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Is Amazon Pharmacy a Good Deal for Older Consumers?

Online prescription services offer free delivery and convenient home shopping

spinner image The Amazon Pharmacy home screen on a laptop computer.
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Already a household name in almost everything from books to electronics to household items, Amazon is now a major health care player with its new digital pharmacy that offers free home delivery and other perks to some customers with Medicare Part D, Medicare Advantage plans and most major commercial health insurance plans.

Amazon Prime members are automatically enrolled in Amazon's new PrimeRx prescription drug benefit and can get a 40 percent to 80 percent discount off the cash price of generic and brand-name drugs. This discount applies if consumers pay out of pocket online without using their insurance or with a savings card at one of 50,000 U.S. pharmacies including Costco, CVS, Walgreens and Walmart.

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Such savings sound big … but will they significantly reduce prescription drug costs for older Americans? Here's what we found:

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Price check: We compared the PrimeRx discount for a 30-day supply of eight top-selling generic and brand-name drugs against prices elsewhere. Amazon's PrimeRx often came in lowest, but not consistently. The savings was about $1 for the popular generic blood-pressure medication lisinopril and the diabetes drug metformin compared to two other discount digital pharmacies (Blink Health and GeniusRx) that also offer free shipping. The asthma drug albuterol was about $10 cheaper than the other two digital pharmacies we looked at and the cholesterol drug atorvastatin was more expensive on PrimeRx. PrimeRx prices for expensive brand-name drugs ranged from $5 less for the insulin Humalog to $179 more for the rheumatoid arthritis drug Humira and $9 more for the clot-prevention med Eliquis, compared to savings cards from GoodRx and WellRx that consumers used in a pharmacy.

"You also have to factor in the $120 Amazon Prime membership fee. That's another $10 a month [currently $12.99 for new members], says Richard Sagall, a doctor and president of needymeds.org, a nonprofit that helps people find affordable medications. “Consumers should check all their options before signing up. Your insurance co-pay, a co-pay coupon from a pharmaceutical company (usually not available to Medicare beneficiaries, but those with private or employer-paid plans may qualify), low-price or free generics at your local supermarket, getting a 90-day mail-order supply of your medications through your health insurer or using a drug assistance program may be cheaper,” Sagall says. “It's important to understand that prices fluctuate. Nobody gives the best price all the time.” One note of caution: Paying out-of-pocket usually won't count toward your insurance deductible, either.

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Safety: Amazon Pharmacy, like other digital pharmacies, promises to flag potential adverse interactions between drugs you take and has pharmacists available by phone to answer your questions. “If you don't list everything you take when you sign up, problems could be missed if you get prescriptions filled in more than one place,” says Carolyn McClanahan, a certified financial planner and physician in Jacksonville, FL. “If you're the kind of person who has a relationship with their local pharmacist where you ask questions and get advice, you won't get that with an online pharmacy."

Convenience: Free delivery “is important for people who don't drive, live far from the nearest pharmacy or have chronic illnesses or mobility issues that make getting to the drugstore difficult,” says Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation. “That's worth a few extra dollars, no matter who you buy your drugs from, especially if you're trying to stay home during the pandemic."

What else you need to know: Amazon Pharmacy is currently available in 45 states, but not yet in Hawaii, Illinois, Kentucky, Louisiana and Minnesota. The service does not offer compounded medications, drugs in liquid form called suspensions or Schedule 2 drugs such as the pain killer oxycodone and the ADHD drugs Adderall and Ritalin. And prescriptions you need the same day, such as for an acute illness or if you need a fast refill, should be filled locally. Amazon Pharmacy did not offer automatic prescription refills or 90-day supplies with refills as of late November. Users need to have a prescription provided to Amazon by a licensed health-care practitioner. An Amazon spokesperson said users’ pharmacy data, including prescribed drugs and medical history, is protected under the rules of the Health Insurance Portability and Accountability Act (HIPAA) and would not be used for marketing purposes. "We do not show ads based on the prescription information provided to Amazon Pharmacy," Amazon spokesperson Jacquelyn Miller says.

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