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

Ladies and gentlemen, thank you for standing by, and welcome to the GoodRx 101 educational webinar. As a reminder, today's conference call is being recorded. I would now like to introduce your host for today's call Whitney Notaro, Vice President of Investor Relations. Ms. Notaro, you may begin.

Thank you, operator. Good morning, everyone, and welcome to the GoodRx 101 educational webinar. Joining me today are Karsten Voermann, our Chief Financial Officer; Justin Fengler, our Senior Vice President of Corporate Strategy and Business Operations; and Arik Moav, our Vice President of Finance. Before we begin, I'd like to remind everyone that this call will contain forward-looking statements. All statements made on this call that do not relate to matters of historical fact should be considered forward-looking statements, including statements regarding management's plans, strategies, goals and objectives, our market opportunity and addressable market for our offerings, future platform features and their benefits to the company and consumers, our anticipated financial performance and the growth and future performance of our offerings, including our subscription offerings, pharma manufacturer solutions offering and telehealth. These statements are neither promises nor guarantees, but involve known and unknown risks, uncertainties and other important factors. These factors may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. Factors discussed in the Risk Factors section of our quarterly report on Form 10-Q for the quarter ended June 30, 2021, and an annual report on Form 10-K for the year ended December 31, 2020, and our other filings with the Securities and Exchange Commission could cause actual results to differ materially from those indicated by the forward-looking statements made on this call. Any such forward-looking statements represent management's estimates as of the date of this call, and we disclaim any obligation to update these statements even if subsequent events cause our views to change. In addition, we may also reference certain non-GAAP metrics, which are reconciled to the nearest GAAP metric in the company's shareholder letter, which can be found on the overview page of our Investor Relations website at investors.goodrx.com. I'd also like to remind everyone that a replay of this call will become available there shortly as well. Following today's prepared remarks, we will open the call for questions. If you would like to submit a question, you can do so at any time using the built-in Ask a Question feature in the webcast player. As a reminder, no new financial information or projections will be discussed on today's call. We thank you in advance for your cooperation. With that, I'll turn the call over to Justin.

Thank you, Whitney, and thank you, everyone, for joining us for this educational session today. Before we jump in, I wanted to share a couple of testimonials one from a consumer and the other from a healthcare provider, highlighting the impact we continue to have on people's lives. This is what gets the hard-working team at GoodRx up every morning. On Slide 3, we have Brenda, who knows that with GoodRx, she's going to be able to afford her prescriptions. For many GoodRx users, just like Brenda, GoodRx is not just about saving money, it's about whether they will be able to buy their medication or their children's medications or not. That is not a fair choice for people have to make, and we're proud to say that it's a choice we're helping more and more Americans avoid making. Moving to Slide 4, Dr. Flores, one of the many healthcare providers that uses GoodRx shared similar sentiment to Brenda in his testimonial, healthcare providers are central to what we do at GoodRx. We know most patient journeys involve a visit to a doctor's office or a clinic, and we recognize the essential role doctors, pharmacists, and medical professionals play in determining the best treatment. They know as well as we do that prescribing a treatment, a patient can't afford isn't really a treatment at all. That's why physicians have embraced GoodRx since our inception. Put simply, we help healthcare providers do what they do best, help their patients. We believe that providers alignment with us and our mutual dedication to helping their patients is a reflection of our focus on them and the foundation of our growth and success. I want to thank the entire GoodRx team for their hard work and dedication and for making these testimonials possible. I'm extremely proud of the great company we've built, and I'm even more excited about our future ahead. Let's turn to Slide 5, for a look at the large market and opportunity we believe we have ahead of us. When you look at some of the largest consumer spending markets today, restaurants, transportation, travel, education and real estate, most of which are multitrillion dollar markets, they are all served by successful consumer-focused, tech-enabled solutions and brands that become household names. Healthcare, as you can see on Slide 6, is significantly larger than any of these other consumer spending markets with approximately $4 trillion of annual spend initial in 2020. However, while each of the other markets has been transformed by consumer tech experiences bringing clear linkage between cost and value, healthcare remains underserved. With healthcare still so far behind, we believe there's a huge opportunity for GoodRx to bring the same transformation consumers have come to expect to this market with our tech-enabled and consumer-focused solutions. And that transformation is needed. On Slide 7, it's clear that even the extremely high level of healthcare spend in the U.S. is not delivering results. While the per capita healthcare spending in the U.S. is 2x higher than other OECD countries, the performance rankings remain low, not to mention that 2/3 of all personal bankruptcies in the U.S. are linked to medical costs. Turning to Slide 8. These challenges in healthcare are not limited to uninsured Americans. Based on our data, approximately 3/4 of people who come to the extensible GoodRx platform have some form of insurance coverage. For many, their insurance may just not be sufficient to meet their healthcare needs on its own, so they turn to GoodRx for help. And the cost of the system related to nonadherence is significant with up to 30% of prescriptions left unfilled, primarily due to cost and $300 billion in costs related to non-adherence. Non-adherence also impacts actual healthcare outcomes and results in many avoidable deaths in the U.S. At GoodRx, we're focused on addressing these challenges by furthering our mission to help Americans get the healthcare they need at a price they can afford. When Doug and Trevor founded the company a decade ago, they wanted to help Americans access information and save money on prescription medications. They started with prescriptions since it is often the most frequent touch point that many consumers have with the healthcare system. Looking at Slide 10. There are 5 billion annual prescriptions in the U.S. compared to only 800 million annual physician visits. That means that an average American goes to the pharmacy much more often than they go to the doctor. For that reason, we believe that helping Americans with prescriptions would be a great way to benefit from frequent touch points and interactions with consumers and establish trusting relationships. Not only that, the prescription drug market is massive. In 2020, it was estimated to be over $500 billion. With our broader vision of transforming the consumer healthcare experience, prescriptions was a great place to start, given the frequency of consumer interactions, the opportunity to build consumer relationships and create a platform for further expansion. Over the last couple of years, we've introduced offerings and services that allowed us to expand into additional markets within healthcare. In 2019, we acquired a telehealth company called HeyDoctor, which we have since integrated into GoodRx to extend our platform and rebranded it as GoodRx Care. Our telehealth offering focuses on low-cost, low-risk prescription associated conditions and provides another entry point to our platform as well as incremental cross-selling opportunities for our other offerings. We also launched our pharma manufacturer solutions offering to help more Americans start and stay on their branded therapies, both our telehealth and pharma manufacturer solutions offerings further increase our TAM. Turning to Slide 11. Over time, our offerings have expanded to encompass more of the consumer healthcare journey. We offer solutions at the prevention and research stage before a consumer is ready to transact, including a variety of written and video content through GoodRx Health, which we launched last week and HealthiNation, which we acquired earlier this year. Moving to the next step of the patient journey, we offer access to affordable and convenient diagnosis services through GoodRx Care and our telehealth marketplace. Post diagnosis, we help consumers get their prescriptions filled and refilled at a low price through our prescription transactions offering. Our gold and Kroger subscription programs, our mail delivery service, and for brand drugs through our pharma manufacturer solution offering. And when we take a step back and think about our platform longer term, we have a great opportunity to continue to extend it by adding valuable services for the almost 20 million monthly visitors that have visited GoodRx year-to-date. Over the last few years, we have successfully extended and added services that consumers love and need to our platform, both organically and inorganically, and we will continue to do so to help consumers better navigate their healthcare journey. We believe there are still many adjacent categories for us to enter where the consumer experience is extremely complex with the goal of making health care simpler, more transparent and more affordable for consumers. Our success is reflected by the numbers on Slide 12, whether it's the value we deliver to consumers, their high level of satisfaction with GoodRx, our expanding reach or the strength of our financials. More specifically, we have saved consumers over $30 billion since the launch of GoodRx a decade ago. Our platform has millions of visitors on a monthly basis and has reached almost 20 million monthly visitors year-to-date. GoodRx is accepted at over 70,000 pharmacies in the U.S., representing virtually every pharmacy in the country. We have over 2 million prescribers have a patient that is used GoodRx, and we have a very high provider NPS of 90. We also have an NPS of 90 with consumers and a strong repeat rate of over 80%, which is another testament to the great value that our platform delivers to consumers and the foundation of our ability to further extend our offerings. From a financial perspective, we delivered revenue of $631 million in the trailing 12-month period ending in the second quarter, with 43% year-over-year revenue growth in the second quarter. We also maintained a strong margin profile with gross margins consistently in the mid-90s and a 33% adjusted EBITDA margin in the trailing 12-month period ending in the second quarter. We've made tremendous progress, but we believe it is just the start. We are building the leading digital platform for consumer healthcare. While we are going to spend a majority of the time today providing an overview of our current offerings, our vision is much greater, and we believe that over the long term, we have a significant opportunity to expand our services and become the go-to consumer healthcare platform. With that, I'll turn it over to Karsten, who will speak to each of our offerings.

Thank you, Justin. I'll start on Slide 14. Today, GoodRx offers the following solutions, which we'll discuss in detail. Our content, which includes the recently launched GoodRx Health and recently acquired HealthiNation, our prescription transactions offering, which provides prescription price discovery, comparison and discount services, our subscription programs, GoodRx Gold and Kroger Rx Savings Club, our pharma manufacturer solutions offering, targeting healthcare providers and their patients and our telehealth offering. We'll spend a few minutes on each of these offerings, providing an overview of the product, the value proposition and the business and revenue model for each. Starting on Slide 15, with our recently launched platform extension, GoodRx Health, our next-generation online health resource where doctors, pharmacists and editorial experts provide answers to users' health questions. We've been investing in our own content for years and have benefited from being the authoritative voice when it comes to healthcare information, education and updates. We have an amazing team of economists, pharmacists and researchers that do an incredible job creating content and research that is broadly used, not just by consumers, but also by healthcare professionals. Good research and content are important pieces of building the brand, driving awareness, empowering consumers and establishing deep consumer relationships rooted and trust. GoodRx Health is a new resource that builds on this decade of experience as America's leading resource for healthcare savings. Our editorial team has already published thousands of stories that have earned top rank and competitive queries about topics from erectile dysfunction to COVID-19 vaccines. Now GoodRx Health expands upon this foundation to include subjects from health insurance to women's health and on to weight loss and mental health. Moving to Slide 16. Going into more detail on GoodRx Health. We launched GoodRx Health to provide research based answers to vital health questions. GoodRx Health gets consumers the health answers they need, covering over 350 conditions across thousands of articles and with over 2,500 videos in our library. Unlike other consumer health destinations, GoodRx Health takes a new approach to health information, providing concise, actionable and personalized knowledge. This includes a number of new products, including GoodRx Answers, Health Wizards for navigating tough choices, personalized newsletters and thousands of award-winning video explainers on today's most crucial health concerns. As you can see on Slide 17, the demand for health and wellness information in the U.S. is significant. GoodRx Health allows us to reach more consumers at the top of the funnel, creating touch points throughout their healthcare journey even before they are ready to transact. By creating new relationships and strengthening existing ones, we are building a platform to help educate consumers and build relationships pre-transaction at a time when consumers are performing research and searching for information. Bring more users to our prescription-related offerings, increasing our MAC and subscriber counts, propel growth in our pharma manufacturer solutions offering by enabling larger awareness opportunities for our pharma partners, increased cross-sell to other GoodRx offerings like telehealth and create new opportunities to leverage M&A to provide incremental services and further lift LTV as we help address the needs of a broader consumer and provider audience. We are very excited about the launch of this new consumer resource. With Goderex Health, we are excited about the potential to deliver more value to our consumers and create new opportunities to increase traffic at the top of the funnel, support the growth of our existing offerings, and extend our platform by launching new services in the future. Turning to Slide 18 and our prescription transactions offering. Our prescription transaction offering provides consumers with an easy-to-use price discovery and comparison tool that allows them to save money on prescription medications by presenting GoodRx at virtually any pharmacy in the U.S. We launched the GoodRx platform with this offering about a decade ago. And as of the second quarter, it made up approximately 80% of our revenue. This is down from 92% a little over a year ago due to the rapid growth of the newer offerings on our platform as we continue to expand our suite of innovative products and services. Looking at Slide 19, it's evident how complex the healthcare ecosystem is when it comes to prescription medications. The existence of so many players that impact the supply chain and price increase inefficiencies in the system many times at the consumers expands. It also creates a lack of consistency in consumer price. Moving to Slide 20, which shows the significant price variability just last week for both generic and brand drugs in Santa Monica, where we're headquartered. Santa Monica is only about 8 square miles. So these pharmacies are all very close to one another, here you can see the wide range in prices for the same medication across pharmacies. Many of you have heard Doug's story about how the idea for GoodRx came about, and it was his own personal experience of this slide. Doug had gone to 3 different pharmacies, which had 3 very different prices for the same medication. He was not aware of that price variability even existed at that time. And when he tried to find price comparison tools for prescription medications, he found essentially none, which led the creation of GoodRx. As it turns out, Doug's lack of awareness of price variability is quite common. In fact, a study we conducted shows that 70% of Americans don't know that prescription prices can vary significantly between pharmacies. We believe we have a great opportunity to continue to educate and increase awareness in this space, so we can help more Americans get the healthcare they need at a price they can afford. We also believe that the same dynamic exists in many categories in the healthcare end market and that we have an opportunity over the long run to help consumers in those other categories as well. Looking at Slide 21, access and affordability are clearly a challenge for consumers. Our prescription transactions offering empowers consumers by doing the hard work for them. We take an ecosystem that is complex, opaque and inefficient and make it simple by showing consumers the price and the pharmacy that makes sense for them. We do that through our proprietary technology, providing consumers with one single access point, great transparency, convenience and accelerating savings. We combine a complex backend with a simple, easy to use and elegant consumer app. As shown on Slide 22, we ingest over 230 billion daily pricing data points from a wide variety of different data sources, including our extensive PBM network, pharmacies -- pharmacy savings programs, Medicare and more and display them in a user-friendly manner. With every prescription filled, our data set becomes more comprehensive and accurate. We use our proprietary algorithms to create actionable insights and continuously improve our consumer experience. Our proprietary data is central to the value that we provide to our consumers through accurate pricing and improved recommendations. We refer to our data as living, meaning that it is dynamic and continually being updated or refined. Our engine is also able to learn from and react to changes in prescribing habits and to ensure that consumers are selecting the accurate dosing or form of a given medication. For example, our engine will automatically show the most common dose of a given medication. We also take into account pharmacy-level dispensing patterns that may impact the price of a medication such as when 2 pharmacy locations that are part of the same pharmacy chain dispense the same medication but source the medication from different manufacturers, which can drive different consumer pricing. Turning to Slide 23. Getting pricing rate is not easy. These are just some of the data and considerations we take into account when digesting and presenting prices to our users. Our price ingestion technology enables us to link with multiple sources spanning the healthcare industry. In addition, we have proprietary patented technology related to collecting and normalizing prices from multiple PBMs and presenting them using a single consumer interface. Displaying our prescription and location specific list of prices to each consumer in near real time requires a rapid processing of a significant amount of data, the use of complex predictive models and sophisticated software programming and design. We have spent a decade building the technology and relationships to allow us to collect and manage this data in a scalable way that is both accurate and provides for a delightful user experience. And like I said, it was not easy. Moving on to Slide 24. For the consumer, using GoodRx is easy as searching Google or Yelp, it is free to use, deliver significant consumer savings, improves health outcomes and benefits many players across the healthcare ecosystem. This simple and easy-to-use product has been key to our success. In addition to consumers, we also provide tools and deliver value to providers through GoodRx for providers, as you can see on Slide 25. Since our inception, GoodRx has supported healthcare providers to help patients. A significant portion of the users in our platform are providers and over 2 million prescribers have a patient who has used GoodRx. We have brand awareness of 88% among healthcare providers and 80% of HCPs recommend GoodRx to their patients according to a survey we conducted. Our strong relationships with providers are based on our mutual dedication to helping patients. We have created and plan to continue creating solutions providers can use to help their patients support to start and stay on their therapies. We offer providers digital tools to easily communicate savings to their patients. We provide access to real-time GoodRx prices. Our agreement with Surescripts is a great example of this. We provide them with educational materials that HCP share with their patients. We have in-office presence in over 400,000 physicians' offices. And we're continuing to work on enhanced functionalities and new features specific to healthcare providers, such as the ability to request drug samples or virtual pharma sales rep visits. Moving on to Slide 26. The value we deliver to both consumers and providers is evidenced through our strong NPS scores of 90 for each. These are not only high scores compared to other healthcare companies, but also relative to some of the strongest consumer-centric brands out there. We're also particularly proud of our 4.8 star rating on the App Store and Google Play Store from over 800,000 reviews as of the end of September 2021. We're obsessed with creating the most delightful user experience for both consumers and providers. Our focus on improving the user experience in healthcare drives everything we do. We're constantly asking our users about their healthcare pain points and then imagining ways to address them. We build relationships that turn a transaction into a relationship rooted in trust. Turning to Slide 27. As we have continued to extend the GoodRx platform, it delivers more value to consumers, providers and multiple other constituents in the healthcare ecosystem. From a consumer standpoint, it's all about access, simplicity and affordability. We've helped consumers save over $30 billion since GoodRx launched. And many times, we help people fill prescriptions they may otherwise not have filled due to cost. We also help them access telehealth services in a more convenient way and avoid long wait time for in-person visits. Providers and more generally, health care professionals want to get their patients to start and stay on their therapy quickly and efficiently, and GoodRx helps them do just that. Payers benefit due to reduced cost in the system. Pharmacies benefit from increased foot traffic and customer satisfaction. In a survey we recently conducted 85% of consumers surveyed said that their positive experience with GoodRx makes them want to return to their pharmacy and 80% of consumers reported that when they purchase secondary items, such as general merchandise or groceries when picking up a prescription, they spent an average of $40 or more at the pharmacy counter in addition to their prescription purchase. For PBMs, which we'll cover in more detail in the next couple of slides, we provide incremental volume at a high margin. Finally, manufacturers are able to leverage the GoodRx platform to reach more users, many of which are high intent and purchase ready and help them start and stay on their prescribed therapies. We believe that we deliver significant value to these constituents, making our offerings a win-win for all who are involved. Moving on to Slide 28. We are working to develop the most significant digital brand in healthcare, giving us the capability to deliver new services and improve care and affordability for Americans. We benefit from a powerful feedback loop that creates a hard-to-replicate virtuous cycle. As we've highlighted today, we've built a trusted brand with a variety of audiences and users, namely consumers and providers. With each new GoodRx consumer in every new transaction, our advantage in scale, data, and pricing power grows, enabling us to deliver better, more competitive prescription prices to our users through our PBM network. This improving pricing results in stronger consumer savings per prescription, which drives better unit economics over time through both user acquisition and lifetime usage of our products. These expanding unit economics support strong profitability, which in turn allows us to further invest in and extend our platform and expand our suite of products and services. This allows us to continue to build the leading digital platform from consumer healthcare and strengthen our brand and network with every transaction. Our success amplifies our opportunities. As we grow, we can further leverage our scale and data, allowing us to drive deeper consumer savings and higher usage. It also enables us to drive richer engagement and lets us expand our subscriptions, pharma manufacturer solutions and telehealth offerings and provide the platform for additional offerings also we can reach more consumers across the stages of the healthcare journey. We believe these advantages combined to create a deep competitive moat that would be difficult to replicate. Turning to Slide 29. By increasing adherence, we believe that GoodRx expands an already large market, which we plan to further penetrate over time. The prescription market was estimated to be approximately $360 billion in 2020 according to CMS data. As discussed earlier, up to 30% of prescriptions are left unfilled, with cost being the leading reason. By lowering the cost of prescription medication for Americans, we believe we can effectively unlock additional spend in an already massive market taking that $360 billion up to over $500 billion in annual GMV. The prescription market is expected to have annual growth of about 6% through 2028, and we believe that over time, we'll be able to capture more and more of it. There are 2 big reasons for that. The first being that, over time our scale has allowed us to deliver more competitive pricing and greater savings to our consumers. In fact, our savings rate compared to the usual and customary prices has increased from 59% in 2016 to almost 80% in 2020. This coupled with the fact that we believe insurance is becoming more complicated, more expensive and more restrictive over time positions us to address an increasing piece of the prescription market over time. Moving to Slide 30. We are empowering Americans with knowledge, choice and care they need to stay healthy regardless of income or insurance status. GoodRx helps both the insured and uninsured with about 3/4 of the people who come to our platform having some form of insurance coverage. According to the GoodRx [ effect ], a study we released earlier this year, GoodRx beat the average co-pay on a list of top drugs over half the time and in those cases, by more than 50%. Today, we are already helping many consumers with insurance, and we believe we have a great opportunity to do more in this space from an education awareness and user experience standpoint to address a larger portion of the insured population in the U.S. Turning to Slide 31. When a consumer presents GoodRx at one of the 70,000 pharmacies where GoodRx is accepted and saves money compared to retail prices at that pharmacy, we are in a fee from our PBM partners. That fee represents a portion of the admin fee that the pharmacy pays the PBM for the transaction. Our take rate represents the fees we earn as a percentage of the discounted price consumers pay at the pharmacy or GMV. Our take rate has increased from approximately 13% in 2016 to approximately 15% to 16% most recently, even with the acquisition of Scriptcycle. This increase was driven by a few factors. First, we were able to deliver more savings to our consumers, thereby reducing the price they pay for their medication at the pharmacy, basically shrinking the denominator. Second, we continue to increase our network of PBMs. At this stage in the life of our marketplace, we'd only add PBMs willing to provide even lower consumer prices. Otherwise, that PBM wouldn't get any volume, better economics to us or both. Third, many of our contracts have volume-based tiers. So as transaction volume increases, the users may save more and our economics improve. And fourth, as we have scaled our platform, we've been able to renew contracts beneficially. We believe that our take rate is fair and sustainable. We have great relationships with our PBM partners. And as mentioned earlier, our relationship provides value to both GoodRx and [ Ben ]. When you think about PBMs, they largely have a fixed cost structure, so they benefit from the incremental volume we provide them which, many times, generates profits at higher margins with no incremental marginal cost. Moving on to Slide 32. Our platform's strong repeat activity is driven by the typical refill cycle and long-term nature of most prescriptions. Since 2016, over 80% of transactions in our prescription transactions offering have come from repeat activity, which refers to the second and later use of our discounted prices by a single GoodRx consumer, whether refilling an existing prescription or filling a new prescription. Our high percentage of repeat activity is partially related to the inherent nature and mechanics of our product. When a consumer uses GoodRx at a pharmacy, the GoodRx information has saved the consumer's profile at the pharmacy. From then on, GoodRx will typically be applied to future refills as well as in many cases, fills for other prescriptions at that location without the consumer having to represent it at the pharmacy. For every refill, GoodRx continues to earn fees from our PBM partners, driving strong unit economics over time. Turning to Slide 33. The value of our prescription transactions offering provides to consumers has led to strong user growth over time. We refer to our users of this offering as monthly active consumers or MACs. MACs represent the number of unique consumers who use our prescription transactions offering to save money at the pharmacy in a given month. When presented for a quarter, it is the average of the monthly MAC number in each calendar month in the quarter. In the second quarter of 2021, MAX grew 36% year-over-year to $6 million. Slide 34 shows a more complete representation of the extensive reach of our prescription-related offerings with both the user base of our prescription transactions offering and that of our subscriptions offering reflected. As mentioned on prior earnings calls, users that convert to MAC or subscribers generally go through the same funnel when searching for prescription prices and if you choose the lowest price, they will often become subscribers without ever having been a monthly active consumer. This is mutually beneficial because we believe that both consumers and GoodRx benefit more when this happens. Since the consumer need and funnel are similar between both offerings, we encourage everyone to look at the combined growth of our MAX and subscribers to get a more accurate view of our growth in the prescriptions market, which was a torrid 40% over last year. Moving on to Slide 35. I'll now speak to the next offering, subscriptions, which is made up of 2 subscription programs, GoodRx Gold and Kroger Rx Savings Club. Turning to Slide 36. We are pleased with the growth of our subscription plans and subscriber counts over time, driven primarily by the rapid growth of GoodRx Gold. The subscription plan can represent more than one member as we offer family plans of up to 6 members for both Gold and Kroger. As discussed in our second quarter earnings call, our subscription plan count delivering strong growth of 86% year-over-year, reaching 1.1 million plans and making up over 1.5 million members. Our subscription offering as already scale business and extends our successful prescription transactions offering, which creates even more predictable revenue for us that addresses similar consumer needs and generally offers even greater savings on prescription medications. Other than the fact our subscriptions offerings deliver more value to consumers and generate higher value to us, which we'll discuss in further later, Gold especially allows us to have a tighter relationship with our consumers. When we started GoodRx, our goal was to provide consumers with an easy, simple and frictionless experience that will get them to the savings within a few clicks, and we've done exactly that. As we continue to deliver value and additional services to our consumers and build trust, we want to allow them to provide us with additional information to deepen our relationship with them and to create a more personalized and customized experience for them. With the subscription offering, we can do so and create a more delightful and valuable experience to our users. Moving to Slide 37. We are extremely excited about the growth of GoodRx Gold, which provides consumers with 3 key benefits. The first is prescription savings that is generally greater than the savings provided for our free-to-access prescription transactions offering. Over 1,000 prescriptions are available for under $10 with Gold with savings of up to 90% of standard list prices. The second benefit is a seamless home delivery service, which provides subscribers with the convenience of home delivery for a variety of prescription medications with no additional subscription cost. And the third is discounted access to our telehealth services. Gold subscribers can see a GoodRx care provider online for as low as $19. We added home delivery and telehealth benefits to Gold in 2020, and we plan to continue to add additional benefits and increase the consumer value for gold members over time with the goal of filling more gaps in our subscribers' health care journey. We believe that this increased value will further support the great momentum we've had with Gold over the last year, driving additional user acquisition and further improving LTV. The current revenue model for Gold is monthly subscription fees, $5.99 for an individual plan and $9.99 for a family plan. The other subscription program we offer is Kroger Rx Savings Club. We partner with Kroger to offer a tailored subscription product to Kroger consumers for an annual fee of $36 for individuals or $72 for family up to 6, which we share with Kroger. Subscribers access lower prescription prices at Kroger pharmacies, including over 100 common generic medications for free, $3, or $6, price points and savings on more than 1,000 other generic medications. On Slide 38, we wanted to address the relationship between the LTV of the MAC and the LTV of a subscriber. Based on the contribution figures we have seen to date for a subscription offering, which has been around for a shorter period of time when our prescription transactions offering, we believe that the LTV of a subscription is higher than the LTV of a MAC. On our second quarter earnings call, we disclosed our subscription revenue for the first time. If you were to calculate the subscription revenue per subscriber, you'd arrive at a number that is lower than our prescription transactions revenue per MAC. However, even though the in-period revenue per user figure may indicate that a MAC is more valuable to us than a subscriber, that figure does not represent the full picture. When comparing our revenue per user and prescription transactions to our subscriptions offering, remember that some of our consumers in the prescription transactions offering are chronic, where there is a significant monthly repeat activity from the first time they use it. Some of them have refilled every month, but some have refills every 90 days, so they come back every 3 months after a short dormancy period. Some of our consumers are acute or episodic where that's not the case, and they may only use this on occasion, meaning MACs come in and out of the number at any given month quarter. When you compare that to the subscription offering, subscription fees are paid every month essentially or in the case of Kroger, a year upfront, and we believe that consumers drive much value and satisfaction from those planned, whether through greater savings on prescriptions or the telehealth and mail benefits offered through Gold. So rather than comparing the in-period revenue for prescription users versus subscriptions, look at revenue or LTV over a series of months or quarters, taking frequency into account. Another element to consider is that many of our subscribers also contribute to our other revenue line through telehealth as they use our discounted care services. We're excited to continue to add more value and increase cross-sell across our platform in the future. To summarize, we believe that subscribers have a higher LTV than MAC. As mentioned, we also have a much tighter relationship with subscribers, which should provide us with better opportunities to cross-sell additional services to them in the future as we continue to extend our platform to cover more and more consumer needs, further increasing their lifetime value. Moving on to Slide 39. I'll now speak to the next offering, Pharma Manufacturer Solutions, which helps consumers with brand drug affordability solutions and allows manufacturers to reach a high intent audience looking to get on the therapy. Turning to Slide 40. Pharma Manufacturer Solutions is GoodRx's fastest-growing offering with the most attractive economics. This compelling suite of solutions creates a highly effective way for pharma manufacturers to reach patients and providers, leveraging our millions of monthly visitors made up of both consumers and health care providers as well as the 20% of searches on our platform that are for brand drugs. In fact, our analysis shows that among the top 100 branded medications, GoodRx has an average of 10x more traffic to the drug savings page for these brands on our platform compared to the same brand savings pages on the manufacturer's owned websites. As a reminder, branded medications present consumers and HCPs with a unique set of challenges when compared to generic medications as they are often much more expensive with or without insurance. To help address this, we built pharma manufacturer solutions to partner and innovate with drug manufacturers. In the last 2 years, we have scaled this offering rapidly, growing year-to-date revenue nearly 3x year-over-year with highly attractive economics and delivering over 150% net revenue retention, meaning we have grown revenue from the same clients more than 50% compared to the same period last year, a statistic we're very proud of and that we believe evidence is the value we provide manufacturers. We work with 19 of the top 20 U.S. pharma manufacturers and with approximately 100 brands across the more than 550 manufacturers in the U.S. Approximately 85% of the revenue related to this offering is substantially flat fee based, making the revenue model both very attractive and highly predictable. More specifically, our substantially flat fee-based model consists of fixed commitments that are paid over the term of the agreement. Turning to Slide 41. What we're best known for a decade's worth of experience saving consumers' money, we've also built broad and deep relationships with providers. Our GoodRx for providers users appreciate our easy-to-use solutions that help their patients afford to start and stay on their therapies. 25% of the visitors to our website are HCPs based on an internal survey, and more than 2 million prescribers have a patient who have used GoodRx. As mentioned earlier, our surveys show we have built our brand awareness among healthcare providers up to an impressive 88%, with 80% of providers recommending GoodRx to their patients. We also found that 93% of healthcare providers see their patients' access to medication improved when using GoodRx and 87% said their patient's adherence increased. This translates to a high Net Promoter Score of 90 from healthcare providers. We believe our trusted brand, increasing scale and reach and deep relationships with stakeholders throughout the healthcare ecosystem uniquely positions us to be the leading healthcare platform to connect healthcare providers and their patients with pharma manufacturers information, access and affordability solutions. We continue to help consumers financially saving them over $30 billion to date. This is not just about saving consumers, be the uninsured or insured money. For many, this is often the difference between someone's ability to start or stay on their medication. We do all of this in a seamless, intuitive way for consumers, leading to a very high Net Promoter Score of 90. All of these dynamics offer an unparalleled platform for pharma manufacturers to reach the bottom of the funnel, reaching both highly engaged healthcare providers and consumers who are searching for affordability solutions. Looking at Slide 42. Let's set the stage with the problem. Brand medications tend to be expensive and insurance coverage is often complicated and restrictive. 69% of consumers have made personal sacrifices in order to pay for their medications and 70% of HCPs cite high cost of the primary reasons patients do not pick up prescriptions. Pharma manufacturers spend an estimated $30 billion annually to address these and other challenges, either to consumers directly or via health care providers. Even with this large spend, these challenges persist and manufacturers are looking for ways to more effectively improve this dynamic. Several factors, not just COVID, have exacerbated the challenges for manufacturers and shifted the way in which they communicate with HCPs. As of September 2020, in-person HCP pharma sales access has fallen by 70% when compared to pre-pandemic levels. As a result, manufacturers are shifting their spend from off-line to digital channels, manufacturers' ability to digitally reach their intended audience is hindered by changes in the Internet advertising landscape, such as changes regarding IDFA and the move to a cookieless world. HCPs are critical not only because they make the prescription decisions but also as a key resource for helping patients navigate difficult and often stressful decisions throughout the patient journey. Costs are going up. Branded medications have increased 78% since 2014. Up to 30% of all prescriptions are left unfilled due to cost. While many manufacturer-sponsored programs exist, patients have low awareness of their existence and thus their utilization is very low. Further, these challenges also impact HCPs. They know affordability is a critical topic for their patients and providers and their staff spend significant administrative time, 14.6 hours every week, navigating administrative tasks related to drug access and/or trying to help their patients get access to these programs. Moving on to 43. Pharma manufacturers deploy strategies along 3 key stages of the patient journey: awareness, access and adherence. They deploy their awareness strategies through an array of channels with decreasing efficiencies given some of the deployment challenges we just discussed. To improve access, manufacturers have developed strategies primarily focused on affordability. These programs include co-pay cards, which buy down a commercially-insured member's co-pay amount funded by the manufacturer. In addition, they provide sample drug programs and operate large call centers to help address challenges patients and physicians face. Manufacturers are also heavily focused on increasing adherence along a holy grail in the industry. While forgetfulness can play a role in adherence, it is more commonly overshadowed by how people feel once on their medications and questions about whether they should remain on therapy. Pharma manufacturers have been working to solve these challenges for quite some time and have deployed both digital and call center-based solutions to try and address non-adherence. Turning to Slide 44. GoodRx understands the patient journey given our extensive experience in the prescription market. With that knowledge is our foundation. We've been reimagining the way patients and HCPs interact with the health care system. We currently offer 8 solutions across the awareness, access and adherence patient journey and continue to innovate more solutions. These offerings are data-driven and draw from a decade worth of insights and learnings about our consumer and HCP audiences. By leveraging the reach of our platform, which has had almost 20 million monthly visitors year-to-date, GoodRx's audience has the attractive profile that manufacturers seek to reach. Our awareness solutions primarily focus on targeted high-quality content. GoodRx is a highly regarded editorial team focused on prescription medications whose work consistently ranked from the top of search results. Written content is a great solution for many consumers, but we also recognize that consumers are increasing leveraging videos a medium to explore and digress content, hence, we recently acquired HealthiNation. With its award-winning staff and extensive library of premium clinician reviewed videos, HealthiNation complements and deepens our capabilities, offering highly relevant and credible video content shot with experts in their respective fields and spanning more than 90 and 150 health categories. GoodRx now offers pharmaceutical manufacturers numerous ways to leverage highly relevant content to help drive their awareness initiatives. Turning to access solutions, as our site visitors navigate to find drug savings, we offer pharma manufacturers an ability to fully integrate their affordability programs via our easy-to-use patient navigator platform, driving both engagement and utilization. Our adherence solutions offer manufacturers the ability to leverage their direct communications and deliver relevant data-driven ways to help patients get on and stay on therapies. These solutions include text and e-mail messaging as well as technology-enabled nurse chat functionality to address adherence challenges patients face. Moving on to Slide 45. By driving awareness, access and adherence with our multichannel approach, we help health care providers who use GoodRx in their patients achieve better outcomes. Manufacturers are able to encourage use of their innovative and life-saving products and services, increasing LTV at a compelling ROI. By way of example, 2020 programs with one of our customers, a top 20 manufacturer, delivered them an ROI of more than 8x across 5 brands. Our net revenue retention with that customer is 170% year-to-date. With the help of GoodRx, consumers are able to easily find authoritative educational resources on medications and conditions, including written and video content. Our visitors can also seamlessly access integrated savings and support solutions such as VR work with Sanofi, a top 10 manufacturer, which encompasses the Sanofi portfolio of insulin branded drugs and leverages our patient navigator access and affordability integration, enabling a consumer to find, register and receive the savings programs from the manufacturer that can be used at any pharmacy. Commercially-insured members pay as little as $0 while uninsured patients pay a $99 cash price for Sanofi branded drugs. This is a great example of our ability to help both uninsured and insured patients. Additionally, health care providers see multiple benefits were a highly valued resource where they recommend to their patients trusted educational resources and affordability solutions. This both reduces time spent searching for information on their patient's behalf while also increasing the chances of medication adherence. All said, we're focused on offering extremely effective solutions that deliver value to manufacturers, consumers and health care professionals. Turning to Slide 46. While we are proud of the tremendous progress, we believe we are still at the early stages of the pharma manufacturer opportunity. Today, we have relationships with just 10% of the estimated 550 manufacturers serving the U.S. market, creating an opportunity for us to continue to scale. We made the strategic decision to target the top 20 pharma manufacturers as we estimate they represent almost half of the $30 billion TAM. We are proud to have successfully secured relationships with 19 of the top 20 manufacturers and have already set our sights on the enormous upside potential ahead as we continue to penetrate these accounts to increase our 4% sell-through of the roughly 1,000 brands represented in this cohort. We also have an opportunity to increase the number of solutions each brand deploys with us. Currently, our customers average 3 solutions per brand, up 2x year-over-year. We also are investing in innovating and increasing the number of solutions we offer. We are excited about the trajectory of pharma manufacturer solutions. It is not only the fastest-growing offering, but also has the most attractive economics at GoodRx, and we believe we are in the early innings. We believe we have significant opportunity to not only further penetrate the top 20 pharma manufacturers, but also into the long tail of 500 or so other manufacturers. We believe we are well positioned to capitalize on the macro shift to an increasing digital mix. Pharma manufacturers increased their digital ad spend by 43% in 2020, and we look forward to helping even more manufacturers and more brands support both patients and their physicians through the health care journey. Moving on to Slide 47, I'll now speak to the final offering, Telehealth. Turning to Slide 48. As mentioned earlier, we entered into telehealth through our 2019 acquisition of HeyDoctor, which we have since rebranded as GoodRx Care. One of the reasons we went into Telehealth was that we learned that 20% of consumers searching for prescriptions in our platform don't have an active one on hand, and we wanted to help them get appropriate treatment from a health care provider in a consumer-friendly way within the GoodRx ecosystem. GoodRx Care allows us to do so and continues to be a growth engine for us with a strong user experience. Care, which is now available in all 50 states, focuses on low-cost prescription associated conditions and access a lower gross margin marketing vehicle that provides another entry point for consumers to access our platform, allows us to be with consumers at a critical point in their health care journey, and drives incremental volume to our Prescription Transactions, Subscription and Pharma Manufacturer Solutions offerings. The rebrand from HeyDoctor to GoodRx Care in combination with the continued work on cross-platform integrations and a unified user experience are delivering strong results. With over 40% of Telehealth visits now converting into Gold subscriptions. More broadly, approximately 60% of Care visits are driving incremental revenue through our other offerings, up from 30% earlier in the year. We believe these types of cross-platform integrated experiences will continue to enhance our ability to cross-sell going forward, increasing the stickiness in LTV of our users. From a revenue model standpoint, other than driving incremental revenue in our Prescription Transactions and Subscription offerings, we make money through visit fees as low as $19 for Gold members and $39 for others, and home delivery service fees of $6 per delivery. I'll now turn the call over to Arik to speak to the monetization of our offerings.

Thank you, Karsten. Moving on to Slide 49, which provides a summary of the revenue model for each of our offerings. We make money in our Prescription Transactions offering by earning a portion of the PBM admin fee, which is paid by the pharmacy to the PBM every time consumers use GoodRx to save money on their prescription medication. We make money from our Subscriptions offering through monthly Gold subscription fees in the share economics from our partnership with Kroger. For Pharma Manufacturing Solutions, the revenue model is based on fees paid to us by manufacturers for the awareness, access and adherence solutions we provide them. Finally, with GoodRx Care, we earn fees related to Telehealth visits and Mail Delivery. Turning to Slide 50. GoodRx offers a rare combination of high revenue growth and profitability. Our revenue CAGR was 54% leading to 2020 with strong revenue growth continuing through COVID into 2021, most recently delivering 43% year-over-year growth in the second quarter. And we've been able to deliver this top line growth with attractive margins and strong EBITDA growth over time. Our adjusted EBITDA margin was 41% in 2019 and 37% in 2020. In spite 2021 being an investment year for us, focused on platform and brand investments and laying a foundation for incremental growth in the coming years, we've been able to deliver an adjusted EBITDA margin of over 31% year-to-date through the second quarter. Turning to Slide 51. We feel incredibly optimistic about each of our offerings and our platform as a whole. As you can see on this slide, our business has continued to deliver strong results and create a variety of growth opportunities. Since we've talked about some of these points, I will just recap a couple of bullets: the nearly 20 million monthly visitors who interact with our platform; over 40% growth in our prescriptions-related operating; approximately 3x year-over-year growth of Pharma Manufacturer Solutions; and finally, 60% cross-sell from Telehealth to our other offerings. We believe we not only have ample runway to grow each of our existing offerings, but also the resources, experience and trusted brands to continue to add services to a highly extensible platform with a goal of reaching more users and improving unit economics, whether organically or through M&A in partnership. I'll now turn the call back over to Justin to close.

Thank you, Arik. Moving to Slide 52. We are so excited to be working to develop the leading digital brand in health care that gives us the capability to deliver new services and improve care and affordability for Americans. Our success amplifies our opportunities. As we grow, we can further leverage our scale and data, allowing us to drive deeper consumer savings and higher usage. It allows us to drive richer engagement and lets us expand our Subscriptions, Pharma Manufacturer Solutions and Telehealth offerings, and provide the platform for additional offerings, also we can reach more consumers across the stages of the health care journey. I'll conclude on Slide 53. At GoodRx, we know there is a better way for Americans to navigate their health care, and that is what drives us as we build the leading digital platform for consumer health care. Transparency and trust continue to be core to our platform. Taking a consumer-first approach is always top of mind. This is how we have fundamentally disrupted the health care industry, and it continues to be a guiding force behind our product innovations. We believe macro trends drive the need for our solutions and technology. One such macro trend is the shift to digital, which we believe we are uniquely positioned to capitalize on, especially through our Telehealth and Pharma Manufacturer Solutions offerings. We believe our first-mover advantage, Doug and Trevor have been doing this for over a decade, and our strong industry relationships, including our work with HCPs, created deep competitive moat. Every transaction reinforces our value proposition to the ecosystem and strengthens our network. We have a unique combination of scale, high growth and profitability, and we are excited by the opportunity to become the leading digital health care platform in the U.S. We are incredibly proud of the effort and dedication of our team and the ability to relentlessly innovate and reimagine the future of health care. We are empowering Americans with the knowledge, choice and care they need to stay healthy, regardless of income or insurance status. We've made tremendous progress over the past decade, but it's just the start. We believe the runway and opportunities we intend to capture are massive. And with that, we'll turn it over to Q&A. Whitney, do we have any questions?

Yes. Thank you, Justin. If you would like to submit a question, you can do so using the built-in Ask a Question feature in the webcast player. As a reminder, no new financial information or projections will be discussed on today's call. We thank you in advance for your cooperation. Our first question is, what exactly is GoodRx Health? And what is the rationale behind the launch of GoodRx Health? Justin, would you like to address that?

Sure. Thanks, Whitney. So we're extremely excited about the launch of GoodRx Health, our next-generation online health resource where doctors, pharmacists and health care experts provide authoritative answers to thousands of [ health-related ] questions. Millions of users already come to GoodRx every month looking for health information, and by adding GoodRx Health to our portfolio of resources, we aim to help consumers at every stage of their health care journey, from diagnosis to treatment and care. GoodRx Health allows us to reach more people in more ways through content that empowers them to be advocates for their own health across a range of decisions. When clinical care is needed, consumers can use our Telehealth platform to see a physician regardless of insurance status. And when consumers need more affordable prescriptions, we can help them through our prescription transaction offering, our Subscription offering and the integration of our Pharma Manufacturer Solutions from the site. Our goal is to help fill gaps in care and deliver strong savings, trusted information and access to care for all Americans. The 4 main areas that GoodRx Health is focused on is: Health Knowledge, where we dive into medical research and scientific literature to address common health questions; Financial Guidance, where we provide resources on costs, savings and insurance coverage to help consumers make smart decisions about their money and their health; Drug FAQs, which are straightforward answers on medications; and Trustworthy Research, which is our -- which we've been doing for a long, long time about drug prices, fill trends and other pieces of the U.S. health care system so that consumers can understand it better. We deliver this information unique format to ensure that consumers can quickly find the information that they need through GoodRx Answers, Health Assistance, Health Debugged and thousands of different video explainers.

Great. Thank you, Justin. Our next question is, given the high manufacturer penetration with the top 20 manufacturers with the low brand penetration, a question that we often get is, how long does it take for a manufacturer to go from one brand to a second and a third and beyond? Karsten, do you like to take this one?

Sure. Thanks, Whitney. I'm pretty excited about Manufacturer Solutions as the CFO, because it's our highest growth business and it also has incredibly high margin. The only real incremental cost of it as selling costs, which, for me, is just great. Our Manufacturer Solutions offering continues to grow this rapidly because we're leveraging our scale and reach to help reduce the cost of brand prescriptions to all Americans and hitting both health care providers and patients. There are a number of ways that we plan to continue to grow the business going forward. We can establish relationships with the 90% of manufacturers we don't currently work with, so primarily those outside the top 20. We can increase the number of brands within each manufacturer we're currently working with, which is what the question went to, and we can increase the number of solutions that we offer to each brand. So talking about those things in order, we believe the largest and most immediate opportunity is increasing our brand penetration with the top 20. We're proud to have successfully secured relationships with 19 of the 20, and we see strong upside potential ahead as we continue to penetrate these accounts to increase our 4% sell-through of the roughly 1,000 brands that are represented by the top 20 manufacturers. Selling within our existing pharmaceutical manufacturer customer base to more brands is working, as evidenced by our 150% plus net revenue retention rate. We also find that most of our customers want to see results of the first brand they launched with us. And usually within 3 to 4 months, they have enough data to assess ROI and effectiveness, and they're ready to start discussing opportunities with many more of their brands. Then on average, it takes a couple of months, maybe 3 months to fully contract and add on those additional brands. We're excited about the opportunity to penetrate the top 20 further. They represent about 50% of spend, we believe, both with more solutions where we currently work with them and new brands as well. But let's not forget the long tail of 500 or so other manufacturers as well that we continue to focus on.

Great. Thank you, Karsten. Our next question is, could you walk us through how your Manufacturer Solutions contracts are structured? We'll turn it over to Arik for this one.

Thanks, Whitney. So as Karsten mentioned earlier, we provide manufacturers with and they pay us for awareness, access and adherence solutions. Approximately 85% of our deals are substantially flat fee deals. And then the remaining 15% are on a more traditional volume-based model. When you think about flat fee structure, that's really one of the reasons that we have such a sticky engagement with our pharma -- our customers and also one of the reasons that our net revenue retention is so high, over 150%, as Karsten just mentioned a couple of minutes ago. Our fee model typically may include a setup fee, a monthly fee that is paid monthly over the term of the agreement, and can also include performance incentive, which will perform above a certain base level. And it takes into account -- the pricing model takes into account many variables, including expected engagement for a specific drug. The price of the drug or reach through online and offline channels, like the presence we have in hundreds of thousands of doctor offices in the U.S., and then finally, the estimated conversion rate on such channels. We then take all these variables, and by calculation that contemplates a targeted return on investment for the pharma manufacturer and create a substantially flat fee deal that gets them to their targeted return, and that's typically for an initial period of 12 months, which is often extended beyond that.

Great. Thanks, Arik. Our next question is, does GoodRx receive a portion of the PBM admin fees when a Gold or Kroger subscriber uses a GoodRx coupon? Arik, do you want to take this one?

Yes. Thanks, Whitney. So we're very excited about the great momentum we have had with our Subscriptions offering. Just a reminder, in the second quarter, we grew the subscription count almost 2x year-over-year, and then revenue grew even faster at 125% year-over-year growth. For Gold, we only earn monthly subscription fees of $5.99 for individual plan and $9.99 family plan, so we earn no admin fee. And then for Kroger savings, there's no PBM involved. So there's no PBM admin fee essentially. Even without us earning a portion of the PBM admin fee for the subscription plans, they still generate a higher contribution for us over the long term, because of the higher frequency of monetization compared to our Prescription Transactions offering. So Karsten ran through an example earlier in the presentation, explaining exactly how that works. And then outside of monetization frequency, one thing that's really important to mention is that subscribers also allow us to have -- subscriptions also allow us to have a tighter relationship with consumers. They provide us with more information. We can create a more personalized experience for them. And what that means is that over time, we should be able to offer them more services, both existing services and new services as we continue to expand the platform.

Great. Thanks, Arik. Our next question is, given that the PBM market is concentrated and GoodRx growth that may cannibalize PBM, other profitable channels, what is the risk for PBMs to negotiate better terms with you? Justin, do you want to take this one?

Yes. Thanks, Wendy. So first of all, we have very strong relationships with our PBMs, many of which are a decade long. We've continue to expand the number of PBMs that we work with. In fact, we've had several this year. And when you look at PBM concentration, the top 2 PBMs that we worked with in 2019 accounted for 47% of revenue, whereas the top 3 PBMs in 2020 accounted for just 42%. So you can see concentration continues to decrease. PBMs that work with us are effectively choosing to participate in our growing marketplace or not participate at all, which would effectively allow consumers to work with other competing PBMs. So when we think about our relationship with PBMs, it really comes down to the fact that we have dominant market share in the areas that we play. We have a really strong brand and a significant number of consumers coming to our site, almost 20 million monthly. And that scale really positions us well in partnership with our PBMs. As we get larger, the desire to partner with us just grows. An evidence of our strong position is both our increased savings rate as well as increasing economics. Similarly, a question came in on take rate, and it relates to an earlier comment on how much scale matters at any given time. We've been able to increase consumer savings roughly proportionately to our take rate. Savings went from 59% in 2016 to almost 80% today, and our take rate went up from the low teens to 15% to 16% today. So growing in proportion. And as we continue to scale, I think that we'll continue to deliver significant value.

Great. Thanks, Justin. Our next question is, can you discuss why pharmacies can't set their own cash pay prices, or why a retail pharmacy can't price match GoodRx price? Justin, would you like to take this?

Sure. Yes, I think this is somewhat straightforward. So pharmacies set retail prices that tend to be quite high since they cannot receive any reimbursement from insurance and government that is more than that retail or list price that they set. And any cash price that is set by a pharmacy that is lower is interpreted by government payers or insurers as the list price. So effectively, any cash price that a pharmacy set that is low is [indiscernible] reimbursement across all payers. And if they were to price match GoodRx effectively would be lowering reimbursement for all payer contracts across the board, which makes it very costly for retailers to have really low cash prices and why you don't see that as a common practice.

Okay. Great. Thank you, Justin. All right. Our next question, what has been the most effective marketing channel? Has there been any impact to marketing strategy or ROI as a result of IDFA? And then you mentioned adjacent categories that GoodRx can grow into. What are the biggest areas of health care that you believe are untapped by GoodRx today? Karsten, do you want to take that one?

Sure. Yes, I'd love to. I think, first of all, in terms of the most effective marketing channels, for us, unpaid has always been the biggest channel that we have. And of unpaid, the significant component is made up of health care providers. I think folks who are familiar with the company now probably know that we have a significant number of health care provider visitors to our platform. That's grown since I think we quoted it last up to about 25% today. And those health care providers a significant proportion of them in turn recommend GoodRx to their patients, about 80% or so of them. I think I should also underscore here that the NPS as we have with both health care providers and consumers hover around 90%. So with those high Net Promoter Scores, they're promoting us in a fairly consistent way. And they've also requested that they get GoodRx materials. For example, GoodRx collaterals sent to them to keep in their doctors' offices, about 400,000 or so offices across the U.S. have these kinds of collateral materials in them. So unpaid for us is absolutely key. It's one of the big reasons that we are grateful that the evolution of COVID has been as it is and that health care has returned and reopened in a manner that is now starting to approach levels that existed in the pre-COVID times. I think along with the health care provider channel and unpaid, we continue though to focus on various other channels, too. Many of you will have seen our TV ads, which continue to be valuable to us. Many of us will have -- many of you have likely also seen some of our other marketing methodologies that are paid. I think what's interesting, though, is our marketing teams don't just focus on how to deploy marketing dollars against vehicles. What's also really interesting is they focus on audience creation. So we look at portions of the American consumer community where GoodRx may have the ability to penetrate much more deeply than it is today. And when we do that kind of work, we often find that we're underpenetrated in a certain segment or in a certain area, and then we can leverage those and get great opportunities to increase new users at relatively low CAC. An example of that is we saw are underpenetrated in certain Medicare communities, and we're able to leverage even older technologies, things like direct mail, in a way that was very positive for us. So we're constantly evaluating different ways to market more effectively in conjunction with constantly reinforcing our relationships that drive the unpaid marketing as high as it's gone. I think to the second question, I think it's probably a question around adjacencies broadly and where GoodRx can expand into from the perspective of marketplace and other areas. And I think here, we've, in previous calls, talked a little bit about the topic. Again, given we're in the quiet period, we don't want to lay out too much product road map right now. But we've consistently talked about things like, for example, radiology, where there are opportunities like in the core pharma market to be able to offer more price transparency for users who are often paying ratios of 10x more or 10x less in the same geography for very, very similar services. Lab work is another example that we've talked about in the past in this way, too, especially as lab work shifts from being served solely in brick-and-mortar to being served in other mechanisms, including online. So those are some of the things we think about today.

Great. Thank you, Karsten. Our next question is what type of monetization opportunities are associated with GoodRx Health? And more specifically, how does it support your Pharma Manufacturer Solutions offering. Arik, do you want to take this?

Sure. Thanks, Whitney. So as Justin said earlier, in the first answer, we really believe that the addition of GoodRx Health to our platform allows us to help more consumers through their health care journey. Or in other words, it really helps us in -- support the increased offer [ final ] traffic and to drive long-term growth across all of our existing offerings and our future offerings as well. At a high level, what we really are trying to do here is to build relationships with more consumers and providers pre-transaction. Not everybody has a prescription at hand or needs to see a physician when they come to our platform. But if we can help those users in other ways through information, insights and useful tools, then we start building a relationship with them early in their health care journey, and that should drive long-term value, both to them and to us. Specifically for Manufacturer Solutions, I think that was a part of the question. So first, we're very excited about the growth and momentum we've had with this offering over the last few quarters. We do think there's a big opportunity here to leverage content to help consumers and providers navigate the complex world of brand medication, and increase awareness, access and adherence. And GoodRx Health is absolutely a part of that content strategy. I'll add to that, that additive to this content strategy is also HealthiNation, which we acquired earlier this year. As a reminder, HealthiNation offers a comprehensive library of thousands of premium videos on a wide range of health topics. And that really makes a great platform for pharma manufacturers to reach a targeted audience and [ high-return ] consumers. So when you think about the investments we've made, both with GoodRx Health and HealthiNation and other investments we're making across the platform on product, we think that's really going to help us to continue to drive growth in Manufacturer Solutions going forward.

Great. Thanks, Arik. Our next question is around Manufacturer Solutions as well. Looking at the mix between awareness, access and adherence solutions that you provide, what are you seeing getting the most traction? And how do you see this solution that evolving over the next 3 years? Karsten, do you want to take that one?

Yes, I can take that one, Whitney. Yes, as Bansi talked about in our Manufacturer Solutions deep dive on our prior earnings call, the solutions we offer span awareness, access and adherence. But to the question, today, the weighting of those solutions and the utilization of them is towards access and awareness, slightly more than adherence. So going in reverse order, the adherence solutions are, in our view, some of the most valuable ones. And they provide sufficiently high ROI to manufacturers so that even higher manufacturer cost offerings, things like being able to connect through GoodRx with nurses to do live nurse chat, to have questions answered on behalf of patients by nurses, either as it relates to administration of a particular medication or interactions of that medication with others, that forms a significant part of our business. But the more significant parts related to things we're doing around access, and that's also super core to our mission, of course, because in generic drugs and lower-priced branded drugs, the traditional GoodRx prescriptions offerings, which saves us, Justin and Arik talked about earlier, nearly 80% off list prices, that serves people very well. But when it comes to high-priced branded drugs, even taking 80% off a $2,000 drug makes it -- puts it outside the reach of many consumers to be able to afford it on a cash pay basis, and that's where the Manufacturer Access Solutions come in. So we've built things like our patient navigator and care portals for example, which manufacturers can sponsor in the care portal context or be actively involved in the patient navigator context to help the patients actually be able to self-serve their way into manufacturers, cost-saving access solutions, co-pay and deductible assistance. And what we've seen is that because for a significant number of the top branded drugs, GoodRx gets way more traffic on its properties than the branded drug manufacturers do themselves. I think we quoted 10x GoodRx properties versus manufacture properties. We're able to drive a lot more volume their way. And the reason that's so important is it's estimated only about 3% of the people who could benefit from these manufacturer access solutions do. And that's where we and the partner to increase that number. And the reason they are so eager to do that, of course, is getting people on medication when many of these medications are chronic, and folks who will be taking them for years and years, maybe for life, is imperative to manufacturers' business models and imperative to keeping the consumers healthy. Finally, hitting awareness. Awareness is the kind of offerings that are more commonly associated, I think, with Internet advertising more broadly, things like sponsored listings, things that are being tied to search and things like fixed placement. So that's also a solution that we offer as many others do as well. And it's very easy for manufacturers to calculate the ROI on awareness size solutions, which makes it a good starting point for them in many cases.

Great. Thank you, Karsten. Our next question is how many PBM partners did it take until you saw true scale in your network? Justin, do you want to take this?

Sure. I think that, first of all, we have over a dozen PBMs today. As I mentioned earlier, that number continues to grow. If any one PBM were to choose to leave the network, which, by the way, no PBM has ever turned an agreement with us, the savings and take rate would barely move at this point. So there's some amount of benefit that you get by having a broad network, but the network is so broad today that I think that there's a material amount of overage that we have from sort of any point of criticality. And I think it's also important to mention, we've gotten a number of questions about PBMs today, but we also have amazing relationships with retailers. We talk to retailers every day. PBMs are just a conduit to those retailers. And we also have significant scale and direct programs that we do with a lot of retailers, the Kroger savings program, for example, and plenty of other retailer programs. So I think that we'd be remiss to just focus on PBMs as our conduit to the market. Really, it's a multifaceted market, and we have some really, really strong relationships across the board that serves very well.

All right. Thanks, Justin. Our next question is around the evolution of our Pharma Manufacturer Solutions offering over the next 3 years? Karsten, do you want to touch on that?

Yes. I think that was part of the prior question. I just didn't do a good job of hitting it with me. So sorry to you and sorry to whoever asked as well. I talked a lot about where the center of gravity was today around access solutions and awareness solutions. But I think when it comes to the future, we expect to see adherence grow significantly. And one of the reasons, as we've talked about in the past is that we have such rich data. So because we can see a particular associate, a particular prescription to a particular user and a particular provider, that has a lot of opportunities for us. On the one hand, it allows us to do things like leverage data to help people in future get on great insurance plans, like we talked about, because if you know, or in this case, we know, what providers you work with, what medications you're on, what pharmacies you pick them up at, that gives us great data to help navigate you into, say, the perfect Medicare plan for you or at least the best of the options available to you. It's also leverageable in an adherence context, too, because if we see you no longer filling a particular prescription that we recognize as chronic and a prescription that you should be on the long term, it gives us an opportunity to help that particular patient, make sure that they have the economic support potentially from manufacturers or from us, depending again whether it's something served through Prescription Transactions offering or a Manufacturer Solutions offering. And we have the ability, like I talked about in the case of the Nurse Chat feature, we have to support them on things like the ability to actually administer. And also really talk a little bit about HealthiNation here, too, because HealthiNation was a great acquisition for us. One of the things that does, for example, and you can find this on our site, is it provides details on how you can self-administer injectables. A lot of people who first get an injectable prescription, whether it's for rheumatoid arthritis, something like an Enbrel or Humira or whether it relates to diabetes, don't necessarily know how to self-administer. So by having excellent physician created or physician refereed content out from entities like HealthiNation that we own, it provides help both to the patient and actually the provider too. The patient can access the information to learn about how to self-administer and stay adherent, but the provider benefits too because the provider can point the patient to that resource, thereby saving themselves a significant amount of time. I think the other thing I'd stress is that generally in our Manufacturer Solutions offering, they are intend to be very provider-centric as well. We cited a stat in the last earnings call that about 14.6 hours a week or spent by providers trying to get patients on medication. That's a sense overhead for our provider. And if we can shrink that down helps patients stay healthier, makes providers happier, and ultimately, it makes our strongest marketing channel, which is the providers and unpaid, makes that even stronger and reinforces it further.

Great. Thank you, Karsten. Our final question today is, let's see, I am a stockholder and a long time happy GoodRx customer, but I'm amazed that your market share is still in the single digits. Can you help explain why that might be? Karsten, do you want to take that?

Yes, happy to take that one. And happy that some on the call is a stockholder and the long-term GoodRx customer. That's a nice combination and we're excited to hear it. I think the important thing to note on market share is relative market share. So we believe that we're roughly 5x bigger than our nearest competitor in the prescription discount space at least, so as it relates to our Prescription Transaction and Subscriptions offering. And the reason that's so important that we're about 5x bigger than they are, is that scale matters in this business. And since we're both bigger and growing faster, that means that we can have better pricing for users, attract more PBMs to our marketplace, have more prescribers who recommend us because they're confident they're going to be recommending the entity that has lower pricing that works at over 70,000 pharmacies in the U.S. And scale begets more scale, as you've basically seen with us, we disclosed we added 2 more PBMs to our marketplace just in the last quarter, and we wouldn't have done that, but for the fact that they're offering better pricing on parts of their formulary than we previously had, which allows us to save customers and consumers more money and allows us to increase, in many cases, our own take rates too. So we feel like we have a lot of upside because even though we're the biggest player and about 5x bigger like I said than the nearest competitor, the real competition is people who just don't know that prescription prices vary. Our study show that about 70% of people don't know that you can shop around for prescriptions and even fewer know that you can save money using tools like GoodRx. So that really defines a huge amount of white space ahead of us and really defines why we're investing so much in marketing and education, both direct to consumers on the paid side and via health care providers. We think it's ours to take, and that's why we believe that we're going to be able to continue to grow the Prescription Transactions offering and Subscriptions offerings we have as quickly as we've showcased. Like when you look at it both on a revenue basis or an account basis, if you look at the 7.5 million, roughly 1 million people who benefited from either prescription transactions or subscriptions offering, that's up roughly 40% year-over-year from where it was last year. And that number is a number that given the white space that I've just talked about, we think we'll be able to continue to propel going forward as well. So we're pretty excited about that.

All right. Thank you, Karsten. And thank you to everyone for joining us for this Educational Webinar's day. We hope you have a great rest of your day.

Ladies and gentlemen, that does conclude our conference for today. Thank you for your participation. You may now disconnect.