Patients Should Pass on Amazon Pharmacy RxPass Program

See our previous analysis of Amazon Pharmacy here and here.

If you’re a member of the healthcare industry, you likely saw headlines about Amazon Pharmacy’s new generics program, RxPass. Plenty of articles are making a mountain out of this molehill, but don’t get too excited.

Amazon’s RxPass is a useful piece of marketing for Amazon. It sounds good: if a patient is willing to pay out of pocket instead of using their health insurance, they can get an unlimited number of certain medications for just five dollars a month. Their prescriptions will be delivered for free directly to their homes.

It sounds amazing, doesn’t it? But as with all things Amazon Pharmacy, there are more than a few caveats to keep in mind.

Membership Required

First of all, RxPass is only for Amazon Prime members. Prime memberships come with an ever-widening array of benefits, but with memberships costing $14.99 a month or $139 a year, it isn’t likely that RxPass alone will motivate customers to get a Prime membership if they don’t already have one.

College students can receive a discounted Prime membership, as can people who receive qualifying government assistance, like SNAP or Medicaid. But guess what: Medicaid members aren’t eligible for RxPass.

In fact, Amazon makes it very clear that even though RxPass doesn’t accept insurance, the program cannot be used by anyone with government-funded insurance (Medicare, Medicaid, CHIP, or Tricare). They can still use Amazon Pharmacy, but they can’t get access to the unlimited generic medications for $5 a month. Of course, these are the demographics that would benefit most from those kinds of savings.

Is It Worth It?

Let’s recap what we know so far: to use RxPass, customers need to be Prime members, but they can’t have government-funded insurance. They also can’t live in the following states:

  • California
  • Louisiana
  • Maryland
  • Minnesota
  • New Hampshire
  • Pennsylvania
  • Texas
  • Washington

Prime members in the other 42 states of the Union are eligible if they have commercial health insurance or no insurance at all. But is it worth paying an extra $5 a month for this benefit?

Really, it comes down to this question:

Is the Prime member taking one or more of the medications on the RxPass list AND paying more than $5 a month for that medication, either in copays or out of pocket?

It appears that the Prime member’s children (under 18 years of age) could also be included in RxPass, since Amazon Pharmacy users are allowed to fill prescriptions for their kids. However, caregivers of people 18 and older cannot fill prescriptions on behalf of another adult. Every adult 18+ needs their own RxPass account and Prime membership.

If the answer to the above question is “Yes, I am a Prime member with commercial insurance or no insurance, living in an eligible state, paying more than $5 a month for one or more of these prescriptions for myself or my children,” then this might be a good program for that person.

But there are still other matters to consider.

Further Concerns

The $5 RxPass fee must be paid out of pocket.

If a patient usually uses their HSA or FSA to pay for prescriptions, they can’t use it for the RxPass fee. In comparison, the Mark Cuban Cost Plus Drug Company, another highly-hyped discount pharmacy, does allow patients to pay for prescriptions with their healthcare savings accounts.

The RxPass drug list is very short.

As of January 2023, there are fewer than 60 medications available, and only certain dosages and formulations of those medications are eligible for RxPass. A great deal of these medications are considered affordable and may already be covered by insurance. Patients should check prices before assuming that RxPass will offer the best deal.

It’s also worth noting that if only some of a patient’s prescriptions are available through RxPass, they’ll need to fill the rest of their medications elsewhere. They might be able to use Amazon Pharmacy, but it’s important to know that Amazon – like a lot of online pharmacies – cannot fill the following prescriptions:

  • Compounded medications
  • REMS medications
  • Schedule II controlled medications, like Adderall
  • Specialty medications, like Humira
  • Suspensions, like liquid amoxicillin

Using multiple pharmacies to fill prescriptions can be risky. Patients need to keep track of all their medications and make sure every pharmacist knows the patient’s full drug list. If they don’t, they put themselves at risk for dangerous drug interactions.

RxPass may only cost $5 a month, but Amazon is strict about it.

Patients who receive a 90-day supply of a medication cannot cancel RxPass after the month in which they actually receive their prescription. They need to pay for the full three months that they are taking the prescription.

There are a lot of other options for home delivery.

If we’ve said it once, we’ve said it a million times. Prescription delivery is everywhere! If you want home delivery but don’t want to switch pharmacies, ask your local pharmacy whether they offer it. If not, tell them to reach out to ScriptDrop. We can help them set up same-day, on-demand, or shipping delivery quickly and easily.


There are very few use cases for Amazon RxPass. In addition, the program simply feels cynical. The subscription model suggests that Amazon hopes to get five extra dollars a month out of each Prime member in the hopes that those members will either not need the service or will forget about it. If patients do look for their medications on that list, chances are good that not all of their needs will be met. Amazon surely hopes that patients will then hop over to the regular Amazon Pharmacy to get their other medications, and will end up spending just as much as they would have before – plus that monthly $5.

Thus, while Amazon may be starting to normalize prescription delivery and a pharmacy experience that eliminates PBMs, it isn’t putting patient care at the forefront. For that reason, we don’t think brick-and-mortar pharmacies need to panic – but they may consider adding delivery to their services.