GoodRx Holdings, Inc. (GDRX) Earnings Call Transcript & Summary

Well, okay. Welcome back everyone to our next fireside chat. It's my pleasure to be hosting the team from GoodRx here at the UBS Global TMT Conference. Thank you to Doug Hirsch and to Karsten Voermann for being here today to have a conversation about the company. Every year, there's a company that's new to the public markets that makes their first appearance at the conference, and I'm super happy to have GoodRx here this year after going through the IPO process and going public just in the very recent past. So guys, hopefully, you've got a little bit of time to breathe after the IPO process, and welcome to the conference.

Thanks for having us.

We're grateful to be here.

So guys, I want to start big picture and set the table, maybe take a step back. And for those who don't know the company or maybe only know the company casually from your brand advertising and what they know about you written in the public domain, just maybe set the table for what the company stands for, what you're trying to build and unlock in terms of an opportunity for the company and how you think you're positioned against that opportunity for the long term.

Sure. I'll take a first stab at this and Karsten, feel free to jump in. GoodRx has been around for almost a decade, and it was really founded based on the premise of trying to find affordable and accessible health care for all Americans. It was just about a decade ago that not too many -- not too far from here, I walked into a pharmacy with a prescription in hand and the pharmacist said it would be $500, and I never expected that. But out of curiosity, I took it back and I went to another pharmacy down the street, and it was $250. I take it to a third pharmacy where it was $400, and they chase me in the parking lot saying, "Let's work out a deal," and it kind of broke my brain. Like as a rational human being, I assume that health care prices were set, and to find out that there was all this variability and all these ways that a consumer could save even outside of using their insurance was just incredibly exciting because so many Americans simply just don't get care simply because they think it's too expensive, they don't have the knowledge. Fast forward 25 -- 10 years later, we have saved Americans $25 billion, and our app is so easy to use. For anyone here who hasn't tried it, I strongly recommend you just -- you literally fire up the app, you type in the first letters of a drug, it'll generate coupons and prices. You can present it at over 70,000 pharmacies in the country. It just works, and it's what health care should do, but doesn't, right? And we're trying to bring the same experiences that people have in other categories to health care and make it simple for people. But underneath it all, there's this incredible technology platform. We process over 200 billion pricing points a day, and we find incredible prices, again, that very often beat insurance discounts. But prescriptions is really just the start. We're doing so much more now. Maybe we can talk today about telehealth. We have branded medication savings programs. We have subscriptions such as our GoodRx Gold program, and we have an exclusive relationship with Kroger. We're really building the leading consumer-focused digital health care platform in the U.S., and we're just super, super excited to continue to roll this out, especially -- I mean, look, we're all on a virtual conference right now. The need for quality, accessible and affordable health care in this country has never been greater, both during this pandemic and after, and we're excited to bring it to everyone.

And maybe when you break that down, you put a lot on the table there, Doug, so I do want to go into almost every single one of those areas in greater detail. You threw a lot back at me. Maybe talk a little bit about what you see as the opportunity across different sets of the prescription food chain, sort of specialty drugs, retail, branded and generics and how sort of GoodRx is lining up with opportunities in all those areas.

Sure. I think I'll throw that one to Karsten because he can break out each of the individual channels in terms of the market sizing and TAM and stuff like that. So...

Sure. Thank you, Doug. I appreciate it. Happy to talk about that. So our business is essentially made up of 2 big categories, which break into smaller categories as we've been discussing here. So the 2 big categories, first of all, Eric, our prescriptions offering and our sort of other revenues. And within our other revenues, those break down into our subscriptions offering, our manufacturer solutions offering and our telehealth and marketplace offerings, respectively. So with respect to those offerings, our prescriptions offering is the largest one, roughly 90% of revenue, and the prescriptions offering is the one that was really the catalyst -- or catalyzed by Doug's experience at the pharmacies where we save consumers significant amounts. In general, over 70% on average off what they'd otherwise paid for their prescriptions, and that's increased from 59% a couple of years ago. So in that business, the consumers simply use our platform and our technology to put in any drug name, and they'll see very quickly where they can get the drug, at what price, at the steep discount that they are looking for. Our revenue model around that is that we make transaction fees usually about 14% to 15% of GMV associated with all the transactions that flow across our platform. So again, the consumer uses GoodRx at the pharmacy. The pharmacy collects the cash. The pharmacy sends a portion of the cash to the PBM, and the PBM then sends the referral fee or payment to us. And what's really exciting about that business is that over 80% of transactions are repeat transactions. So once consumers start using us, they just keep doing it, which is great, and there are a lot of structural reasons why that's the case. But at risk of running long, I better not do more on this, and I'll talk a little bit about the other revenues. So there, we talked about our subscriptions business. That one is a lot like our prescriptions offering, except there, we also charge a monthly fee for even lower prices. And our subscribers generate about 2x their first year contribution compared to the folks in our prescriptions offering. And of course, along with that greater value of our users, we also benefit from the fact that the revenue is quite predictable. And our subscriptions offering, those include their own GoodRx Gold offer as well as our Kroger partnership, where we power all of Kroger subscription, prescription, offerings across all the different Kroger brands in the U.S. Then we have our manufacturer solutions offering, and that's a way to incrementally, on top of our prescriptions offering, to help monetize the branded drugs and help our users get better pricing. So as you know, the branded drugs can be really quite expensive. And because of that, manufacturers have created a plethora of different opportunities for consumers to save money, co-pay assistance programs, various different things. The problem is consumers don't know about them, and so you find manufacturers advertising on CNN and other places that really aren’t very targeted. Our manufacturer solutions program allows manufacturers to reach the over 15 million monthly visitors who come to GoodRx platform, prescription in hand, where about 20% of them are looking for information exactly on this, on branded drugs and how to save money and get access to those branded drugs. So that's one of our fastest-growing business lines, and because we already have the 15 million visitors and have the platform with the inventory for the ads, we can combine those things in a manner that's extraordinarily high margin for us. And then finally, there's our telehealth offering. Our telehealth offering contains our own telehealth service, HeyDoctor, which we run. And it also has a marketplace, which HeyDoctor is effectively an anchor tenant of that allows users to also go to a variety of other telehealth and service providers more generally. The Hey Doctor offering is one where we charge, effectively, per visit. And on our marketplace, much like in our core prescriptions and in our subscriptions offering, we make a take rate off all the transactions that flow through our telehealth marketplace. Kind of a lot there, I realize, but I hope that was concise enough that you could follow, Eric. Happy to take follow-ups, though.

No, totally got it. We're going to go down some of those roads as well. That's great. Maybe one last big picture question and a second part to it that sort of begins the process of going a little bit deeper. We talked a little bit about what you built and what the proposition is to the consumer. Maybe point one or question one would be, can you give us a good sense of who the GoodRx customer is? You now have quite a scale, millions and millions of customers. Who are they? How do they find you? And then the second piece is, obviously, by your own statements here, you want to continue to compound customer growth and bring more and more people inside this platform. How do you think about aligning your acquisition strategies, so you're growing and retaining and remarketing to people to drive engagement and consumption on the platform?

Sure. I'll take a first stab at it, and Karsten, feel free to fill in the blank.

Happy to jump in, yes.

Yes. So I mean, the irony of it is we feel that our customer is almost everybody, right? The reality is that about 3/4 of the people that use GoodRx actually have insurance coverage. I think the default assumption from people is, though, this is for people who are down on their luck and don't have any insurance and -- or have no coverage whatsoever, and that's just not the case, right? 3/4 of people have some form of insurance. Many of those people have not just high deductible health plans, but just regular old commercial insurance plans like people on this call. They may have Medicare Part D or Advantage, and yet there's always gaps in care. I don't think at this point in 2020, we have to tell any American that insurance is paying for less and that you're paying for more. And so our customer base has been -- is quite wide. Our primary sort of competition in this space is really just consumers who don't know any better. It's people who think that insurance card in their wallet is all they really need. And so I think I just want to continue to emphasize a great example. A New York Times reporter called us up just a few years ago and was like, "I don't believe you guys. There's no way this works for insured customers." We actually went through for the top 100 drugs in the country, comparing her New York Times co-pay against what GoodRx prices were, and we beat the co-pay 40% of the time. And that was assuming she'd even satisfied her deductible, which, as you know, is getting bigger and bigger. So we believe the market is quite big. Our 2019 GMV was $2.5 billion. And again, 70% of Americans aren't even aware the prescription prices vary. Karsten, do you want to add anything to that?

Yes. No, I think the only adds that I'd really put on that are that the prescription market, too, is only a tiny portion of the overall market. The manufacturer solutions TAM is $30 billion, the prescriptions TAM at $360 billion, plus another 30%, which takes you to $524 billion for unfilled prescriptions due to price. And of course, with us lowering price, we make those affordable for people and increase the TAM. Those are huge numbers. And a way to think about it, I think, for folks on the call who sort of think about what portions are the most accessible or least accessible is on one dimension what Doug talked about, which is do you exclude people because maybe they're insured or not. And there, you shouldn't because with only 22% of our user base being uninsured, we're clearly not an offering targeting those folks, and we're relevant to pretty much everybody, as Doug said, given the gaps in coverage. The other dimension is that we cover -- in the prescriptions market TAM alone, not just the generic portion of the TAM, but also a decent element of the branded side, too. So that's also a relevant TAM for us. And whenever we help save consumers money, not just in manufacturer solutions, but also through our core prescriptions offering.

And then maybe just dovetailing it into the second piece. When you think about your sales and marketing expense, your user acquisition strategy, I am curious to maybe separate it into 2 pieces. How much of what you're doing is to build brand awareness, category awareness, just knowledge base among consumers versus targeting user growth, retaining users and driving consumption on the platform?

Sure. Again, I'll take a stab first and feel free to jump in. One of the things I'm most proud of is that our most significant source of traffic in consumer acquisition is unpaved, right? I mean, we have an incredible brand. We have an NPS score of, I believe, it's over 80 in both the consumer and physician side. People refer -- actually, let me back up -- the medical system, especially doctors, refer people to GoodRx. That is an invaluable relationship that we're incredibly proud of. And then consumers tell their friends about it, right? I think we're at an interesting juncture now where we are investing more and more in content to help consumers learn about GoodRx. We also are launching all these new services that we've already talked about. And we're a multiproduct company now, right? We're not just -- I think if you go back in time, you did a search for a drug, you got a coupon. Today, we have a whole variety of services that Karsten has already walked you through. So we continue to invest in things like new ways that we can reach out to consumers, so you see a lot of TV from us. I apologize if anybody watches like the Golf Channel here sees our ads. A lot of efforts with health care professionals because we have this incredible partnership with health care professionals. We're testing out lots of new channels. And then, honestly, I think we are building a brand. We're building a really, really strong brand in health care that represents affordability, represents convenience. And so I think we're really, really proud of both, I'd say, the traditional channels that we're working hard on, but also extending our brand beyond just, oh, those are the coupon guys, too. Those are the guys that are going to be my guide to the -- to health care. So first, Karsten -- one last comment, by the way. We did just hire our first Chief Brand Officer, a guy named Simon Cassels, who was previously the CMO at Ring. So he's doing a lot of work on this as well. Karsten, do you want to add anything?

Yes. I think the only thing I'd add is, to Doug's point, the NPS, both among health care providers and users that we have, which is 86 and 90, respectively, is pretty amazing because that drives a heck of a lot of business when you have people actively promoting you, both in our customer base and in the broader health care community. I think what's also important is that outside our prescriptions offering, our HeyDoctor offering does not have 4.9 stars. It has a full 5 when you go look at it online. And I think what all this really points to, Eric, is that there isn't really a dramatic difference between growing the user base and growing the brand. It's kind of the same thing because when we -- when you're the largest relative market share player like we are, we're much bigger than our next closest competitor. Anything that supports understanding of the market and helps folks realize, the 70% of folks who don't even know that prescriptions can have different prices at different pharmacy, anything that expands the market helps us. We even see that sometimes when competitors -- much smaller ones -- advertise, they run ads, we pick up the uplift in terms of business because they find out, wow, prescription prices can be different, but they don't necessarily remember the name of the entity involved. And all of those folks tend to aggregate with us just because we have so much scale relative to anybody else.

Great. It's obviously been a challenging year with the global pandemic on a lot of levels. You've seen a little bit of volatility in your own business. It relies on people wanting to leave the house, go out to prescriptions. But then you've also made investments in areas like telehealth. Can you talk a little bit about how, you, as a management team, have sort of navigated through this past year? What some of the key learnings or opportunities you see that you might want to repivot the platform too for the PBM to long term -- sort of navigated through the year plus path forward from what you've learned?

Sure. And I think I'll start with -- look, obviously, this pandemic has been traumatic, but it's also -- if you step back in time for a second, the biggest issue facing Americans when this election was coming prior to the pandemic was the cost of health care. It was literally the #1 issue that the presidential candidates were talking about, which is the same as it was in 2016. And then the pandemic came along, which, of course, is health care as well, which everyone is so focused on. This could not be a more important issue that Americans need to focus on. And I think when, hopefully, knock on wood, this vaccine gets in a broad usage, what's going to happen? A few things. First of all, every American is going to be required to go to an urgent care center or a pharmacy and engage yet again with the health care system and then, of course, make up for all the things that they put off for the course of the last year. So we're just -- there's an incredible opportunity for us to continue to engage with consumers and show them these better ways as consumers basically come out of their homes and start to reengage. So I'm excited about that. Specifically though with telehealth, we had the foresight back in 2019 to acquire HeyDoctor to reach the 20% of the consumers on our platform who didn't have a prescription when they did a drug search. And HeyDoctor, as Karsten already mentioned, is amazing. It literally has 5 stars. The -- again, it's one of these things you have to kind of experience it to believe it. But the idea that a consumer can literally be sitting on a computer and within minutes can get a prescription for common, chronic, safe medications and have them sent to their house in no time is a no-brainer, and it's one that we're super, super proud of and one that has really done quite well through the pandemic. And combining that with our marketplace remains a really, really great place for us to continue to invest in because, again, convenience is something that -- if we go back in time, telehealth was nothing back in early 2019. Now it's everywhere. I think there's going to be a permanent home for telehealth in a consumer's health care journeys. Not everywhere -- I think people will continue to go back to the doctor, but I think that telehealth will definitely play an important role, for example, in things like mental health -- that just seems like a no-brainer, for things like common refills, for -- there's -- I think there are certain categories where if you just think for just a sec, you can realize that telehealth makes much more sense than the more costly and inconvenient process of going to a physician. So we're really proud of it. We will continue to invest in ways that drive convenience for our consumers. We still expect the majority of consumers will continue to go to retail, and we can talk about Amazon in relation to that, too. But we are very, very proud of our telehealth offering, and we feel that it's going to continue to thrive past the pandemic as well.

Great. And maybe that will be a good segue into some of those other revenue segments you've talked about. I wanted to talk about sort of the branded manufacturing opportunity first. We go out and have a lot of conversations with folks in the advertising community as part of our broader work, and it seems like there's the potential for something quite large to be built there by the team. You have consumers. They have an intent to purchase. They're doing queries. You brought a lot of brand partners on. Can you give investors a little sense of what the dialogue is like with the industry broadly about bringing people in as partners on the manufacturer solutions side?

Sure. I can help with that one, Eric. And it's been entirely positive, and that's reflected in the growth of the business. I think earlier on, we've said it had been growing 4x Y-o-Y over the summer. And since then, obviously, folks have seen other revenues in aggregate grow quickly, and this is a big piece of those. So that further reinforces the same evidence that folks on the manufacturer side are finding this to be incredibly valuable. On the third quarter earnings call, we announced that we had expanded the number of partnerships we had with manufacturers quite dramatically. We'd use a number of over 30. And the reason that's so important is for something that wasn't really marketed until acquired recently, we, this summer, hired Bansi Nagji, who used to be one of the top officers over at McKesson to, among other things, run this business. And because it hadn't been marketed aggressively and didn't really have a full team to take it to market until quite recently, we're really seeing an acceleration of it. I think the biggest benefit that manufacturers recognize is that it's just such a perfectly targeted audience of relevant folks who we can provide access to and who the manufacturers can help through the various programs they have to make branded drugs more affordable, and that's completely aligned with our mandate, of course, making health care convenient and affordable for all Americans. So that alignment -- strategic alignment, combined with our ability to do exactly what the manufacturers need, has proven to be a winner. And of course, the hard part, in many cases, getting into given manufacturer, so establishing that first MSA and being able to partner up on one or another given drug. But once you're in, the opportunity to expand becomes much, much more accessible to you, and I think that's where we really find ourselves now. So we're continuing to hire into that business and continuing to feel more and more folks in anticipation of being able to serve manufacturers in even greater quantities than we do today. Again, we only have a tiny bit of a TAM. It's about $30 billion TAM. And when you look at it, we don't even have 1% of it yet, even though, in many ways, we're pretty much the most logical player to be able to do exactly what manufacturers need. So it gives us a lot of runway ahead. Doug, do you want to add anything to that?

The only thing I'll add to that is one of the amazing things about the gift that I've been given over the last decade of working at this company is that generally, we've been the recipient of inbound interest, right? So manufacturers are coming to us because they know -- I mean we can talk about Washington and politics and all that. They know that they are in the spotlight and that they need to come up with new and better ways to serve the American population. And so we are -- we represent the American population there where we have that direct relationship, that trusted relationship with both consumers and health care professionals. And so it's -- honestly, it's just been a joy when we get calls from senior leadership at pharma who say, "Hey, look, we know there's got to be a better way. We've got to come up with an affordable way to do this. We've got to communicate better with patients about the cost of our product." And so look, I -- it fulfills an opportunity for us that we have the opportunities to work directly with everyone throughout the ecosystem, whether it be pharmacy, manufacturers or PBMs, et cetera, who really just want to come up with a better way. And we plan to be there for them, regardless of whatever goes on in Washington.

Maybe just 2 more follow-up questions within the other revenue segment. First, I want to maybe dive into subscription. When I see a platform company that's serving the needs on supply and demand and then you start talking about subscription, that normally means the value of the platform in the eyes of consumers is moving up. So what are you seeing in terms of subscriptions? You obviously had your own offering. You have a partnership with Kroger. How are you thinking about the opportunity set to bring more and more customers into a subscription offering and what that might mean for unit economics on the platform over the medium to long term?

Sure. I can probably jump in on this one, Eric. First of all, so the subscriptions offering, yes, we view it as incredibly valuable because our subscribers have about 2x their first year LTV relative to our prescriptions offering folks, and that's driven by the fact that the basket size for our subscribers gets bigger, which is great for us and great for all of our ecosystem partners. Both our own GoodRx Gold offering and our Kroger offering are growing quite rapidly. Again, they're part of that extraordinarily fast-growing other revenue bucket, too, and we just recently renewed our Kroger relationship for multiple future years. So it's clearly working for the subscribers, for Kroger and for us on the Kroger side and on the GoodRx Gold side. It's working equally well for us and our subscribers there. And we really see that as a huge area of expanding opportunity because it allows folks to have -- us to help folks more, and it makes us more relevant to them at the same time because the relative rate of savings is just even bigger on our subscriptions side than it is on our prescriptions offering where we already save folks over 70% off what they would otherwise be paying. So we've integrated the programs much more tightly, too. So right now, if you use the GoodRx app, you'll see that the subscription prices are shown beside the regular prescriptions offering prices, too. And we only quite recently did that over the last few months and quarters, so that allows people to really get exposed to incremental benefits they can have and it makes it much easier to adopt the subscription offering. And even though our existing transaction business has an over 80% repeat transaction rate on the prescriptions offering, the subscriptions offering is even more compelling because it helps consumers, more higher value for us and, frankly, more predictable, too. So I think you nailed it when you said subscriptions make both platforms more valuable and allow us, more importantly, to provide more value to our users as well.

Great. Okay. That was great. One question we get a fair bit about the other revenue segment that maybe we'll close it out this topic on this is, obviously, there could be various pieces of growth in margin contribution from all these businesses. You're building out telehealth. That's a very different type of business than subscription. How should investors just think about the puts and takes or what they should be monitoring, watching as other revenue in total grows and how to think through some of the elements of a mix shift that could play out through the P&L from these very different offerings within other revenue.

Sure. Yes, I think you summarized it really elegantly there, Eric, because you're sort of describing spectrum of businesses we'd looked through the lens of sort of margin, where things like our manufacturer solutions offering where, earlier, I said, on the one hand, you have a platform that's already built, 15-plus million visitors who want to use the platform. So there, effectively, the only cost of doing business is selling -- very, very low -- it's almost all contribution. Then you have the subscriptions offering, which looks, frankly, a lot like our core prescriptions offering in terms of margin profile, so very high margin, too, because it's basically the same -- it's the exact same product just packaged differently, so our users are able to access it through that subscription modality instead of one-off. And then beside that, when you sort of considered those 2, when you shift more towards telehealth and marketplace, the HeyDoctor offering does have true cost of goods sold associated with it, but it doesn't look like a Teladoc type offering because we focused on limited conditions that can be served quickly and effectively, often asynchronously way. So that allows us at any given volume to have a cost structure that's lower than significantly larger players who don't use asynchronous modalities to serve the customers and the patients. And then finally, on our marketplace, that, again, like subscriptions, looks a lot like our core prescriptions offering because there, too, we're connecting our users to a variety of folks who can provide them with services. And for that, we're earning a take rate, just like we do in our core prescriptions offering. So again, you can think of it like a spectrum where manufacturer solutions pulls margins up at the gross margin level and also at the EBITDA level, and where subscriptions and where the marketplace look frankly pretty darn similar to our existing prescriptions offering. And then for telehealth, that one does have some cost of goods sold associated with it. But given we have the marketplace, we're able to serve our users through the marketplace as well as through our own HeyDoc offerings, so don't have to drive that cost of goods sold up, particularly dramatically even as we scale.

Got it. That was great. Obviously, there's been a lot of questions as of late with Amazon launching a pharmacy product and coming to market differently than they did with PillPack via acquisition. Could you give investors a sense -- because this is probably number one question that's come up in very short term. I know we'd like to -- I prefer to talk in longer-duration themes. But what do you see from Amazon's moves, how you think it could impact GoodRx and how you maybe would compare and contrast what they're trying to accomplish versus what you're trying to accomplish?

Yes. And we can talk about this for quite some time because pharmacy is actually quite, quite complicated, as you know, Eric. And I think that's part of the challenge here is just that because it can be very confusing and because pharmacy often acts counterintuitive to how markets typically move, I think it's created a lot of confusion in the space. Just to kind of lay the groundwork a little bit here, I think you know most of this. Amazon has been trying to work on mail-order pharmacy for quite some time, right? If you look at back in 2000s, actually, they actually were a majority investor in Drugstore.com, which was going to revolutionize mail-order pharmacy. Then, of course, they bought PillPack 2 years ago. And of course, this latest thing, to some extent, a rebranding and a slight reimagination of the PillPack service. I should mention, by the way, GoodRx is actually partners with PillPack and Amazon Pharmacy. You can use GoodRx discount at the Amazon mail-order pharmacy. Where I think people got confused is they just naturally assume, because in some markets, it's like Amazon versus traditional retailer. Remember, we're not a traditional retailer. We are a marketplace. [ And this program ] when people bring in lower-cost services, and we're thrilled. The challenge is that mail is really, really, really hard. And I think you probably have seen some data. Mail makes up a little more than 5% of prescriptions in the U.S., and that is not growing even during the pandemic. And there's a variety of reasons. It's people like going to -- having an interaction with a medical professional, especially a free one at the pharmacy. People like going and picking up their toothpaste and shampoo while they're there. It's very painful to move a prescription from retail to mail. It can take 5 days to 2 weeks. And the PBMs who are behind a lot of these relationships basically prohibit and/or maybe disadvantage pricing if someone wants to use a different mail-order service besides the ones that they control. So without going into too much [ details ], suffice to say that we like the fact it's Amazon. We think it's complementary and helpful to our service that they can drop this, but I think we remain a partner of Amazon. However, I want to emphasize that we don't think it's detrimental to our business. We think it's actually -- it's positive because it builds more awareness. As for the -- this Inside Rx relationship and this Prime card, just emphasize quickly, in order for Amazon to show prices on their website because health care is so wacky, they need to work with a third party. They can't do it themselves or they risk violating both their insurance relationships as well as their Medicare/Medicaid partnerships. It's actually -- it can be actually a felony for executives to get in trouble when it comes to pricing like this, so they use a third party. They chose Inside Rx. Inside Rx, again, is a partner. It was actually a launch partner of GoodRx. We worked together with them to launch this program. This does not mean that Amazon is trying to invade Walmart, CVS and Walgreens. I mean, I don't work for these companies, but I can tell you that it seems highly illogical that you would imagine a customer would take an Amazon Prime Rx card into a Walmart to get a discount off of Walmart, where it's already low prices. Remember, Amazon wants you to buy things by mail. Walmart certainly does not want invite Amazon into the Walmart purchasing flow. So I don't want to sound defensive because, honestly, it's not -- we think it's actually a net positive thing. It drives more awareness. And when people become aware of the fact that prices vary and they can find alternative ways to get prescriptions, we tend to be that first result. So yes, I mean, you've probably heard about this already, so I'll leave it there. I don't know if Karsten has anything else to add.

I think that was a great summary, and I think it reflects the reality of sort of what we're seeing, too, which is some initial interest and then since then, not that much, honestly, because there -- this hasn't really changed reality very much at all from where we stand and from where our users and our customers stand. I think the only big change, frankly, has been that it's driven some of our partners even closer to us than they would otherwise have been on the pharmacy side and, for that matter, on the PBM side, too. So it creates some unique opportunities to do more things like we've done with Kroger around subscriptions, CVS around some of the integrations into their systems and expanding even further the growth from 2 to 8 vaccination programs that we've grown from last year to this year, vaccination programs that we partner with pharmacies to do. So we're looking forward to deepening those relationships and leveraging even further.

Great. That was super helpful. And then maybe just one quick follow-up, but the question is really not about Amazon per se, just about the broader business, but Amazon might play a role in this over time. How should investors be thinking about take rate evolution over time? Obviously, you're doing more with consumers and partners in various lines of business. But how should investors think about either the competitive angle to take rate versus just broader industry components in terms of how take rates going to evolve in the coming years?

Sure. I can probably jump in and maybe Doug can follow on this one. Our take rate has been pretty stable over time, Eric. It's always hovered between sort of 12%, 13% and 14%, 15%. And the reason that we've kept our take rate about the same versus, say, growing it as we save consumers more money is because we really are focused more on growth and on helping the consumers than on shifting that number up. I think, going forward, again, given the realities that we're seeing and the fact that with our scale, again, the largest relative market share player in the space, with the barriers to entry we have, again, pretty much every health care provider in the states, about 2 million of them have a patient who has used GoodRx by our calculations. And based simply on the growth we've evidenced so far, we continue to be able to cut better and better deals for our consumers with the PBMs and others. So the bottom line is that, I think, while take rate could be a lever, we just haven't had to use it because we find other ways to create value and to be able to drive the growth going forward. We're already cheaper than Amazon, since you brought them up in the context of this question, by our analysis, about 90% of the time. And where we're cheaper, we're cheaper by a lot. Where they're cheaper, it's by a little. Same thing with respect to any other competitors we see out there. So we have the best offering for consumers while having a healthy take rate, and that creates a pretty defensible position given the scale we have. And like I said, in response to the previous question, given the fact that any PBM that's not called Inside Rx is more eager than ever to work with us.

Great. We only have a few minutes left, and I love to end on sort of a big picture that can bring both of you into the conversation. Companies like yourself that are compounding growth have unlocked an interesting opportunity, building a platform. You always have to have debates around growth versus profitability. So from Doug's perspective, I would love to know what you see as the most exciting opportunities forward, what's at the very top of your list that you think GoodRx should be going as fast as possible in terms of either building product or investing against. And then Karsten, how do we bring that dynamic back to some of the things you've talked about where you want to bring the business from a margin standpoint over the medium to long term?

Sure. I'll let Doug go up first.

Sure. Again, I've been doing this now for 10 or 11 years, and I have never been more excited. I mean, we are in a tough, tough time, right? Again, it's -- we're all sitting on Zooms. We're all wondering how this is all going to play out. But all of it revolves around consumers engaging with the health care system. And the health care system, honestly, is failing most Americans. And so I wake up every morning and I think if we can just continue to provide -- be that trusted resource, again, for consumers, for health care professionals, for manufacturers, for PBMs, for insurance companies, for employers, like everyone is looking for an alternative, and we are that alternative. We are -- we have this virtuous cycle, as Karsten mentioned, where for everyone, we view everyone as a customer and they view us as a customer, right? We help PBMs and insurance companies and pharmacies make money. They help us make money. We help drive down the prices. They use us as a way to drive prices because they can't do it themselves. It's just -- I've been blessed to be able to operate this company where we do well by doing good, and we continue to see so many opportunities. But just to give you some examples, pharmacy is 10% of the $4 trillion that's spent in this country every year, right? So there's wide open opportunities for us to continue to look at the rest of care, like, for example, telehealth like what we're talking about. We all know telehealth is going to have a permanent place in the future of this company -- sorry, in the future of this country. And so we are going to be there to provide those solutions for consumers, and we do it already today. When we look at home and mail delivery, like we've talked about Amazon, it's really hard, but we also have a service there. As Karsten already mentioned, our prices are cheaper, and we're seeing wonderful growth, and we're very, very excited about our home delivery options. I just -- I'm so -- and not only [ but ] above that, there's technology. There's some incredible devices that are coming along that are going to help Americans have a closer relationship with the health care professionals at a lower cost. And so I just think -- and the last thing I'll throw in, of course, is we have politics, right? We have Washington and whatever administration, who knows there's a problem here, consumers are demanding answers. For example, a great example, just transparency, just how about the ability for me to know before I go to a doctor's office what that visit is going to cost me. Can you believe it's 2020, we still don’t have that? So I know I'm talking super big picture, but that's the way we're thinking. We're thinking about all these incredible opportunities and all these constituents who are ready to do something, and we are ready to invest to make those things come to reality. Karsten, I'm going to give the last minute because I was standing on my soapbox.

No, that's great.

And I think we only have about a few seconds left. So from a margin perspective, during the third quarter earnings call, we talked about the fact that in fourth quarter and beyond into 2021, we're going to continue to invest aggressively in marketing because we think folks just don't know the degree to which we can help them, and we look forward to increasing their awareness. Again, our biggest competitor is the 70% of folks who think, in our pharma business, drug prices are the same everywhere. And on top of that, to fulfill the vision that Doug was outlining, we're going to continue to double down and invest in products as well. So in the near term, those are our plans, but that really sets a foundation for us to be able to achieve great margins in the mid- to long term as well because as the largest player in this marketplace space and given how marketplaces work, as our awareness continues to increase, the efficiency and effectiveness of advertising gets better. The investments we get in -- making our platform get leveraged across more users, and all those things are good outcomes for us and for our shareholders at the end of the day.

That was great. Thanks, guys. So with that, I'm going to bring the webcast to a close. I want to thank Doug and Karsten for making themselves available to do this. Next year, I hope we can do this in person, instead of on webcast. Congrats again on a great year in terms of going public. And we're wishing you both great holidays. Stay safe, stay well, and look forward to what the company does in 2021. Take care, guys. And thanks, everyone, for joining today.

Thank you. Bye-bye.

Appreciate it, Eric. Great to see you.