Epic, Amazon, Cost Plus Announce Point-of-Care Cash Price Tool

Epic announced that Prescription Marketplace, a new feature for health systems using its software, will allow clinicians and patients to compare what a medication costs at different pharmacies, with and without insurance, before the prescription is sent. The company plans to release the feature in summer 2027.¹

Any pharmacy will be able to share its cash prices with health systems on Epic, according to the company. Epic defines a cash price as what a pharmacy charges someone paying without insurance. Prescription Marketplace will display those prices next to what the patient would owe through their plan, and Epic noted that paying cash can sometimes cost less depending on the medication, plan and pharmacy.¹

The feature extends Epic's Real-Time Prescription Benefit tool, which shows physicians a patient's insured cost and generic alternatives when they prescribe. Epic said that tool helped patients save more than $250 million in 2025.¹

The company tied the expansion to cost-related nonadherence. In a KFF poll conducted Feb. 24 to March 2, 2026, 43% of U.S. adults said they had not taken a medication as prescribed in the past year because of cost.²

“This will give patients transparency,” said Mark Cuban, co-founder of Mark Cuban Cost Plus Drugs, one of the pharmacies working with Epic to build the feature, in a press release.¹ “If someone's insurance says a prescription costs $500 but they can buy the exact same drug for $100 at CostPlusDrugs.com, they should know that before they leave the doctor's office.”¹

Who Is Backing Prescription Marketplace?

Amazon Pharmacy has worked with Epic since early 2025 to help shape the feature, according to the announcement. Tanvi Patel, vice president and general manager of Amazon Pharmacy, said customers “deserve to know what their medications will cost, choose whether to use insurance or pay cash, and get their prescriptions in a way that works for them.”¹

Costco pointed to reducing abandonment among the potential benefits. “Having integrated access to clear and transparent pricing enables patients and prescribers to make better decisions, reduce abandonment at the pharmacy counter, and close care gaps,” said Ricky Li, assistant vice president at Costco.¹

Eli Lilly brings a manufacturer perspective to the effort through LillyDirect. Jen Mazur, Lilly's general manager of U.S. LillyDirect, said giving patients and providers more visibility into pharmacy options and costs at the point of care is another step toward reducing friction in the healthcare experience.¹

How Does It Compare With Other Point-of-Prescribing Price Tools?

Epic's announcement follows a related move by PBMs. In August, 10 PBMs committed, in coordination with CMS, to display TrumpRx cash prices alongside benefit-based costs in RTBTs.

However, Adam Colborn, vice president of government affairs at the Academy of Managed Care Pharmacy (AMCP), told Pharmaceutical Commerce in an August statement that doctors rarely accept RTBT alerts.³ Research he cited, published in Health Affairs, found clinicians made changes in response to only 11% of the RTBT alerts they received and rarely accepted the alternatives the tools originally suggested.⁴

However, Epic’s feature may sidestep part of that problem, since the company says patients, not just clinicians, will be able to compare prices before a prescription is sent.¹ Prescription Marketplace also adds a different source of pricing. RTBTs return benefit data from PBMs, while Epic’s feature will draw cash prices directly from participating pharmacies.

What Does Point-of-Care Cash Visibility Mean for Manufacturers?

Lilly's presence in the announcement, alongside three pharmacies, signals manufacturer interest in where cash prices surface during prescribing.

Bill Roth, senior vice president of consulting and advisory services at Integrichain, has argued in a series of Pharmaceutical Commerce columns that cash has become a third payer economy alongside commercial insurance and government programs, and for some products a path to market in its own right. In the final installment of his Great Repricing series in September, he wrote that cash “is increasingly becoming a launch strategy” for brands, and that cash, direct-to-employer and direct-to-patient models “can coexist with commercial and government channels rather than replace them.”⁵

In a May column, Roth put the cash market at roughly 9% to 10% of all prescriptions in 2023, citing Avalere and Boston Consulting Group, and identified what it still lacked. “What is still missing are four things: cash pharmacies, the patients’ awareness, empowerment of cash options and for brands to enter the game,” Roth wrote.⁶ Prescription Marketplace speaks directly to the second of those gaps, putting pharmacy cash prices in front of patients and clinicians before a prescription is sent.

References

1. Epic. “Prescription Marketplace Will Let Patients Compare Pharmacy Cash Prices Before Leaving the Doctor's Office.” PR Newswire. October 15, 2026. https://www.epic.com/epic/post/prescription-marketplace-will-let-patients-compare-pharmacy-cash-prices-before-leaving-the-doctors-office/

2. Kearney, Audrey, Alex Montero, Julian Montalvo III, Isabelle Valdes, Ashley Kirzinger, and Liz Hamel. Public Views on Prescription Drug Costs: Regulation, Affordability and TrumpRx. KFF. March 13, 2026. Accessed October 16, 2026. https://www.kff.org/public-opinion/public-views-on-prescription-drug-costs-regulation-affordability-and-trumprx/

3. “Will PBMs' TrumpRx Price Pledge Reach Prescribers?” Pharmaceutical Commerce. August 21, 2026. https://www.pharmaceuticalcommerce.com/view/will-pbms-trumprx-price-pledge-reach-prescribers

4. Ganguli, I., N.E. Daley, M.J. Soto, C.E. Sloan, F.R. Goss, and A.D. Sinaiko. “Prescription Real-Time Benefit Tools: Clinicians Receive Frequent Alerts Yet Rarely Accept the Suggested Changes.” Health Affairs. 2026;45(2):146-153. https://www.healthaffairs.org/doi/10.1377/hlthaff.2025.00783

5. Roth, Bill. “The Great Repricing: Seven Assumptions That No Longer Hold.” Pharmaceutical Commerce. September 14, 2026. https://www.pharmaceuticalcommerce.com/view/the-great-repricing-seven-assumptions-that-no-longer-hold

6. Roth, Bill. “The Great Repricing: How Self-Pay Cash Fits in Commercialization Strategies.” Pharmaceutical Commerce. May 22, 2026. https://www.pharmaceuticalcommerce.com/view/the-great-repricing-how-self-pay-cash-fits-in-commercialization-strategy