Amazon Pharmacy expands RxPass subscription service to Medicare patients

Amazon Pharmacy is expanding its prescription drug subscription program, called RxPass, to Prime members on Medicare insurance.

The RxPass program, launched in January 2023, provides unlimited access to 60 eligible generic medications and will ship the medications to customers' homes for a flat monthly fee of $5, along with 24/7 access to a pharmacist, according to the company.

Amazon Pharmacy also offers same-day delivery in nine cities. 

A Medicare beneficiary who takes at least one medication available through RxPass could save approximately $70 per year and a beneficiary who takes two or more medications could save even more, John Love, vice president of Amazon Pharmacy, said in an interview.

The online retail giant estimates that if all Medicare beneficiaries, a population of about 50 million people, transitioned their eligible medications to RxPass, Medicare spending would be reduced by nearly $2 billion, and customer out-of-pocket spending would also decrease.

In January 2023, Amazon's pharmacy business rolled out RxPass for Prime members to order commonly prescribed generic medications that treat more than 80 common health conditions, including high blood pressure and acid reflux, and the service includes free delivery. The service is now available in 46 states. A Prime membership costs $14.99 per month, or $139 a year. Annually, RxPass will cost Prime members an additional $60 a year.

Love said it was Amazon Pharmacy's long-term vision to expand that benefit to Medicare beneficiaries.

"Our vision has always been: help everybody get access to their medication. I think the value is going to come, for some of the Medicare population, the mobility feature can be very compelling. If you don't have easy access to a car or easy access to a retail pharmacy, the ability to get meds delivered is compelling," he said.

Along with the RxPass subscription service, Amazon Pharmacy also offers a prescription savings benefit for Prime members, Prime Rx, that enables discounts of up to 80% off generic and 40% off brand-name medications at more than 60,000 participating pharmacies nationwide, when paying without insurance.  

Amazon's Prime savings programs, including RxPass, helps to provide more affordable access to commonly prescribed generic medications, while also offering a more convenient pharmacy experience, Love noted.

Amazon's logistics and tech capabilities enable medications to be shipped to consumers' doorsteps, often with same-day or next-day delivery, which helps to address the growing problem of pharmacy deserts.

According to a study published in Health Affairs Scholar in April, about 16 million people in the U.S., or about 4.7% of the population, live in pharmacy deserts, spanning urban and rural settings in all 50 states. On average, communities that are pharmacy deserts have a higher proportion of people who have a high school education or less, have no health insurance, have low self-reported English ability, have an ambulatory disability, and identify as a racial or ethnic minority.

"We have lost a lot of pharmacies. Bartell's is gone. Rite Aid is gone. Twenty-four-hour pharmacies are not really a thing. To be able to get these very common generic medications, at low cost delivered to your door, I think the access piece is very important," Love said.

Making it easier for patients to get medications they have been prescribed can also help to improve medication adherence, Love noted.

Research shows people don’t take their medications as prescribed about half the time. Most older adults (76%) report that the cost of prescription drugs is unreasonable. An estimated 10% of people face mobility concerns. As the U.S. population continues to age, these challenges are projected to grow. 

“There are a high number of adults who, whether due to cost, mobility, or simply not having time to collect their medications from the pharmacy, are not adhering to a medication regimen that could be life-saving,” said Vin Gupta, M.D., Amazon Pharmacy's chief medical officer and a practicing pulmonlogist, said in a statement. "When a patient’s medication arrives regularly at their door, at a price they can afford, we see better long-term health outcomes.

An estimated 129 million people in the U.S. manage at least one major chronic disease, such as heart disease, hypertension or diabetes, according to the Centers for Disease Control and Prevention (CDC). That's about 39% of the U.S. population.

Nearly nine in ten (89%) adults 65 and older report taking prescription medications regularly, and more than half of adults 65 and older (54%) report taking four or more prescription medications.

Amazon is seeing early indications that RxPass can improve adherence outcomes among patients, Gupta said.

"Many common health conditions can be well-managed through consistent use of medicine and healthy lifestyle choices. Expanding RxPass to Medicare beneficiaries can help solve for affordability and access challenges among a patient population who experiences high levels of chronic disease," he said.

Amazon shook up the retail drugstore market when it acquired PillPack in 2018 and then again when it rolled out Amazon Pharmacy in 2020. The online retail giant has been rapidly expanding its reach in the healthcare space, most notably with its $3.9 billion acquisition of One Medical, which closed in early 2023.

Amazon Pharmacy has largely been focused on price transparency and affordability of branded and generic drugs. Along with RxPass and PrimeRx, it launched a feature to offer automatic coupons on insulin and other diabetes care products.

In October, the company rolled out drone delivery for prescription medication orders with the service initially taking flight in College Station, Texas.

The company has been using its logistics and supply chain muscle to make it faster and easier for patients to get their prescription medications and speed up "triage to treatment," executives said in previous interviews.

Offerings like RxPass or the Prime prescription savings program can provide affordable medication stability for patients with no insurance or high deductibles, according to executives.

“Treatment guidelines continue to evolve with evidence supporting the use of combination therapy (2+ meds) for conditions like high blood pressure,” said Gupta. “Programs like RxPass were designed with these treatment considerations in mind, enabling initiation of two blood pressure medications instead of one without any additional cost to the patient.”

In February, Amazon confirmed that it was eliminating a "few hundred roles" across One Medical and Amazon Pharmacy.

But, in the past few years, Amazon Pharmacy also has been building out partnerships to with pharma companies and payers.

Eli Lilly is partnering with Amazon's pharmacy unit to offer home delivery for diabetes, migraine and obesity medications, including GLP-1 weight loss drug Zepbound. The drugmaker launched its direct-to-consumer service, LillyDirect, in January to provide consumers access to telehealth and pharmacy services and the ability to get some medications directly from the company via online pharmacies.

Blue Shield of California also tapped Mark Cuban's Cost Plus Drug Company and Amazon Pharmacy for its preferred pharmacy networks.