Americans spend more than $420 billion per year at pharmacies for prescription drugs, according to a 2022 report from the Department of Health and Human Services.

Prescription discount cards help people save money on prescription drugs by offering savings at participating pharmacies.

One popular company, GoodRx, offers discounts of up to 80% on prescription drugs at over 70,000 U.S. pharmacies with its prescription savings program. And according to the company’s website, “there’s absolutely no cost and no catch.”

But earlier this year, GoodRx was penalized by the Federal Trade Commission for disclosing patients’ personal health information without their consent. And using GoodRx’s discounts isn’t always easy or predictable.

Here are four potential catches the federal government, pharmacists, researchers and the company itself say you should know about before using GoodRx.

1. DEDUCTIBLES

“Keep in mind you cannot use GoodRx and insurance at the same time,” the company’s website says. It encourages users to pay for prescriptions as a “cash” payment with a GoodRx coupon. (In this context, paying “cash” means you’re paying out of pocket - without insurance.)

Using GoodRx rather than insurance means your insurance doesn’t have to reimburse you or count your spending toward your deductible or out-of-pocket maximum.

Whether this matters to you depends on your coverage and what you expect to spend on prescription drugs each year.

“Who cares if it’s not going to count toward your deductible if you were never going to spend so much that you’re going to hit your deductible anyway,” says pharmacist Shannon Rotolo, who recently left the University of Chicago for a new position at the University of Rochester.

But if you know that you’ll spend enough to hit an out-of-pocket maximum or Medicare Part D catastrophic coverage, Rotolo recommends having it count toward your deductible. “Get the lower prices from your insurance plan sooner in the year,” she says.

2. PRIVACY VIOLATIONS

GoodRx’s “not-so-good privacy practices” made it the first-ever company penalized for violating the FTC’s Health Breach Notification Rule, according to a post by senior attorney Lesley Fair on the agency’s business blog.

“In our complaint, we alleged that GoodRx violated the FTC Act (which prohibits unfair and deceptive practices in the marketplace) by sharing sensitive personal health information for years with advertising companies and platforms - contrary to its privacy promises that it would not do so,” FTC spokesperson Juliana Gruenwald Henderson wrote in an email.

The FTC imposed a $1.5 million civil penalty on GoodRx. (For context, that’s about 0.2% of the company’s 2022 annual revenue of $766.6 million.)

The FTC also prohibited GoodRx from sharing any of its users’ health data with third parties for advertising, and the company must obtain consent before sharing data for any non-advertising purpose.

When asked whether and to whom GoodRx sells or shares patient data today, a company representative referred in an email to a February 2023 “GoodRx Response to FTC Settlement.”

“The settlement with the FTC focuses on an old issue that was proactively addressed almost three years ago, before the FTC inquiry began,” the GoodRx statement says. The company disagrees with the FTC’s allegations and does not admit wrongdoing.

GoodRx says that “privacy and security are paramount to us and an essential part of how we conduct our business,” and it encourages customers to review the company’s privacy policies.

3. UNPREDICTABILITY

GoodRx’s prices “fluctuate frequently,” the company’s website says. So it might be hard to predict what you’ll pay and where you’ll have to go for your medications.

“If you’re really trying to find the lowest price with GoodRx, you can end up spending as much in gas money driving to a pharmacy across town one month, and then the next month, you’re driving to a pharmacy in the other direction or the adjacent town,” Rotolo says.

Prices for common generic medications on GoodRx can change by hundreds of dollars per fill over just six months, according to research published in 2022 by Rotolo in the journal Supportive Care in Cancer.

“You may be better off just using your local pharmacy’s cash price, even if it’s a couple bucks more,” Rotolo says (although the price difference will sometimes be much higher, she acknowledges). “It may be worth it,” she adds, “just to know that you’re going to continue to get that same price at that place, probably for a while.”

4. PHARMACY CHOICE

To get the lowest price with GoodRx, you may have to use a specific pharmacy - probably a large chain.

“A lot of (independent) pharmacies won’t even accept the GoodRx card,” says pharmacist Jessica Robinson, assistant professor at East Tennessee State University’s Gatton College of Pharmacy. Smaller pharmacies might not be able to afford it.

“What happened was independent pharmacies were very excited to help patients any way they can, and then found out that a lot of the price negotiations are reimbursing below the cost of the drug,” Robinson says.

Pharmacies don’t get to negotiate with GoodRx, but “they are usually willing to sell a medication to a cash-paying patient at cost.” So while an independent pharmacy might not take GoodRx, they may have other options to help you afford medications.