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Will Amazon’s new RxPass be able to flag potential drug interactions?

Expert discusses pros, cons of Amazon Pharmacy’s new $5 prescription subscription

CHICAGO --- Amazon Pharmacy on Tuesday announced RxPass, its $5 monthly prescription medication subscription for Amazon Prime members. Northwestern Medicine licensed pharmacist Dr. Minoli Perera is available to discuss with media some pros of the new subscription service, such as affordability and access, and some cons, such as not being able to flag potential drug interactions. 

Perera’s research is on the clinical translational aspects of adverse drug reactions. Her lab focuses on pharmacogenomics (using a patient's genome to predict drug response) in minority populations, which requires her to have a clinical understanding of which drugs are used to treat which conditions, which drugs might interact with one another and what side effects some drugs may have. 

Cons:

  • Missing possible drug interactions: “If you go to the same pharmacy chain, say Walgreens, for all your prescriptions, that company knows all the medications you’re taking. The system flags questions for the pharmacist so they can at least ask the patient, ‘Are you still taking this? If you are, you need to know there’s a potential risk of it interacting negatively with this new drug,’” said Perera, associate professor of pharmacology at Northwestern University Feinberg School of Medicine.

“What if your medication is not on Amazon’s list of more than 80 common drugs? You’d need to fill it at a regular pharmacy, so, in dividing where you get your prescriptions, there’s potential for people to miss those drugs that may be interacting. I saw the Amazon model does have some tie-in, like a discount with Walgreens, but I’m not sure if that means they share their records.”

  • Better access but only for Prime members: “This is limited to only Amazon Prime members, who have disposable income to pay for Prime. While the new plan is quite affordable, is it really benefiting the people that would have the problem affording the medications?”
  • Loss of in-person pharmacist interaction: “One other downside—but it’s not unique to Amazon— is that for many people, their first encounter with health care may be their pharmacist. Maybe they get a bunch of medications for their child, but now the child is running a fever and the parent wants to know if they can also add Tylenol or a decongestant. Many times, their first interaction is going to be with the pharmacist, not the doctor. In those sorts of situations, they don’t have that interaction any longer when they’re getting things refilled automatically.”

Pros:

  • Affordability: “Prescription medications are unaffordable for a lot of Americans, so the affordability of paying $5 per month to have access to as many of these medications as you want is remarkable and addresses the problem we have.”

“It will be most beneficial to people who are on multiple drugs at once. Even generic drug costs, with insurance, are probably not $5 per month, so that’s an incredible savings for someone taking six to seven drugs a month.”

  • Accessibility: “It’s been well documented that people of lower socioeconomic standing will think about if they really need a medication compared to groceries, electricity, etc. There’s a bargaining in which you say, ‘Is my blood pressure medication really worth the price of all the other bills I have to pay?’ Until you have a heart attack or stroke, there aren’t physical manifestations telling you this is an absolute thing you need to take, but certainly patients will have dire consequences for not taking the medications.”