Epic moves drug price comparison into the prescribing workflow
Epic is preparing to bring pharmacy price shopping directly into the examination room. The company is partnering with Amazon Pharmacy, Mark Cuban Cost Plus Drugs, Costco, and Eli Lilly’s LillyDirect on a prescription marketplace that will let clinicians and patients compare medication costs before the prescription is sent.
The tool is slated to launch in the summer of 2027 for health systems using Epic. At the point of care, users will be able to compare insurance-based prices with cash prices across participating pharmacies, and Epic says any pharmacy will be able to share cash pricing with health systems on its platform. In practical terms, the workflow aims to answer a question patients often face only after leaving the office: whether a drug is cheaper through insurance, through a cash-pay option, or at a different pharmacy altogether.
For patients managing chronic disease, the timing can determine whether a prescription is filled at all.
Cost-driven nonadherence is the clinical problem behind the platform
The business partnerships matter because the underlying clinical problem is large. More than 40% of American adults say they do not take medications as prescribed because of cost, according to a KFF survey cited in the release. In the outpatient setting, that kind of price shock can lead to delayed starts, abandoned fills, and rationed doses, especially when patients discover a lower cost only after the prescription has already been sent.
Epic already operates a real-time prescription benefit feature in its electronic health record that shows physicians what a patient will pay under insurance, alongside generic alternatives. The company says that feature helped patients save more than $250 million in 2025. The new marketplace extends that logic beyond the insurance quote and into broader pharmacy shopping, including cash pricing, which can undercut the insured price for some medications depending on the drug, the plan, and the dispensing channel.
In a field where adherence can hinge on a few dollars, a transparent price at the point of prescribing may change the entire encounter.
Why cash pricing can beat insurance at the counter
The most clinically relevant part of the design is the comparison itself. Not every prescription is cheapest through the patient’s insurance plan, and not every pharmacy applies the same cash price. For some drugs, patients may pay less if they bypass insurance entirely, a pattern that has become increasingly visible as pharmacies, retailers, and direct-to-consumer drug companies compete on transparency.
That matters because the average prescriber rarely sees the full financial picture in real time. When cost information is delayed until the pharmacy counter, treatment decisions can become disconnected from the patient’s actual ability to pay. Epic’s marketplace is built to collapse that gap before the order leaves the office, allowing prescribers and patients to weigh insurance coverage, pharmacy selection, and cash pricing in one step.
Amazon Pharmacy has worked with Epic since early 2025 to help shape the marketplace. Tanvi Patel, vice president and general manager of Amazon Pharmacy, said the goal is to make medication access “simple, transparent, and convenient,” including home delivery or pickup at an Amazon Pharmacy kiosk where available. That combination of fulfillment choices and price visibility reflects how tightly convenience and affordability now intersect in medication use.
Direct-to-consumer models are reshaping pharmacy competition
The partnership also reflects a broader shift in how drugs are being bought and sold. Mark Cuban Cost Plus Drugs launched in January 2022 as an online pharmacy built around transparent pricing. LillyDirect rolled out in early 2024 as an end-to-end portal for telehealth consultations and direct ordering of therapies from the manufacturer. Amazon has layered on multiple savings programs, including RxPass and Prime Rx, to expand its pharmacy business and deepen consumer use.
These models compete on a common premise: if patients can see pricing clearly, they can make better choices and avoid surprises. Ricky Li, assistant vice president at Costco, said integrated access to transparent pricing can reduce abandonment at the pharmacy counter and close care gaps. Jen Mazur, general manager of U.S. LillyDirect at Eli Lilly, said patients should not have to navigate the system alone to understand filling options and costs.
The market signal is clear. Pharmacy access is no longer just about where a prescription can be filled; it is about where it can be filled affordably enough to be filled at all.
What the Epic marketplace could change at the bedside
From a clinician’s perspective, the appeal is straightforward. A medication that is clinically appropriate but financially out of reach is not truly accessible care. When price transparency is embedded in prescribing, a physician may be able to switch to a lower-cost pharmacy, choose a cash-pay route, or identify a cheaper dispensing option before the patient leaves the visit. That could reduce pharmacy-counter abandonment, a common and costly failure point in outpatient treatment.
The likely near-term impact is most obvious in conditions that depend on steady medication use: diabetes, hypertension, asthma, depression, lipid disorders, and many specialty therapies. Even modest cost differences can shape whether a patient fills a first prescription, refills a maintenance drug, or continues a biologic or branded therapy long enough to benefit. By surfacing price information earlier, the marketplace may turn an abstract formulary decision into a concrete conversation about affordability.
Still, the practical value will depend on adoption. Price data must be timely, accurate, and broad enough to reflect the pharmacies patients actually use. If cash pricing is incomplete or uneven across regions, the promise of transparency could narrow quickly. If health systems do adopt it widely, the marketplace could become another layer in the movement toward more direct and visible drug purchasing, with the prescribing visit serving as the first checkpoint instead of the last.
A 2027 launch leaves key questions open
The launch is not scheduled until next summer, and the intervening months will determine whether this becomes a meaningful clinical utility tool or another consumer-facing overlay on an already fragmented pharmacy market. The unanswered operational questions are familiar ones: how often prices will update, how widely pharmacies will participate, and how seamlessly the information will appear inside Epic’s workflow.
For now, the development sits at the intersection of medication access, health-system technology, and retail pharmacy competition. The central problem remains stubbornly concrete: a prescription that patients cannot afford is often a prescription that never gets started.