yeah.

So pharma makes a coupon available just like Pampers coupon or any Tide coupon, any kind of coupon that brings down my out-of-pocket cost as a consumer.

Yeah.

But there's about$30 billion, which is a yay of consumer savings available to consumers every year, but only about 10% of that is used. And the answer to why is that? Nobody knows they exist and they can't find'em even if they did.

Yeah.

So we decided to really turn up the microphone and make them easily accessible all at the same time. We built the first ever 100% of all copay coupons database. Put it in an API. And we want everyone here to subscribe to it to make those coupons visible in their workflow. Okay.

Talk about interoperable data. Exactly.

Just put it

out there.

So through the last year, we've only been in the market for a little over a year. We. Kept getting these questions about cash.

Mm-hmm.

At the same time that direct to consumer was starting. And you've got Mark Cuban doing the work of Saints out there. Mm-hmm. And you've got, a lot of cash discount cards like SingleCare or Buzz Rx. So you really have millions, about 20,000 drugs in rotation right now. Millions of price points. If you're paying cash. Mm-hmm. But how do I know what is the cheapest cash price?

Yep.

And how do I know whether to pay cash or use my insurance?

Yeah.

From an affordability perspective. Mm-hmm. Right. So we did the same thing. We have aggregated all of the cash price points for every drug, for every pharmacy in the nation. And so we put that in an a p.

real time

if you care. And it is real time.'cause they're very dynamic. They change. Yeah. Even throughout the day, they can change the, the cash side. Mm-hmm. So we said, if you're here and you really care about, let's pick one consumerism. Mm-hmm. Affordability, price transparency or medication adherence. Just pick one of'em.

Yeah.

Let the people see the prices and let them choose. So we are, we're just very excited. We don't think that anyone. Has cared about this aspect of healthcare, even though we say we care about the consumer. Mm-hmm.

Mm-hmm.

But what you go to the pharmacy and get, that's actually your life.'cause you're going there every month.

You touched on this thing that I have some strong concerns about. I'm curious if you'll take a sidebar with me.

Sure.

Which is, as health plans become so expensive mm-hmm. you know, it might cost thousands of dollars to cover my family and then I have to pay$8,000 per person before coverage kicks in. That's right. The, I was hearing, you know, like on other podcasts about the idea that like. The consumerization of healthcare right, is like shifting just all of the decision burden, the efficacy burden, the cost burden onto consumers to decide theirselves because playing within the existing system is just so expensive. They, they either can't or they're opting out, right, to go manage it on their own. Do you have. Is the consumerization of healthcare solving for the problems with our insurance as it is now, or is it just a different set of challenges or,

yeah.

do you have a thought on

I actually listened to a podcast recently, and I think they called it the, the D insurance thing or something of the, of the. So in my case, I have, sort of a reasonable premium. but I have a$10,000 deductible.

Yeah,

it takes a lot of things to happen before my insurance ever kicks in. And if I had a, you know, if I was an average family, I'm paying$25,000 for premium average family for plus another 10, 20, 40 before you ever use. So at the same time that has happened, we've had the rise of. Retail health. Mm-hmm. Or telehealth in the hymns and hers, yeah. Of the world. I personally went to one of those called Joy. It's Joy and Blokes, JOI. Mm-hmm. Started by an entrepreneur, Katie Wheeling out of Nashville. But I had a lot of things that I need help with. I have insomnia, I have hot flashes, I have intestinal problems, I have joint pain, I got problems. If I went to a primary care doctor, I would literally have had to go to five other doctors to get treated for those five things, but by going paying cash

mm-hmm.

And going to this telehealth consumer first

Yeah.

Supplier of healthcare called Joy. Mm-hmm. I spent 45 minutes on the phone with a nurse practitioner, hung up the phone and had medications and a treatment plan for every single one of my symptoms and diseases that I'm trying to manage. So that's an example of I've just had. Have gone outside the old insurance model.

Okay.

And that's why in our business, if people are gonna pay cash, well what the hell is the cash price? Yeah. How much is it?

Yeah.

Well it's, could be any number of prices,

but if it saves you five appointments, you know, versus 45 minutes

Exactly.

That value in busy executive time, like starts growing fast.

Yet at the same time we have. Within today's existing system. Yeah. Still all of these shell games and opacity that are not getting people what they actually need. Yeah. In a way that they can do it in their normal life. Mm-hmm. You know, so it, I, I'm not a fan of the incumbency. I've only been in the industry for 42 years, and so of those 42 years, I think 25 years has been about value-based care. Yeah. I mean. no. So fee for service still rules. So we just have, we, we live, I love capitalism. I'm an entrepreneur. I'm all about it, you know? however, when you set up businesses to make money, really it is profits over people. Mm-hmm. I just, I just really do think it is. and that's, that's why we're stuck with raising cost and

low outcomes. There's a bit of that conflict of interest, right? Like I think that's right. It's hard to do The values thing because that doesn't drive the, the capitalistic KPIs.

Yes, right.

Goodness, Miriam, we're, we are having such a good time on like introductions.

to you more.

I just to get into all of this. So, the, the name of the show is the Tech Glow Up. Oh yes. And I use the idea of a Glow Up as a way to talk about goals or a notable transformation Yes. That we're working on. So first of, at the healthcare level. How does healthcare need to Glow Up in 2026?

Definitely needs to Glow Up around price transparency. Yes. So we actually have this thing called transparency in coverage, and if you remember mm-hmm. That's what drives the hospitals needing to post their prices. Mm-hmm. And the health plans needing to post their prices. That's a very good thing. what we're lagging behind on and why this is the year of price transparency. Yeah. Is the thing that, the payers have not yet done that they were required to do in 2022 and it's 2026 now is publish

mm-hmm.

Their negotiated drug prices so that people could see if I have blue, blue cross shield of Tennessee, this is how much my planner will pay for Eliquis. Well, they just haven't done it and they keep continuing to kick the can. You know, there was the kicking the can on the. Hospital prices. Yep. Right, so there are a lot of folks focused on price transparency. Payer sit is one here. Yeah. The example Turquoise. You may have heard of what, what I think of RX utility is we're like applied. Price transparency we're like, it's great that there's a bunch of prices, but if nobody can see, like, can you really see them and use them? Mm-hmm. We just have one master that we serve, which is the consumer, let the people see. So I do think price transparency, especially now that, yeah. PBM reform has passed, is the Glow Up of the year, in my view. And It, it just, it's encouraging to see that in PBM reform, it's required now that patients pay on net prices.

Mm-hmm.

Because in the past, if you can believe it, back to Eliquis, a bottle of Eliquis$600.

Yeah.

List price or Right list price. But if, and I would pay that at the counter because I have a$10,000 deductible, remember, but if my employer paid for it

mm-hmm.

he or she would pay.$600 minus the$300 rebate.

Automatically applied to somebody.

So pay on the net price.

Yeah.

But the consumer has to pay on a list price. It's completely unfair. Cost shifting. Yeah. To your point about how cost is getting shifted, that's why I said earlier when we were talking about healthcare as a whole, that we say we're patients first, yet we make patients pay more than the big businesses pay. Mm-hmm.

Yeah.

Transparency.

Show me the money.

Yeah, exactly. Show me the prices.

I feel like we've got a Cuba Gooding Junior Super Bowl commercial in your near

future.

Yeah,

we got it. Yeah. A vibe

there.

For

sure. So Miriam, let's take it inward. Yes. A little bit. What's the Glow Up specifically? For RXutility that you're working on in the next six months.

So we are leaning hard into just telling our story. Because people haven't really focused on the consumer out of pocket story. So we want to raise that awareness. And our biggest Glow Up, our biggest joy would be distribution.

Mm-hmm.

So we use the word utility very intentionally, that we don't have to be a recognizable brand. But we want this democratization. Of price data to start flowing. So whether you're in the pharmacy, doctor's office, payer a navigation piece of software, digital health, just subscribe to the data. Let the prices flow through your tool. It can show up on your screen, whatever that screen is. so that we're not creating another workflow or something somebody has to log into. So the focus is distribution partnership and letting people innovate around how they show the prices. To make it easy for consumers to buy. If people can't buy the drugs they need.

Yeah.

They will not get healthy. They will not stay healthy,

feel like.

And outcomes will be worse.

I feel like there's so many hospital caseworkers who are just like waiting for this kind of data to be in their tools. Exactly. We get like a list of five things. Like maybe these pharmacies would have the drug and like, yes, maybe these pharmacies have a coupon you could do. And it's always like, well maybe here's a resource. Right. And I, I like that you're like, we have the data. Just put it in your tools, please. exactly.

And that's what we want to minimize the seRXing and wandering in the desert. Yeah. You know, to try to figure something out.

Miriam, you've had a lot of spicy hot takes. So, in just the last couple minutes that we have, I've found that asking founders about the people who have helped them and encourage them along the way is one of my favorite questions to hear about. because sometimes as a leader, as a founder, as a CEO, just one person saying like, yeah, I think you can do it. Go for it. Can mean the world. Can you quickly share how a mentor or a coach has supported the work that you are and helped you get to where you are today?

Yes, thank you.

this era,

I'm going to. credit George Lazenby, who was the CEO of a company called M Dion. Mm-hmm. Which then changed to change healthcare. Mm-hmm. And when he became the CEO of that very large business, I was his first outside, executive team hire. Yeah. But, George always encouraged me and supported me. And when I was thinking about starting RX Utility mm-hmm. I, he was one of my first calls and I said, am I, am I crazy? Is this ridiculous?

Mm-hmm.

And he said, no. I mean, that's really an interesting idea and was very, very supportive.

Yeah.

But I am so grateful that he saw in me. the talent to be part of that executive team and help run and build a very large company and take it public.

Yeah.

and if I need guidance or counsel, I call him up and he, he's always there. So thank you, George.

That's amazing. Miriam, it has been such a treat to meet you. Me too. And this mission that you have to help consumers. Get access to the medications that they need.

Save money on

medicine. save money on medicine. Yeah. I love the vision that you have for both the healthcare industry and for your work. Can't wait to follow up on your Glow Up in a few months.

Thank you. I would love to do a special edition.

Amazing.

dial anything up? I don't know.

Yeah. Well, let's get some data and report back.

That's, that's a,

There's just one last thing to do. Yeah. We're gonna clap it out.

Oh, okay.

All

right. You ready? 1, 2, 3.

Love it.

Amazing. Thank you so

much. Oh, You're so fun. Thank you.

can I ask you a favor? If you really enjoyed this episode, could you share it on your Instagram stories or maybe post the link with what you enjoyed on LinkedIn? The sort of sharing and engaging really helps small podcasters like me reach the audience that I know really cares about these kinds of conversations. If you've made it this far in the podcast, I really appreciate you. Thanks for listening. Please make sure to like and subscribe so that you never miss an episode of the Tech Glow Up. And hey, can I ask you a favor? If you really enjoyed this episode, could you share it on your Instagram stories or maybe post the link with what you enjoyed on LinkedIn? The sort of sharing and engaging really helps small podcasters like me reach the audience that I know really cares about these kinds of conversations.