Amazon Study 26 (✚) – Smile Insights+

From market structure to DSP: the key success factors for pharma on Amazon

It is probably the most profound shift in the German online healthcare market in recent years: with €2.7 billion in health revenue in 2025, Amazon is the undisputed No. 1 in the German health market – clearly ahead of Shop Apotheke and the DocMorris Group, and without having its own Amazon Pharmacy in Germany. Based on 7.6 million health ASINs across 643 subcategories, the Amazon Study 26 shows how Amazon is changing the market logic in the digital pharma market – from market structure and the seller landscape to the Buy Box, categories, conversion, DSP and Rufus.

Amazon generates more than twice as much nonRx revenue as Shop Apotheke and 2.5 times as much as the DocMorris Group – on average, Amazon revenues already account for 27% of the total revenues of leading mail-order pharmacies. Despite this leading position, health revenue still represents only 4.5% of Amazon.de GMV of around €60 billion – leaving enormous growth potential. Visibility on Amazon does not happen by chance: search, category rankings, product data, availability, reviews and AI-generated answers in Rufus have a direct impact on reach and sales. Anyone who still sees Amazon merely as a marketplace is leaving strategic potential untapped.

Market analyses, category dynamics, Buy Box evaluations, shopper profiles, a detailed DSP strategy and concrete levers for Rufus visibility – the Amazon Study 26 provides the data-based foundation for manufacturers that want to manage Amazon more strategically. You will learn which seller models shape the market, which levers truly drive conversion, why DSP expands the classic Sponsored Ads logic by around 5,000 external publishers – and how your brands remain visible in Rufus answers before users even click on the search results list.

Contents of the study:

Market dynamics & key figures
Market overview: market structure, manufacturers & seller landscape
Category and Buy Box analyses on Amazon
Customer analyses: shopper behavior & conversion factors
Advertising opportunities with Amazon DSP
AI use on Amazon: Rufus & AI-generated reviews

Highlights of the study:

Amazon is the new No. 1: With €2.7 billion in health revenue on Amazon.de in 2025, Amazon ranks ahead of Shop Apotheke and the DocMorris Group – without having its own Amazon Pharmacy.
Search, Buy Box and categories in focus: How the market is distributed across 643 subcategories, which categories are growing by double digits and how product data quality, Buy Box presence and other factors determine visibility.
A closer look at the Amazon pharma shopper: Why reviews from 4.3 stars upward, price and PDP quality are the most important conversion levers – and which 4 shopper types shape Amazon.
Full-funnel advertising and AI advantage: How Sponsored Products, Brand Ads, DSP and Streaming Ads increase the purchase rate by a factor of 249 – and why up to 35% of Amazon searches could run through Rufus by the end of 2026.