Telehealth
Amazon Pharmacy study touts refill rate
In a new paper published in JAMA Network Open, Amazon employees present data suggesting people who sign up for the company's RxPass subscription are more likely to refill prescriptions for common drugs like statins and antidepressants than those not enrolled in the program. Launched in 2023, the subscription gives members access to 60 generic medications for a $5 monthly fee. Drugs do not just show up because someone is enrolled in RxPass; users must choose to refill them. Many RxPass drugs are meant to be taken for a long-period of time, so the data helps make the case that Amazon's service supports medication adherence and better health care outcomes.
The study design is pretty clever, but not bulletproof. The study compares 5,000 people who enrolled in the program to 5,000 people who clicked enroll but lived in states where the program wasn't available. To reduce the impact of people going to other pharmacies, the study was limited to those who had used Amazon to fill two prescription for drugs available through RxPass. According to the data, six months after enrolling or (or clicking enroll), people in the program had on average 10 more days medication on hand and a slight uptick in refills.
The paper makes a number of arguments about what may be driving this positive change, including the impact of price sensitivity and "cognitive and behavioral factors." But I think it's pretty clear that if you make it cheap and easy to do the right thing, people will do it.
Are there confounders? Of course. Is it neat to see Amazon show some data about Amazon Pharmacy? Absolutely. Since launching RxPass, the company has only moved more aggressively into Pharmacy which remains its most successful foray into health care so far. It will be interesting to watch if the company continues to build evidence that the business is improving the health of users.
Medicare Hospital at home advocates remind us that, yes, it's February
I know you can't believe it either, but it's February. Even with the seismic activity happening in the federal government right now, there's a separate political fight around funding the government on the horizon. At the end of last year, Congress failed to arrive at a full-year spending deal and opted to just fund the government through March 14th. For our purposes, an important consequence is that multi-year extensions of health tech-friendly policies adopted during the pandemic did not pass.
Earlier this week, Moving Health Home, a group that represents huge hospital systems like Ascension and vendors of home health tech like Best Buy, sent a letter to lawmakers asking them to include in the forthcoming March funding package a five-year extension of a Medicare program that allows approved hospitals to deliver inpatient care in people's homes. At the end of last year a five-year extension was on the way to getting done when the broader funding deal fell apart.
It's just a letter, but it's also a reminder that this hospital at home program as well as an expansion of telehealth covered by Medicare may be in a tough extension vortex for the foreseeable future. People I've spoken to are unsure what will happen. Given all that needs to be done it seems likely that the upcoming deal will only extend the policies to the end of the year, when advocates will again have to jockey to get longer extensions into the spending package. And if Congress doesn't fund the government for the rest of the year next month, we may be having this conversation again sooner.
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