Section of Health Policy and Equity at the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA.
Section of Health Policy and Equity at the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA.
Am Heart J. 2024 May;271:20-27. doi: 10.1016/j.ahj.2024.02.004. Epub 2024 Feb 15.
US adults often overpay for generic prescription medications, which can lead to medication nonadherence that negatively impacts cardiovascular outcomes. As a result, new direct-to-consumer online medication services are growing in popularity nationwide. Amazon recently launched a $5/month direct-to-consumer medication subscription service (Amazon RxPass), but it is unclear how many US adults could save on out-of-pocket drug costs by using this new service.
To estimate out-of-pocket savings on generic prescription medications achievable through Amazon's new direct-to-consumer subscription medication service for adults with cardiovascular risk factors and/or conditions.
Cross-sectional study of adults 18-64 years in the 2019 Medical Expenditure Panel Survey.
Of the 25,280,517 (SE ± 934,809) adults aged 18-64 years with cardiovascular risk factors or conditions who were prescribed at least 1 medication available in the Amazon RxPass formulary, only 6.4% (1,624,587 [SE ± 68,571]) would achieve savings. Among those achieving savings, the estimated average out-of-pocket savings would be $140 (SE ± $15.8) per person per year, amounting to a total savings of $228,093,570 (SE ± $26,117,241). In multivariable regression models, lack of insurance coverage (adjusted odds ratio [OR] 3.5, 95%CI 1.9-6.5) and being prescribed a greater number of RxPass-eligible medications (2-3 medications versus 1 medication: OR 5.6, 95%CI 3.0-10.3; 4+ medications: OR 21.8, 95%CI 10.7-44.3) were each associated with a higher likelihood of achieving out-of-pocket savings from RxPass.
Changes to the pricing structure of Amazon's direct-to-consumer medication service are needed to expand out-of-pocket savings on generic medications to a larger segment of the working-age adults with cardiovascular risk factors and/or diseases.
美国成年人经常为通用处方药支付过高的费用，这可能导致药物依从性差，从而对心血管结果产生负面影响。因此，新的直接面向消费者的在线药物服务在全国范围内越来越受欢迎。亚马逊最近推出了一项每月 5 美元的直接面向消费者的药物订阅服务（Amazon RxPass），但尚不清楚有多少美国成年人可以通过这项新服务节省自付药物费用。
估计通过亚马逊新的直接面向消费者的订阅药物服务，患有心血管危险因素和/或疾病的成年人在通用处方药上的自付费用节省。
对 2019 年医疗支出面板调查中 18-64 岁的成年人进行横断面研究。
在患有心血管危险因素或疾病且至少开有一种可用于 Amazon RxPass 处方集的药物的 25,280,517 名（SE ± 934,809）18-64 岁成年人中，只有 6.4%（1,624,587 [SE ± 68,571]）会节省费用。在节省费用的人群中，估计每人每年的平均自付费用节省为 140 美元（SE ± 15.8 美元），总计节省 228,093,570 美元（SE ± 26,117,241 美元）。在多变量回归模型中，缺乏保险覆盖（调整后的优势比[OR] 3.5，95%CI 1.9-6.5）和开处方的 RxPass 合格药物数量较多（2-3 种药物与 1 种药物：OR 5.6，95%CI 3.0-10.3；4+种药物：OR 21.8，95%CI 10.7-44.3）与通过 RxPass 获得自付费用节省的可能性更高相关。
需要改变亚马逊直接面向消费者的药物服务的定价结构，以便将通用药物的自付费用节省扩大到更多患有心血管危险因素和/或疾病的有工作成年人。
