Amazon Pharmacy Brings Prescriptions to Clinic Kiosks

A New Model for Medication Access

New dispensing technology aims to close gaps in medication adherence as traditional pharmacies struggle

Amazon is fundamentally changing how Americans might pick up prescriptions by launching automated dispensing kiosks inside medical clinics, a move that could help address the nation's growing medication access crisis while challenging traditional pharmacy chains already facing financial pressures.

Starting December 2025, Amazon Pharmacy Kiosks will begin operating at One Medical clinic locations across the greater Los Angeles area, allowing patients to receive medications within minutes of their doctor appointments without making a separate pharmacy trip. The kiosks work like sophisticated vending machines, stocking hundreds of commonly prescribed medications including antibiotics, inhalers, and blood pressure treatments, with inventory customized to each clinic's prescribing patterns.

Addressing Critical Gaps in Care

The initiative targets a significant healthcare problem. Nearly one-third of prescriptions in the United States are never filled each year, and only 51% of customers report their prescriptions were quickly filled at retail pharmacies.

Approximately one in four neighborhoods nationwide are considered "pharmacy deserts"—areas lacking convenient access to medication dispensing services. Recent analysis by GoodRx shows that 48.4 million Americans, or one in seven people, now live in pharmacy deserts, up from 41.2 million in 2021. Research published in Health Affairs Scholar identified nearly 16 million Americans living in these underserved areas.

The access problem disproportionately affects vulnerable populations. Nearly 90% of those in pharmacy deserts live in rural areas, and 22.3% of pharmacy desert residents are aged 65 or older. Rural residents in pharmacy deserts must travel an average of 85 minutes round-trip covering 36 miles to reach the nearest pharmacy.

How the System Works

After a provider writes a prescription and sends it to Amazon Pharmacy, patients order through the Amazon app, selecting kiosk pickup. A licensed Amazon pharmacist reviews the order remotely before the medication is dispensed. Patients can also consult with pharmacists via secure video or phone through the kiosk interface.

The tamper-resistant kiosks weigh approximately 1,700 pounds, are secured to floors, and include vibration sensors and surveillance cameras. There is no additional fee to use kiosks for Prime or non-Prime members—patients pay only for prescriptions at standard insurance rates.

Notably, the service will not initially include medications requiring refrigeration, such as GLP-1 weight-loss drugs, or tightly regulated controlled substances. At launch, kiosks are available only to patients receiving in-person care at One Medical, though One Medical membership is not required.

Mail-Order Pharmacy: The Dominant Model for Chronic Conditions

While Amazon's kiosks represent innovation in immediate prescription access, they enter a market where mail-order pharmacy has already transformed chronic disease medication management. For patients with conditions like diabetes, hypertension, hypothyroidism, and prostate cancer requiring ongoing hormone therapy, mail-order has become the standard rather than the exception.

Most Medicare Part D and employer-sponsored insurance plans now strongly incentivize mail-order pharmacy for maintenance medications through lower copays and mandatory 90-day supplies. A patient might pay $10 for a 30-day supply of metformin at a retail pharmacy but only $20 for a 90-day supply via mail-order—effectively receiving three months of medication for the price of two months retail.

Major mail-order pharmacy operators include:

• CVS Caremark: Operating one of the nation's largest mail-order operations alongside retail stores
• Express Scripts (Cigna): Processing millions of prescriptions monthly through automated fulfillment centers
• OptumRx (UnitedHealth): Integrating mail-order with the company's broader healthcare services
• Amazon Pharmacy mail delivery: Offering free two-day delivery for Prime members and same-day delivery in eligible areas
• Amazon PillPack: Now serving 50 million Medicare Part D beneficiaries with pre-sorted medication packets delivered monthly

For chronic conditions, mail-order provides several advantages:

• Cost savings: Typically 30-50% lower copays than retail for 90-day supplies
• Convenience: Eliminates monthly pharmacy trips for stable medications
• Automatic refills: Reduces risk of running out of critical medications
• Medication synchronization: All prescriptions delivered on the same schedule
• Adherence packaging: Services like PillPack sort pills by date and time

The economic incentive structure makes mail-order compelling for both insurers and patients. For someone taking levothyroxine for hypothyroidism, metformin for diabetes, lisinopril for blood pressure, and atorvastatin for cholesterol—a common combination—mail-order can save hundreds of dollars annually while reducing the burden of monthly pharmacy visits.

Kiosks vs. Mail-Order: Different Use Cases

Amazon's kiosk strategy appears designed to complement rather than replace mail-order pharmacy. The two models serve different needs:

Kiosks excel for:

• Acute prescriptions needed immediately (antibiotics, pain medications, short-term steroids)
• First fills of new chronic medications (where patients and doctors want to assess tolerability before committing to 90-day supplies)
• Medications requiring immediate initiation after diagnosis
• Patients who prefer in-person pharmacist consultation
• Emergency situations when mail-order timing doesn't work

Mail-order dominates for:

• Stable chronic medications taken indefinitely (diabetes, blood pressure, thyroid, cholesterol medications)
• Hormone therapies for prostate cancer (ADT drugs like leuprolide, oral agents like enzalutamide)
• Medications requiring 90-day supplies under insurance plans
• Cost-conscious patients maximizing insurance benefits
• Patients with mobility challenges or transportation barriers
• Rural residents in pharmacy deserts where physical pharmacy access is limited

For prostate cancer patients specifically, the hybrid model may work well: using kiosks for immediate needs like antibiotics during treatment-related infections or steroids for side effect management, while relying on mail-order PillPack for synchronized delivery of hormone therapy, bone-strengthening medications, and cardiovascular drugs.

Cost Considerations and Savings Options

Medication costs remain a critical barrier to adherence, making pricing transparency and savings programs essential for patients managing chronic conditions like prostate cancer.

Amazon Pharmacy offers Prime members discounts of up to 80% on thousands of medications when paying cash, and the RxPass program provides a $5 monthly subscription for unlimited access to over 50 common generic medications. The company has partnered directly with pharmaceutical manufacturers like GSK and Novo Nordisk to automatically apply coupons and copay assistance at checkout.

The RxPass program deserves particular attention for patients with multiple chronic conditions. At $5 monthly ($60 annually), it provides unlimited quantities of common generics including metformin (diabetes), lisinopril (blood pressure), levothyroxine (thyroid), atorvastatin (cholesterol), and many others. For uninsured patients or those with high-deductible plans, this represents extraordinary value—potentially providing five or six medications for less than a single copay at traditional retail pharmacies.

However, RxPass competes directly with mail-order offerings from traditional pharmacy benefit managers. Many Medicare Part D plans offer similar or better pricing on these same generics through their mail-order programs, often with $0 copays for preferred generics. Patients must compare their specific plan's mail-order costs against RxPass pricing.

The economic impact of medication costs cannot be overstated. According to IQVIA Institute data, prescription abandonment rates remain below 5% when prescriptions carry no out-of-pocket cost but rise to 45% when costs exceed $125 and 60% when costs exceed $500. In 2021, among adults aged 18-64 taking prescription medications, 8.9% did not take medications as prescribed to reduce costs.

For cancer patients, cost-related non-adherence can be particularly dangerous. Skipping doses or delaying refills of hormone therapy or supportive care medications can compromise treatment effectiveness and quality of life. Patients should explore all available cost-saving options, including:

• Mail-order pharmacy through insurance: Often the lowest-cost option for maintenance medications
• Amazon RxPass subscription: Best for uninsured or high-deductible patients taking multiple common generics
• Manufacturer copay assistance programs: Many pharmaceutical companies offer patient assistance for expensive medications
• Amazon Prime benefits: If already a Prime member, the pharmacy discounts may provide significant savings
• GoodRx discount cards: This independent service allows price comparison across pharmacies and can sometimes beat insurance copays for certain medications
• Medicare Extra Help: Low-income seniors may qualify for additional prescription drug cost assistance
• Generic alternatives: Discussing therapeutic equivalents with oncologists can dramatically reduce costs

Poor medication adherence contributes to more than $500 billion in avoidable annual healthcare costs, approximately 125,000 potentially preventable deaths, and up to 25% of hospitalizations in the United States.

Medicare Part D and the 2025 Out-of-Pocket Cap

For the approximately 11,000 Americans turning 65 daily and entering Medicare eligibility, recent changes to Medicare Part D prescription drug coverage represent the most significant cost reforms in the program's history.

Starting in 2025, the Inflation Reduction Act established an annual cap on out-of-pocket drug costs at $2,000 for Medicare Part D beneficiaries. This cap applies to all covered medications under a patient's Part D plan and represents a dramatic change from previous cost-sharing structures that left many seniors facing thousands or even tens of thousands of dollars in annual prescription expenses.

For prostate cancer patients on Medicare, this cap is particularly significant. Hormone therapies like enzalutamide (Xtandi) or abiraterone (Zytiga), along with newer treatments and supportive medications, can carry substantial costs. Previously, patients could face high copays throughout the year, particularly during the coverage gap known as the "donut hole." The $2,000 cap now provides financial predictability and protection against catastrophic drug costs.

Medicare Part D plans typically require or strongly incentivize mail-order pharmacy for chronic medications, and this structure remains unchanged under the 2025 reforms. Many plans require patients to switch to mail-order after the second or third retail fill of a maintenance medication, or they impose significantly higher copays for retail fills beyond initial prescriptions.

Amazon Pharmacy has expanded its PillPack service to 50 million Medicare Part D beneficiaries, positioning itself as a mail-order provider for Medicare plans. However, patients should verify that:

• Amazon Pharmacy is in-network for their specific Part D plan
• Their medications are covered under their plan's formulary when filled at Amazon
• Whether Amazon qualifies as their plan's "preferred mail-order pharmacy" (some plans have tiered pharmacy networks)
• Any specialty medications requiring prior authorization are properly coordinated
• Their plan's preferred pharmacy network doesn't offer significantly lower copays elsewhere

Additional provisions in the Inflation Reduction Act include cost-sharing smoothing under the Medicare Prescription Payment Plan and a standard $35 cap on cost-sharing for a month's supply of each covered insulin product.

The 2025 reforms also address some non-cost barriers to adherence. Medicare beneficiaries receiving the Low-Income Subsidy had lower odds of reporting cost-related medication nonadherence but greater odds of reporting non-cost-related medication nonadherence, suggesting that factors beyond price—such as beneficiary preferences, understanding of coverage, and ability to access pharmacies—remain significant contributors to overall nonadherence.

For Medicare beneficiaries, the combination of the $2,000 out-of-pocket cap, mail-order pharmacy incentives, and services like pre-sorted PillPack medication packaging may work together to improve adherence rates. However, patients must still navigate plan formularies, prior authorization requirements, and preferred pharmacy networks to maximize these benefits.

Implications for Prostate Cancer Patients

For men managing prostate cancer, who often juggle complex medication regimens including hormone therapies and drugs addressing treatment side effects, both mail-order and kiosk options offer distinct advantages.

Mail-order remains optimal for:

• ADT injections coordinated with urology offices
• Oral hormone therapies (enzalutamide, abiraterone, darolutamide) taken daily indefinitely
• Bone-strengthening medications (denosumab, zoledronic acid)
• Cardiovascular medications (many men develop hypertension or lipid issues during treatment)
• Medications for hot flashes, fatigue, or other chronic side effects

Kiosks may benefit patients needing:

• Immediate antibiotics for urinary tract infections (common during treatment)
• Short-term pain medications for bone metastases management
• Steroids for acute side effect management
• New medication trials where immediate access helps assess tolerability

Amazon has expanded several services relevant to chronic disease management. The company's PillPack service now serves 50 million Medicare Part D beneficiaries with pre-sorted medication packets, which can be particularly helpful for patients taking multiple daily medications at different times—a common scenario for men on ADT who develop metabolic complications requiring diabetes and cardiovascular drugs.

Cancer patients should be aware that while the kiosks offer convenience for common medications like antibiotics (for infection management) or blood pressure drugs (which many cancer patients need), specialized oncology medications typically require specialty pharmacy services that provide:

• Prior authorization assistance for expensive treatments
• Financial counseling and patient assistance program enrollment
• Clinical monitoring for side effects and drug interactions
• Coordination with oncology teams
• Temperature-controlled handling for sensitive medications
• Navigation of Medicare Part D formularies and coverage rules
• Delivery coordination for injectable medications

Medicare Part D plans often have multi-tier formulary structures where specialty cancer medications may fall into higher cost-sharing tiers. The $2,000 annual cap provides protection, but patients may still need to budget for monthly costs that can range from hundreds of dollars early in the year until the cap is reached. PillPack's medication synchronization and pre-sorting may help patients better track their spending toward the annual cap.

Most specialty oncology medications will continue flowing through dedicated specialty pharmacy channels rather than kiosks or general mail-order. These pharmacies—operated by companies like Accredo, Onco360, Optum Specialty, or CVS Specialty—provide services that general pharmacies cannot match for complex cancer treatments.

The Broader Crisis in Prescription Access

The medication adherence problem carries enormous costs beyond the individual patient. Poor medication adherence contributes to approximately $100 billion to $300 billion in potentially avoidable annual healthcare spending and is associated with 125,000 deaths yearly in the United States. Research shows that 25% to 50% of patients do not take medications as prescribed, and nearly half of patients discontinue medication within the first year.

Multiple factors drive non-adherence. In surveys, patients report forgetfulness as the most common reason for missing medications (24%), followed by perceived side effects (20%), high drug costs (17%), and perception that prescribed medication would have little effect (14%).

Mail-order pharmacy addresses some of these barriers—particularly forgetfulness through automatic refills and cost through lower copays—but creates new challenges. Some patients prefer in-person pharmacist consultations for medication questions, find mail-delivery timing inconvenient, or struggle with the upfront cost of 90-day supplies even when per-unit pricing is lower.

For Medicare beneficiaries specifically, the issue remains serious despite insurance coverage. In a national survey of adults aged 65 and older in 2022, 20.2% reported cost-related medication nonadherence. The 2025 out-of-pocket cap should reduce this percentage, though time will be needed to assess its full impact.

Traditional Pharmacy Chains Under Pressure

Amazon's expansion comes as established pharmacy chains face severe challenges. CVS closed 900 stores between 2022 and 2024 and plans to close an additional 270 locations in 2025. Walgreens announced plans to close 1,200 stores by 2027, representing one in seven of its locations. Rite Aid filed for bankruptcy protection for a second time in May 2025 and subsequently closed all remaining stores.

Chain pharmacies expanded aggressively during the 1990s and 2000s but are now closing stores due to declining profit margins on prescriptions, competition from online retailers and big-box stores for front-end merchandise, and failed expansion strategies into primary care services.

These closures are creating expanding pharmacy deserts, with GoodRx analysis showing that over 1,300 pharmacies have closed in the past five years. When neighborhood pharmacies close, research shows patients who previously filled cardiovascular medication prescriptions at those stores experience clinically significant declines in medication adherence.

This crisis particularly affects Medicare beneficiaries who may have mobility challenges or lack reliable transportation. The combination of pharmacy closures and the convenience of Amazon's kiosk model or mail-order PillPack service may make Amazon increasingly attractive to this demographic, especially as the company continues to integrate with Medicare Part D plans.

Ironically, traditional chains like CVS and Walgreens operate massive mail-order fulfillment operations even as they close retail locations. CVS Caremark processes millions of mail-order prescriptions monthly, suggesting the company recognizes where the chronic medication market is heading. However, Amazon's integration of technology, competitive pricing, and customer experience may give it advantages even in the mail-order space where traditional players are established.

What Patients Should Consider

While Amazon's kiosk model offers convenience and potentially addresses access gaps, prostate cancer patients should evaluate several factors:

Medication availability: The kiosks currently stock common acute-care medications. Complex oncology drugs and specialty medications will likely continue requiring traditional specialty pharmacy services or mail-order delivery.

Cost transparency: Through the Amazon app, patients can see upfront costs including available discounts and estimated insurance copays before ordering. This transparency allows comparison with other options like GoodRx discount cards at traditional pharmacies or mail-order services.

Mail-order vs. kiosk decision-making:

• For stable chronic medications: Mail-order typically offers better pricing and convenience
• For new prescriptions: Kiosks allow immediate access and pharmacist consultation
• For acute needs: Kiosks provide same-day access without delivery delays
• For multiple chronic conditions: Compare RxPass ($5/month unlimited generics) against your plan's mail-order copays
• For specialty medications: Neither kiosks nor general mail-order may be appropriate; specialty pharmacy likely required

Medicare Part D integration: Patients should:

• Verify Amazon Pharmacy participates in their specific Part D plan network
• Confirm their medications are covered under Amazon's formulary arrangements
• Understand how costs count toward the $2,000 annual out-of-pocket cap
• Compare copays at Amazon versus their plan's preferred mail-order and retail pharmacies
• Check whether specialty medications require use of specific specialty pharmacies
• Understand their plan's mail-order requirements for maintenance medications

Clinical consultation: Oncology pharmacies often provide specialized counseling on drug interactions, side effect management, and adherence support. Patients should assess whether remote pharmacist consultations meet their needs for complex cancer-related regimens.

Insurance integration: Verify that Medicare Part D or private insurance plans work seamlessly with Amazon Pharmacy for all cancer-related prescriptions. Some specialty medications may have preferred pharmacy networks that affect out-of-pocket costs.

Geographic access: The service launches in five Los Angeles-area locations with expansion plans, and Amazon executives indicated Seattle could be "high on the list" for future deployment. Availability remains limited initially. Mail-order serves all geographic areas.

Comparing costs: Even with insurance and the 2025 Part D cap, prices can vary significantly between pharmacies before reaching the cap. Patients should compare:

• Insurance copays at Amazon Pharmacy kiosks (typically 30-day supplies)
• Insurance copays for mail-order (typically 90-day supplies at lower per-month cost)
• Cash prices with Amazon Prime discounts versus Part D copays
• Amazon RxPass ($5/month) for common generics versus insurance copays
• GoodRx prices at traditional pharmacies
• Manufacturer patient assistance programs
• Progress toward the $2,000 annual out-of-pocket cap

Tracking the cap: Medicare beneficiaries should monitor their prescription spending to know when they approach the $2,000 cap. After reaching the cap, all covered medications for the rest of the calendar year have no additional out-of-pocket costs. Services like PillPack may help track this spending through synchronized delivery and consolidated billing.

Looking Forward

Hannah McClellan, Amazon Pharmacy's vice president of operations, stated that kiosks have "runway far beyond One Medical, and frankly, far beyond primary care offices," suggesting potential expansion to other healthcare and retail locations.

As pharmacy access challenges intensify and traditional chains restructure, innovations like automated dispensing may reshape how Americans obtain medications. For cancer patients managing ongoing treatment regimens, these changes present both opportunities for convenience and cost savings, as well as questions about maintaining the specialized pharmaceutical care their conditions require.

The convergence of pharmacy deserts, Medicare Part D reforms including the $2,000 out-of-pocket cap, mail-order pharmacy dominance for chronic conditions, rising medication costs, and new technology-driven solutions creates both challenges and opportunities. Patients who actively compare prices, utilize discount programs, understand their Part D benefits, leverage mail-order for maintenance medications while using retail or kiosks for acute needs, and work closely with their healthcare teams to find affordable medication sources will be best positioned to maintain treatment adherence.

For Medicare beneficiaries specifically, 2025 represents a watershed year with the new out-of-pocket cap providing unprecedented financial protection. Combined with expanding pharmacy access options, mail-order incentives, and services designed for chronic disease management like PillPack, these changes may significantly improve medication adherence rates—but only if patients understand how to navigate the evolving landscape of pharmacy services and insurance benefits.

The future likely involves hybrid medication management: mail-order for chronic medications like diabetes, blood pressure, thyroid, and prostate cancer hormone therapies; specialty pharmacy for complex oncology treatments; kiosks or retail for acute prescriptions; and digital tools for price comparison and adherence tracking. Patients who master this multi-channel approach will achieve the best outcomes at the lowest costs.

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Sources

Primary Announcements:

Amazon. (2025, October 8). Amazon Pharmacy introduces in-office kiosks to help patients get medications immediately after appointments. About Amazon. https://www.aboutamazon.com/news/retail/amazon-pharmacy-kiosks-one-medical

Business Wire. (2025, October 8). Amazon Pharmacy launches in-office kiosks to help patients get medications immediately after appointments. https://www.businesswire.com/news/home/20251007520087/en/

News Coverage:

Schlosser, K. (2025, October 8). Amazon Pharmacy introduces kiosks that can quickly dispense medications at the doctor's office. GeekWire. https://www.geekwire.com/2025/amazon-pharmacy-introduces-kiosks-that-can-quickly-dispense-medications-at-the-doctors-office/

Palmer, A. (2025, October 8). Amazon debuts prescription kiosks at Los Angeles One Medical clinics. CNBC. https://www.cnbc.com/2025/10/08/amazon-debuts-prescription-kiosks-at-los-angeles-one-medical-clinics.html

Niasse, A. (2025, October 8). Amazon Pharmacy to launch electronic kiosks for prescriptions at One Medical locations. Reuters via Yahoo Finance. https://finance.yahoo.com/news/amazon-pharmacy-launch-electronic-kiosks-100546858.html

Pharmacy Access Research:

Qato, D. M., et al. (2024). Locations and characteristics of pharmacy deserts in the United States: A geospatial study. Health Affairs Scholar, 2(4). https://academic.oup.com/healthaffairsscholar/article/2/4/qxae035/7630415

GoodRx. (2025, March 20). 48.4 million Americans lack convenient access to a pharmacy. https://www.goodrx.com/healthcare-access/research/many-americans-lack-convenient-access-to-pharmacies

Pawlik, T. (2024, August 28). Nearly half of U.S. counties have pharmacy deserts. Ohio State Health & Discovery. https://health.osu.edu/discovery-and-innovation/research-advances/pharmacy-deserts

Yale School of Medicine. (2025, April 11). A new metric to identify—and prevent—pharmacy deserts. https://medicine.yale.edu/news-article/a-new-metric-to-identify-prevent-pharmacy-deserts/

Medication Adherence and Cost Research:

Bosworth, H. B., et al. Medication nonadherence increases health costs, hospital readmissions. Duke Health Referring Physicians. https://physicians.dukehealth.org/articles/medication-nonadherence-increases-health-costs-hospital-readmissions

Cutler, R. L., et al. (2018). Economic impact of medication non-adherence by disease groups: A systematic review. BMJ Open. https://pmc.ncbi.nlm.nih.gov/articles/PMC3934668/

Centers for Disease Control and Prevention. (2023, June). Data brief: Adults who did not take medication as prescribed due to cost. https://www.cdc.gov/nchs/products/databriefs/db470.htm

Dusetzina, S. B., et al. (2023). Cost-related medication nonadherence and desire for medication cost information among adults aged 65 years and older in the US in 2022. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805012

IQVIA Institute for Human Data Science. (2022). Medication adherence is not a zero-sum game. American Journal of Managed Care. https://www.ajmc.com/view/contributor-medication-adherence-is-not-a-zero-sum-game

Magellan Health Insights. (2024, February 19). Prescription predicament: The impact of rising drug costs on medication adherence. https://www.magellanhealthinsights.com/2024/02/19/prescription-predicament-the-impact-of-rising-drug-costs-on-medication-adherence/

Medicare Part D and Policy Research:

Strachan, K., et al. (2024). Non-cost-related sources of medication nonadherence in the Medicare population. Health Affairs Scholar. https://pmc.ncbi.nlm.nih.gov/articles/PMC11630555/

Pharmacy Chain Closures:

CNN Business. (2024, October 16). Why your drug store is closing. https://www.cnn.com/2024/10/16/business/walgreens-cvs-store-closures

NPR. (2024, October 16). Walgreens is closing stores; CVS is announcing layoffs. Here's why. https://www.npr.org/2024/10/16/nx-s1-5154129/cvs-and-walgreens-closing-stores-why

Newsweek. (2025, May 28). CVS closing 270 stores nationwide: List of locations impacted. https://www.newsweek.com/cvs-closing-270-stores-locations-impacted-2077982

The Street. (2025, October 4). 63-year-old bankrupt retail chain closes all stores permanently. https://www.thestreet.com/retail/63-year-old-retail-chain-closes-all-of-its-stores-permanently

Industry Analysis:

Polevikov, S. (2025). Amazon Killed Traditional Pharmacy This Morning. AI Health Uncut (Substack newsletter). https://sergeiai.substack.com

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This article is for informational purposes only. Patients should consult with their oncologists and pharmacists before making changes to how they manage prescriptions. Always compare medication costs across available options and explore patient assistance programs. Medicare beneficiaries should review their Part D plan documents to understand coverage, network pharmacies, mail-order requirements, and formulary requirements.