Amazon Pharmacy’s Subscription Service Associated With Improved Medication Adherence, Reduced Costs
Approximately 29% of patients were also more likely to refill their medication, leading investigators to consider an association between medication adherence.
Enrollment to Amazon Pharmacy’s RxPass was associated with subscribers having 27% more of their medication on-hand compared to those who were not enrolled in the program. Further, 29% of patients were also more likely to refill their medication, leading investigators to consider an association between medication adherence and pharmacy prescription services.1,2
Although there are many barriers, rising cost of prescriptions is a major barrier for a lot of patients. | Image Credit: sofiko14 | stock.adobe.com
“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.1 "Addressing medication non-adherence can prevent further disease progression and reduce overall costs.”
Published in JAMA Network Open, investigators evaluated the association between enrollment into the subscription-based service with medication refills, days’ supply, and out-of-pocket costs.2 It is currently estimated that over half of medications prescribed are not taken as directed for treatment of chronic diseases, according to the American Heart Association.3 Although there are many barriers, rising cost of prescriptions is a major issue for many patients. Poor adherence is associated with a $300 billion health care cost per year, in addition to medical appointments, emergency department visits, and hospitalizations.
Investigators used Amazon Pharmacy’s RxPass, which is a program that provides 60 common generic prescription for $5 per month in 45 states. For the program, prescriptions can be filled as a 90 days’ supply, and during the study period, Medicare and Medicaid beneficiaries were not included as the program was not available for these patients. Investigators compared the outcomes of 6 months prior to and after the program implementation. Patients included in the study were younger than 65 years, and were included in either the control group, those who were not enrolled in the program during the study period but clicked on the program enrollment page at least once, and the exposure group, those who were enrolled in the program. The outcome of the study was total days’ supply of medication on hand (per person per month [PPPM]), with secondary outcomes being number of prescriptions and out-of-pocket costs.2
Data were collected from July 24, 2022, to January 24, 2024, and a total of 5003 enrolled patients and 5137 patients in the control group were included. Before the program, investigators noted that 65% of individuals either did not have insurance or paid with a discount program. Investigators found that enrollment was associated with an increase of approximate 10.39 days in medication supply compared with when the patient was not enrolled in the program. Furthermore, there was an increase in prescription refills of 0.19 PPPM, indicating a 29% increase. For out-of-pocket spending, there was an approximate $2.35 PPPM decrease, associating with a 30% decrease.2
Investigators also conducted subgroup analyses, including a statin cohort (1219 enrolled patients and 1354 control patients), antihypertensive cohort (1180 enrolled patients and 1133 control patients), and antidepressant cohort (1783 enrolled individuals and 1705 control patients.) For the increase in the days’ supply, investigators found the program was associated with an increase of 8.56 days, 3.70 days, and 5.29 days, respectively. For refills, the increase was 0.15 refills PPPM, 0.06 PPPM, and 0.10 PPPM, respectively. Further, enrollment in the program was associated with a decrease of out-of-pocket costs of $1.47 PPPM in the statin cohort, $0.73 PPPM in the antihypertensive cohort, and $3.59 PPPM in the antidepressant cohort.2
"Patients face multiple barriers to medication adherence, making it a challenging issue to address across healthcare," Kai Yeung, PhD, PharmD, of Amazon Health Services, said in the news release.1 "Our early findings indicate a low-cost subscription model can be an effective tool to help patients get and stay on their medications.”
