Epic Builds Pharmacy Cash-Price Tool With Amazon and Cost Plus Drugs

Epic Systems announced on Thursday, October 15, a Prescription Marketplace that will show clinicians and patients what a drug costs at different pharmacies, with and without insurance, before the prescription is sent. The company is building it with Amazon Pharmacy and Mark Cuban Cost Plus Drugs and plans a 2027 release. The move puts cash-price comparison inside the electronic health record, which is where prescribing decisions are made.

The announcement is a few days older than our usual window, but trade coverage continued through the weekend and the commercial questions it raises are still open.

What exactly did Epic announce?

According to Epic's news release, Prescription Marketplace will show pharmacies' cash prices, meaning what a pharmacy charges someone paying without insurance, next to what the patient would pay through their plan. Epic says that, depending on the medication, plan and pharmacy, paying cash can sometimes cost less.

Pharmaceutical Commerce reports that any pharmacy will be able to share its cash prices with health systems on Epic. TechTarget notes the key design choice: users can see the price before the prescription is sent, not after, so a patient and prescriber can pick a different pharmacy while still in the conversation.

Timing is reported slightly differently. Most outlets, including Quartz, cite a summer 2027 release. A KFF Health News morning briefing says the company is looking at a May 2027 rollout. Treat both as targets, not commitments.

Who is building it with Epic?

Cost Plus Drugs and Amazon Pharmacy are named as pharmacies helping to build the feature. Fierce Healthcare reports that Amazon Pharmacy has worked with Epic since early 2025 to shape development, and that Costco and Eli Lilly's LillyDirect are also part of the effort. Costco's Ricky Li, an assistant vice president, said in a statement that integrated pricing access can help reduce abandonment at the pharmacy counter.

Cuban's statement, quoted in the release, makes the commercial pitch plainly. If insurance says a prescription costs $500 and the same drug is $100 on CostPlusDrugs.com, he argues, the patient should know before leaving the doctor's office.

Why does the problem matter to business readers?

Epic cites March 2026 KFF data showing that more than 40% of adults have skipped medications because of cost. A separate KFF survey, as relayed by TechTarget, found that 16% of people with one or two chronic conditions skipped or rationed a dose because of price.

Non-adherence is a cost problem for providers, payers and employers as well as a patient problem. Anyone paid on outcomes, whether under value-based contracts or self-insured employer plans, has a financial reason to want fewer abandoned prescriptions.

How does it build on what Epic already sells?

The marketplace extends Epic's Real-Time Prescription Benefit feature, which shows prescribers what a patient will pay under their insurance and suggests generic alternatives. Epic says that feature saved patients more than $250 million in 2025. That figure is the company's own, and we could not verify it independently.

What changes is the comparison set. Today the tool answers the question of what insurance will charge. The new tool adds what else is available, including prices that sit outside the insurance system entirely.

What does this mean for pharmacies, PBMs and other vendors?

This section is our analysis, not reporting from the sources. Three groups should pay attention.

• Pharmacies. Because any pharmacy can share cash prices, price competition moves into the prescribing workflow. Independent and chain pharmacies that publish competitive cash prices could win prescriptions at the moment of decision. Those that do not publish may simply not appear in the comparison.
• PBMs and insurers. A visible cash price next to the plan price makes the gap between them hard to ignore. Pharmaceutical Commerce notes the launch follows an August commitment by 10 PBMs to show TrumpRx cash prices in real-time benefit tools, so pressure to expose cash alternatives is coming from several directions at once.
• Competing health IT and pricing vendors. Putting this feature into the core EHR workflow can crowd out standalone price-transparency products that rely on separate integrations.

Amazon and Cost Plus Drugs also gain a distribution channel. Their prices appear at the point of prescribing, in front of clinicians, without a separate marketing effort. For Amazon, the partnership extends a relationship with Epic that began in early 2025.

Will clinicians actually use it?

This is the main risk. Pharmaceutical Commerce cites a Health Affairs study finding that clinicians changed their prescribing in response to only 11% of the alerts that real-time benefit tools generate. A new comparison feature adds more information to an already busy screen.

Jeff Park, president of digital prescription company Waltz Health, told MedCity News the announcement is directionally correct and a great step forward. He also cautioned against expecting patients to sort through prices, benefit rules, coverage, alternatives, pharmacy choices and manufacturer programs during a visit. His point is that the tool's value depends on how much of that sorting it does for the user.

The design details will decide the outcome: how the tool ranks options, whether it defaults to the cheapest, and how much work it leaves for a nurse or pharmacist. Epic has not published those details in the sources we reviewed.

What should executives watch next?

The announcement leaves several questions open. The sources do not say how cash prices will be validated, how often pharmacies must refresh them, or whether a cash purchase outside insurance will count toward a patient's deductible. Each affects whether a patient who chooses cash gets a better deal overall.

Health system leaders on Epic should ask their account teams how the feature will be configured and whether pharmacy partners can be prioritized. Pharmacy operators should decide now whether to publish cash prices, since the comparison will reward those who do. Digital health vendors in medication pricing should work out where they still add value once a basic comparison ships inside the EHR.

Finally, watch the participation list. At announcement, the named contributors were Amazon Pharmacy, Cost Plus Drugs, Costco and LillyDirect. Whether the large retail chains and PBM-owned pharmacies opt in will determine whether the marketplace is a real comparison or a showcase for new entrants.