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Amazon's RxPass Shown to Improve Days' Supply, Refills, and Out-of-Pocket Costs for Common Medications
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Key Takeaways
- RxPass, a $5 subscription service, offers Prime members access to 60 generic medications, improving affordability and adherence for those on multiple medications.
- A study found RxPass led to a 27% increase in days’ supply, 29% increase in refills, and 30% decrease in out-of-pocket costs.
Amazon Pharmacy’s subscription service could cause sale disruptions for traditional retail pharmacies.
RxPass, Amazon Pharmacy’s subscription service for common medications, has demonstrated significant improvements in medication adherence and out-of-pocket cost reductions, according to research published in JAMA Network Open. However, RxPass could disrupt traditional retail pharmacies, making it difficult to compete with Amazon Pharmacy’s business model.1-3
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Amazon Pharmacy launched in 2020 as an online service that allows customers to complete their entire pharmacy transaction online with the Amazon app, using a secure pharmacy profile. With the launch, Amazon Prime Members were granted access to automatically receive unlimited, free 2-day delivery on their orders, along with a prescription savings benefit when paying without insurance. Additionally, PillPack expanded to Amazon, initiating a distinct service for customers with multiple daily medications, aiding older adults and individuals with chronic conditions.4
Following the initial launch, Amazon Pharmacy announced RxPass in 2023, a $5 subscription service offering Prime members access to 60 generic prescription medications at a flat fee.5 RxPass granted affordable access to many commonly prescribed medications, including statins, anti-hypertensives, and antidepressants.1
The program aimed to address financial challenges experienced by 25% of adults taking 2 or more daily medications.5 Challenges with medication adherence account for an estimated 125,000 deaths and nearly $300 billion per year in additional medical appointments, emergency visits, and hospitalizations, according to study authors.1
To evaluate the potential of subscription models to support prescription medication access and adherence, researchers created a first-of-its-kind retrospective, population-based cohort study, assessing the association between RxPass and medication refills, days’ supply, and out-of-pocket costs.1,2
The study used a difference-in-difference approach to compare health outcomes 6 months before and after program enrollment among 5003 enrollees compared to 5137 individuals in a control group from states where the program was unavailable. All individuals were younger than 65 years and not on Medicare or Medicaid.1,2
The study’s primary outcome was the number of days’ supply of medications on the subscription program list per person per month (PPPM). Secondary outcomes included the number of prescription refills and out-of-pocket medication costs, including subscription fees for the same medications, also measured by PPPM.2
The results demonstrated that enrollment in RxPass led to a 27% increase in days’ supply and a 29% increase in prescription refills compared to individuals that were not enrolled in the program. Additionally, enrollment was associated with a 30% decrease in out-of-pocket spending by $2.35 PPPM.1,2
“This study suggests RxPass is a promising tool to improve medication management among patients with chronic conditions, especially those who take multiple medications and may have a limited income," Vin Gupta, MD, chief medical officer at Amazon Pharmacy, said in a news release. "RxPass is a simple option for a significant problem in healthcare. Addressing medication non-adherence can prevent further disease progression and reduce overall costs.”1
While the findings are positive for RxPass, the program could disrupt retail pharmacies and present a severe threat to traditional mail older pharmacies. However, the disruption could be larger than medication sales.3,5
"Pharmacies have an attachment factor—you go there for one product and buy another one on the way out," Steven Wardell, managing partner at Wardell Advisors, said in a news release. "Anything that challenges this model is bad news for your neighborhood pharmacy."3
Amazon’s pharmacy accounted for $1.25 billion in sales in 2024 and is estimated to reach $1.8 billion in 2025, as major retail chains’ sales fell 3.5% from the previous year.3 Additionally, satisfaction with mail order pharmacies has demonstrated a 6-point increase in overall customer satisfaction, while chain drug stores have seen their overall satisfaction scores decrease, according to the JD Power 2024 US Pharmacy Study.3,6,7
Although RxPass appears to be a promising intervention for improving medication adherence and affordability, traditional retail pharmacies could face disruptions in medication and merchandising sales.
REFERENCES
1. Amazon Pharmacy's RxPass program improves medication adherence, helps prime members save money, study finds. EurerkAlert!. News release. Published February 3, 2025. Accessed February 11, 2025. https://www.eurekalert.org/news-releases/1071530
2. Pharmacy Subscription Program and Medication Refills, Days’ Supply, and Out-of-Pocket Costs. JAMA Network Open. News release. Published January 27, 2025. Accessed February 11, 2025. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829551
3. The "Amazon effect" on pharmacy isn't about medicine. Axios. News release. Published January 2, 2025. Accessed February 11, 2025. https://www.axios.com/2025/01/02/amazon-pharmacy-cvs-walgreens
4. Antrim A. Amazon Launches Amazon Pharmacy, Prescription Delivery Service. Pharmacy Times. News release. November 17, 2020. Accessed February 11, 2025. https://www.pharmacytimes.com/view/amazon-launches-amazon-pharmacy-prescription-delivery-service
5. Antrim A. Amazon Pharmacy Introduces RxPass Generic Drug Subscription Service. Pharmacy Times. News release. January 24, 2023. Accessed February 11, 2025. https://www.pharmacytimes.com/view/amazon-pharmacy-introduces-rxpass-generic-drug-subscription-service
6. Hohmeier K. Amazon Pharmacy: Distraction or Disruption? AJMC. News release. July 28m, 2021. Accessed February 11, 2025. https://www.ajmc.com/view/amazon-pharmacy-distraction-or-disruption-
7. Study: Rise of Mail Order Pharmacies Impacts Brick-and-mortar Pharmacists. DBusiness. News release. Published August 1, 2024. Accessed February 11, 2025. https://www.dbusiness.com/daily-news/study-rise-of-mail-order-pharmacies-impacts-brick-and-mortar-pharmacists/
