Online pharmacy program improves medication adherence and helps members save money, study finds

Approximately half of all Americans do not take their medication as prescribed by their doctor. This medication non-adherence causes an estimated 125,000 additional deaths and as much as $300 billion a year in additional medical appointments, emergency department visits, and hospitalizations.

A new study published in the JAMA Network Open finds Amazon Pharmacy’s subscription service for common medications, RxPass, leads to significant improvements in medication adherence while reducing out-of-pocket costs for patients. This first-of-its-kind study evaluated the potential of subscription models to support prescription medication access and adherence.

The research found that enrollment in RxPass led to subscribers having 27% more of their medication on-hand compared with customers not enrolled in the program, enabling them to be clinically adherent to their medications. Similarly, subscribers were 29% more likely to refill their medications. Enrollment was also associated with a decrease in out-of-pocket spending of $2.35 per month, a 30% decrease.

A promising tool for medication management

“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,” said Dr. Vin Gupta, Chief Medical Officer at Amazon Pharmacy. “RxPass is a simple option for a significant problem in health care. Addressing medication non-adherence can prevent further disease progression and reduce overall costs.”

Launched in January 2023, RxPass offers Prime members access to 60 prescription medications for a flat fee of $5 per month. The program provides affordable access to many of the most commonly prescribed medications including statins, anti-hypertensives, and antidepressants, which treat chronic conditions. RxPass medications help people manage high blood pressure, high cholesterol, anxiety—conditions that impact hundreds of millions of Americans.

The research, conducted by a team led by Senior Health care Research Scientist Kai Yeung, Ph.D., Pharm.D., of Amazon Health Services, compared a sample of approximately 5,000 RxPass enrollees and control subjects over a six-month period.

Non-adherence has many causes

Conditions such as cardiovascular disease, when not treated regularly with medication, can develop into more severe health issues including heart attack or stroke. Ongoing high blood pressure can lead to heart disease, stroke, or kidney failure.

“Patients face multiple barriers to medication adherence, making it a challenging issue to address across health care,” Dr. Yeung said. “RxPass tackles patient challenges holistically, simplifying medication management by reducing both the financial and administrative burdens.

“Subscribers know the cost upfront, have medications delivered to their door, and benefit from 24/7 access to a pharmacist. Our early findings indicate a low-cost subscription model can be an effective tool to help patients get and stay on their medications.”

Subscription programs like RxPass leverage a number of cognitive and behavioral factors including transparent pricing, automatic subscription renewal, bundling of goods or services, and enhanced customer support to engage customers.

“Improving health is often reliant on a series of small, consistent steps,” said Dr. Gupta. “I’m excited by the promise of the subscription medication model for chronic care, and compelled by how it could evolve the way we think about supporting our patients.”

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