Breaking barriers: how Amazon Pharmacy RxPass is improving health equity

Amazon Pharmacy is rewriting the rules in the healthcare industry with its latest pharmacy prescription service, RxPass.  

For $5 a month, Prime members can get all of their generic prescriptions delivered to their door, as long as they fall on the list of eligible medications. The list is composed of 50 of the most commonly prescribed medications to treat over 80 health conditions including high blood pressure, anxiety, and erectile dysfunction.  

Patients can access cheap generics through RxPass without insurance.  

“There are 150 million Americans who take one or more of the medications on this eligible [medication] list that we’re launching with,” said John Love, vice president of Amazon Pharmacy. Love projected “millions” of U.S. patients, “given their insurance situation, might save an average of $100 a year versus the lowest price either through insurance copay or paying cash.”  

KFF Polling revealed that 3 in 10 people haven’t taken their medicine as prescribed due to cost. Also, 18% did not fill their prescription at all, 21% used over-the-counter prescriptions instead, and 15% cut their doses in half.  

“Two in 5 Americans are underinsured,” said Vin Gupta, M.D., chief medical officer at Amazon Pharmacy. “We know that 1 in 4 find it difficult to afford their medications. I’ve seen this with my own eyes in the pulmonary clinic that often even if somebody does have insurance, there isn’t price transparency.”  

Mark Cuban’s pharmaceutical company, Cost Plus Drugs, promises consumers at-cost price plus 15% for overhead, $3 pharmacy fee, and $5 shipping fee. Cuban says he can provide good prices to consumers by “cutting out the middlemen.” Like Amazon Pharmacy, insurance isn’t necessary to take advantage of these prices.  

Amazon Pharmacy is not the only consumer-centric company disrupting the pharmaceutical industry, but they are in a unique and powerful position. They can usher their existing 200 million person membership base to their new virtual health clinic to gain immediate business.  

Those on Medicare and Medicaid are not eligible to use RxPass. So while it offers an intriguing step toward better health equity, it doesn’t serve the most vulnerable — low-income and elderly patients — but it does open the door for many people to save money on most of their medications.  

Cost Plus Drugs offers a wider range of drugs. Mark Cuban announced Cost Plus Drugs charges $47 a month for leukemia drug Imatinib while other retailers charge $9,657.  

Professor Craig Garthwaite in the pharmaceutical sector at Northwestern University Kellogg School of Management doesn’t find these new offerings revolutionary, and notes that cheaper prescription options have been available for a long time.  

It’s true. Companies like GoodRx and GeniusRx have been able to provide coupons to savvy consumers, and do so by participating in the backdoor negotiations that create prescription drug pricing.  

“Generic medicines are often exploited by middlemen that seize significant profits at the expense of patients and the companies that make the medicine,” said Allen Goldberg, a spokesman for the Association for Accessible Medicines.  

Lack of price transparency in the pharmaceutical industry is one the biggest issues affecting patients and nations, and new drug discount companies like Cost Plus Drugs are working to overcome that.  

Currently, UK officials are asking Pzifer not to raise their prices on their Covid-19 vaccine.  

“The U.K. has already been paying the highest known prices for Pfizer’s vaccines, with your company reportedly having already increased the price per dose from (approximately $22 to $27). With Pfizer’s vaccine estimated to cost ($6.15) to produce, even the original price represented a 340% markup,” wrote four U.K. lawmakers in a letter to Pfizer CEO Albert Bourla.  

In the U.S. three of the big pharmaceutical companies – — Sanofi, Novo Nordisk, and AstraZeneca – — just won a lawsuit challenging the interpretation of a provision to the 340B drug discount program.  

The program was established three decades ago to provide medical care to those living in rural or low-income areas. To ensure the program meets this purpose, drug manufacturers that take part in Medicare or Medicaid have to offer their products at reduced prices to the participating hospitals and clinics, ranging from 25% – 50%.  

Under this program, patients receive medicines at little to no cost. If the provision is reinterpreted, hospitals and patients will take on the cost.  

Research from Brigham and Women’s Hospital, Boston, compared the cost of 89 generic drugs sold by Cost Plus Drugs in 2022 to the price paid by Medicare Part D in 2020. After accounting for changes in drug cost, the study found that Medicare would spend 45% less on prescriptions if it went through Cost Plus Drugs ($4.5 billion compared to $8.1 billion). 

While programs like Amazon Pharmacy and Cost Plus Drugs aren’t perfect, they are promising for consumers looking for stable and fair drug pricing.