If Amazon can use its considerable bargaining power to drive down drug prices, I'm all for this. "If you want to sell your [medication name] through Amazon, you can't charge more than $X."
3
With the US Supreme Court's recent (5-4) ruling in the sales tax case: S Dakota v Wayfair, Inc, states can now garner sales tax for most internet sales made to their residents. So, for years, Amazon enjoyed an almost 7% sales tax discount over brick and mortar stores on most consumer goods sold to residents of NC counties. Yet, pharmaceutical sales are generally sales tax exempt.
For comparative purposes:
Net Profit Margins (for trailing 12 month period) are:
Amazon: [(Net Profit/Total Revenues) x 100] = [($3.2b/$193.2b) x 100] = 1.7%
For: CVS [($5.1b/185.9b) x 100] = 2.7%
For: Walgreens [($4.3b/$124.0b) x 100] = 3.5%.
Gross margin = (Total Revenues - Cost of Goods Sold).
For Amazon, based on its 2017 income statement:
Gross Margin = ($177.9b - $111.9b) = $66.0b
And, the gross margin ratio equals
[(Gross Margin/Total Revenues) x 100]. And for Amazon:[($66.0/177.9b x 100) = 37.1%].
For CVS its Gross Margin is: [($184.8b - $156.2b) = $28.6b].
And, [($28.6b/$184.8b) x 100] = 15.5%.
For Walgreens, its Gross Margin is equal to:
[($118.2 - $89.1) = $29.1b and its Grosss Margin ratio is:
[($29.1b/$118.2b) x 100] = 24.6%
The higher net profit margins for CVS and Walgreens show that the retail drug sector's margins are above Amazon's current profit of 1.7 cents per dollar of sales. The lower gross margins for CVS and Walgreens show the sales margin over COGS Amazon has to work with as it brings its logistics expertise to this sector.
6/29 F 12:23p Greenville NC
For sure this is going to make those El Salvadoran drug cartels and their terror wrought look like amateurs, begging the only question: where are we free to flee to?
I don't know why scarfing down pills is equivalent to "healthcare"?
3
I think Amazon will do a terrific job online. And for the folks who want to drop off their prescriptions, I can see pharmacy’s in their new WholeFood stores.
4
All I want to know is their prices for Humalog and Lantus.
4
When will Amazon start selling cannabis online? Give it a few more years. Amazon Green anyone?
6
I'm sure there is one thing, they will do the same as all pharmacies!
On the label, it will instruct that the Pills Should Be Taken By Mouth! You have to wonder how dumb the industry thinks Americans are, circa 2018! ( Please don't mention the election of President Trump!)
1
It's incredible that Americans are just willing to continually submit to a truly awful monopolist rent-seeker, "because technology"!
The entire economy in the United States is dominated by a few health insurers, a few drug companies, a few airlines, and a single "tech company" sucking up everything else -- from retail to groceries to pharmaceuticals.
This is not normal. The quality of consumer goods and food in the United States is dramatically lower than in Europe and Japan, even as Americans pay much higher prices for these goods.
What's emerging is a kind of "Soviet America," but with the exploitation of the capitalists instead of the incompetence of the state.
Americans accept so much abuse and exploitation and then say, "Please, Jeff Bezos, may we have some more?"
4
I realize that this article is not selling Pill Pack, but it sold me. I signed up -- easy-peasy. Now I don't have to drive 10 miles (round trip) to get my medications, sometimes just one. Add the costs up for that hassle. And there's always a long wait at the local pharmacy. Nevermore!
I used to work for Merck-Medco, now Express Scripts, so I'm very comfortable with the process of mail-ordering medications. The system usually works gangbusters.
I dislike change, like many folks, but sometimes the new way is better. I predict that most of the current crop of oldsters will not use Pill Pack; their kids, however, will.
I know it's hip to diss Amazon, but they have made my life so much better and easier. I regret not patronizing my local vendors, but what have they really done for me except overcharge me? And Amazon charges tax, so Florida gets its pound of flesh.
America just gets better and better. (I know it's wrong to say that in print, but I'm a bit of an outlier.)
Let us go boldly forward.
7
"I regret not patronizing my local vendors, but what have they really done for me except overcharge me?"
Seriously. You state you used to work for MerckMedco/Express Scripts. Have you ever owned your own brick and mortar business? Ever heard of something called overhead, including rent/lease, licensing fees, employee salaries and benefits, and let's not forget taxes, which we small business people cannot evade as easily as Bezos and the like. He just got the city of Seattle to repeal at tax on businesses with over 20 mill a year in revenue that the city council recently voted for unanimously. Small business have no such power. We get fined, fee-ed, and taxed to death because only the wealthy are worthy of tax cuts and easy access to business financing.
Did you consider your salary as "overcharging" your employer, or fair compensation for the work/services you provided?
Amazon is one of the leaders in our current race to the bottom, in which people have no right to expect living wages and skid row housing is a luxury.
4
Ms. Castel, CVS spokesperson, I am a CVS customer and no you don't really offer the ability to switch between the store and mail order pharmacy. I have been a long time user of the mail order pharmacy and somehow (I never figured out how) it became a in store prescription. I made multiple calls to both the store and the on line pharmacy and neither one would help switch it back, In fact they were ignorant of the others existence. In the end I had to cancel the store prescription and have the doctor write a new prescription. A waste of everyone's time because of your incompetence. Hopefully with Amazon entering the business you will raise your level of customer support or go out of business. I favor the latter.
6
Is anyone else uncomfortable with sharing Personal Medical information with big Data collectors?
I would need to know the restrictions on Amazon, who has so much of my life already on file.
3
I’m dismayed and flabbergasted by the number of commenters who don’t understand how this will impact their right to keep their personal health information private. This article doesn’t address whether Amazon will be subject to HIPAA regulations. Don’t be surprised if Bezos finds a way around this.
It is not unfathomable to foresee the day Amazon may control all aspects of health delivery services and start making medical decisions for us.
As a retired nurse I will never give up my right to control my personal health information without a fight. Unfortunately, it seems not all people feel the same.
5
Price of a drug, is decided by a contract among the Insurance Company, drug manufacturers,Pharmacy Benefit Manager (PBM) and Dispensing Pharmacy. This price is fixed months before the next years insurance plans are priced and sold.
What plan one buys, defines what price one pays for the drugs. Regardless of the plan one buys, the relative profit / expense percentages for all the players except the insured remains in the same ballpark.
Even with vertical integration among insurers, PBM and pharmacies, no reduction of premiums for the insured has occurred.
Amazon is a retail entity used to profit margins in multiples of what the current players are used to.
After the initial price cut to enter the market, the final expectations of rate of return of companies like Amazon will be devastating to the people.
The quality of generic drugs, in-spite of FDA will further deteriorate. If in doubt ask any industry insider where they would get their generic medications from ? Costo or the regular pharmacies?
1
Trump hates Bezos because of his ownership of the Washington Post so we should expect Jeff Sessions and the Justice Department to oppose this merger.
5
There should be ONE nationwide price for prescription drugs like in most European Countries.
All this price haggling to treat the sick is immoral .
17
When does Amazon become "too big?" Is it not already bigger than what Bell Telphone used to be with its regional Bell's, Bell Labs, AT&T, etc? It has become an octopus of enormous size and reach. If it continues at this rate it may gobble up many more local merchants seriously damaging the local economies.
Watch out!
3
It’ll be good when you can look up the price of a knee replacement at a number of hospitals as easily as looking up the price of a barbecue grill from a variety of sellers.
6
And the user ratings.
5
Pillpack is not new to me. For the past 4 years I have been doing business with a local pharmacy which packs my daily pills for me in these little packs, sets them in a box from which I can pull out the days supply, and best of all they deliver them to me once a month. I was desperate at a time after surgery when I could not drive to pick up my prescriptions and other pharmacy supplies, called local CVS who delivers to a Sr. community in town but not to individuals (unfair since these seniors are fully capable of driving), then Walmart who offered no help as far as delivery of meds, then called Walgreen's who steered me to this little independent pharmacy who would deliver a much needed Rx almost immediately and I've been with them ever since. I am very happy to deal with local independent establishments for anything tho I do use online shopping venues, do my banking online, but am particular about pharmacy needs. I have a hard time imagining how this will work with an unknown, far away business, medications are too important to fool around with. Maybe this will engage the CVS's and Walgreen's to offer the same service. Better the known than unknown.
Sometimes it seems that a future is coming when there will be basically one retailer in the country - Amazon. There will be little choice other than to order online whether furniture, clothes, drugs or even food. Surely, not everyone is loving that trend.
I am getting older, but am certainly no tech-fearful old geezer. I have been online for 20+ years, do all of my financial transactions online; have ordered meds online for nearly 20 years, often order clothes and other items that way, as well as buy tickets, make reservations etc.
That said, buying clothes and shoes online is the pits as clothes often don't fit (no matter how closely I follow the measurement charts), shoes are often just wrong and hurt. Buying furniture online where color or quality of fabric cannot be seen as well as in person is a crap shoot (I've been looking). As to groceries - well, I'm fussy about my produce and refuse to let some indifferent, busy warehouse clerk filling the umpteenth order of the day simply toss any stalk of broccoli she grabs or any pepper to hand into my order.
IMO, too much will be sacrificed in the name of 'convenience.' How convenient is it if some of the grocery order goes in the trash? How convenient is it to keep rewrapping clothes or shoes that don't suit or don't fit to send back? What does one do with the sofa which is all wrong when delivered?
19
Anne-Marie Hislop:
Walmart is a bigger retailer than Amazon and with their purchase of Jet a couple years ago are rapidly ramping up their online presence. I welcome Amazon as a counterweight to Walmart. What is wrong with competition?
4
Amazon and Walmart gobbling up smaller companies and amassing a greater and greater share of the overall market is not really competition. Competition would be smaller businesses that are able to maintain a local/regional share as a counterweight to the dominance of both Amazon and Walmart.
At least Walmart is trying to pay better wages. And their physical presence actually helps to stimulate the local economy around their store location, which provides jobs in various communities. Amazon seems to be trying to avoid hiring more workers and instead contract out more of their operations. I hope they'll be giving contract workers a discount on medication since they won't be providing these people with any benefits, including health insurance or sick leave.
This is another step in pharmacy catch up. A long overdue one at that. Amazon/PillPack will offer the public another option: one that we need.
I take a large number of meds and at the age of 81, the costs are starting to hurt. I will involve with Amazon/PillPack if my current pharmacy can't stay close in meeting the improved costs. I deal with Walmart now and am completely happy with their services but lowering costs will be the ultimate decision maker.
2
Amazon bought Zappos a long time ago but both footwear retail stores and mail order houses are still around.
I use a mail order shop in California because it has a better selection of technical running shoes, sometimes with good discount because they are last year models.
If drug manufacturers set the prices and insurance companies set the reimbursement rates, can this move really lead to lower prices for consumers? I see the potential for Amazon and Bezos to make money.
At what point are we going to acknowledge that one company having such a large share of retail markets undermines the competition necessary to limit the most predatory elements of capitalism. The quest to pay lower and lower prices for everything only ensures the depression of wages/salaries for our skills and labor.
The drug manufacturers are making a killing by inflating the prices for medications sold here in America, because other countries negotiate reasonable and stable pricing. Check the stock prices and executive compensation of the major drug companies. That's where the money is going more than to line the pockets of the local pharmacist.
17
Maybe Amazon will lower the cost of prescription drugs. With it’s large customer base. I’m sure it could market health insurance too.
Take the do nothing politics of congressional self enrichment out of the equation and maybe people can vote directly by dollar instead PAC capers and Kocha politics.
5
"90 percent of all prescriptions are filled at a pharmacy counter"
Wow. I've been getting my scripts mailed to my door every 90 days for almost 5 years now, and it's cheaper than I can get from any chain ... and I don't ever have to wait at any counters.
It's entirely possible that Amazon can shake up -even shred- the current pharmacy business, and I spend a whole lot of money with them every day, week, month and year, but as long as the 106 year old pharmacy I love sticks around Mr. Bezos isn't getting my co-pays.
2
As a retired nurse I find this a bitter pill to swallow. Once mega-corporations enter any medical service the best interests of the patient is lost. Patients are already considered liabilities.
The perfect health insurers’ scenario is making individuals buy expensive comprehensive health insurance coverage. The perfect patient pays premiums until they very thoughtfully and conveniently expire before using benefits.
Let’s jump ahead, Amazon Rekognition (notice the “K” they chose to use) is a service offered to law enforcement to track and identify people. It doesn’t matter if you are innocent or a lawbreaker you will be treated the same.
Now combine Amazon Rekognition and Amazon PillPack, you have corporate interests that are in direct opposition to each other. On the one hand, you will be supplied with the pain medication you desperately need. While on the other hand, you will be reported to law enforcement as a possible danger to society for possibly driving while Intoxicated (DWI). Which side do you think they will favor?
Amazon will favor the most lucrative business model. In other words, Amazon will sell you out.
Patients using healthcare dollars are liabilities. Law enforcement buying patient data will be considered an asset.
Law Enforcement cross-referencing patient PillPack and Rekognition data will be very lucrative. Your medical and health needs will be sold out for profit.
Welcome to Oceania....
or is it Eurasia?
They are constantly in flux.
9
Despite gloom and doom forecasts....Amazon is a great equalizer.
It makes products available, and promotes competition, comparison, and bargain hunting, available to all. 24/7.
As a health care provider I welcome it.
Insurance companies have different benefits for different zip codes.
Every pharmacy benefits provider has different formularies.
Many of them are owned outright by Pharmaceutical conglomerates, and only permit you to use medications from their own warehouses. Gate keepers for patient and provider hell.
Some only allow the pharmacies where they have their kickback deals to pocket the patients' money.
I find that I have a lung condition that requires inhalers to keep me functioning and out of the hospital, saving thousands of dollars. They aren't covered. Over $300 a month, when you can buy a three month supply for less than 20% of that on line.
Amazon's success is simply freedom of the marketplace. Free markets allow competition and may the most functional and customer savvy businessman win.
Amazon serves its customers. What a concept.
Aloha,
7
@Virginia
Amazon maximizes its profits and will continue to do so, what an old concept.
1
Ah, Amazon - they know what we read, what consumer products we buy, and now they'd ALSO like our Medicare numbers and drug histories to be stored with them as well. What could go wrong, eh?
I don't trust Jeff Bezos as far as I could throw him; he just wants to be the monopoly in yet ANOTHER area where consumers spend money. I absolutely DON'T trust Amazon to keep my medical/pharmacy info confidential.
Bezos will try to monetize my information - and everyone's information - for his own bank account's benefit. Because, as you know, being worth over $100 billion just isn't enough for Jeff!
I envision that while I'm shopping for a book, at the bottom of the page it will say "Items you recently looked at" and it will list a birth control pill Rx, or an antibiotic, or a blood thinner. No thanks!
It'll also be interesting to see what happens to people who need BRAND name drugs; I can picture Amazon saying "no dice, you can have random-manufacturer's brand or else you get nothing at all." Again, no, thanks!
10
You are right on point.
1
This is tailor-made for Amazon. They are gonna kill it.
2
This buyout should be blocked. Amazon Prime prices have gone up 66% from $79 to $99 to $119 in just a few years. Amazon is taking over without actually saving anyone money.
.
Amazon is a monopoly which abuses its power. Antitrust law died this year. It is not being enforced. I expect the worst.
.
For a good read on the subject I suggest....
https://www.yalelawjournal.org/note/amazons-antitrust-paradox
6
Wow! This means that the rest of the market with its arrogant attitude, just got a big competitor!
The current market is like the old wild, wild west. Prices change and are indeed all over the map, with no logic behind it.
Policy changes occur at a whim, and there is little regulation of the way they operate.
While some may argue about Amazon's size, the fact is that they get the job done efficiently and inexpensively. YEA!!
1
I hardly see the appeal of mail order for anything except regular, long term prescriptions, then there is some value.
The pharmacy industry is ripe for disruption in general though. Let's face it - pharmacists are glorified human vending machines!
I work as a pharmacy technician, and if you think that we are "glorified human vending machines," you have no idea what we/they do.
We catch medication interactions that can cause death (i.e. inhalers that interact with A-Fib medications), directions/strengths that don't make sense (today a 5 year old was given amoxil with no strength, 30 tablets, yet directions for a Z-Pak), help patients manage chronic conditions (especially seniors and parents of ill children), battle with insurance/work with doctors offices to get meds covered or approved, assist patients get the best deals they can in an overpriced market (manufacturer coupons, online discounts, etc.. I've spent hours on the phone with insurance/looking up manufacturer coupons for customers before they even step in the door), and manage to do it all as quickly/cheerfully as possible with little thanks or being verbally assaulted. However, I enjoy my work and many of my customers who understand how hard we work and appreciate it--many of whom I have become friendly with over the past few years.
I think Pill Pack's biggest hurdle will be trying to convince seniors to get their medications online. When there are changes to their meds, new manufacturers used, or the price changes due to the donut hole/other insurance practices, they need much more reassurance and in-depth explanations about what is happening. I think the senior population would probably choose brick and mortar and their familiar pharmacists, over online.
7
The insidious Amazon is taking over the world. Walgreens/CVS don't need price competition. We need to fix the whole system. IT DOES NOT WORK, ALL OF IT!
5
I am a retired pharmacist. How do people know who is
filling their prescriptions if they come through the mail?
I remembered customers' name if they came often. I will
not be using mail order for my prescriptions.
5
Like the previous article on Amazon private labels, this smacks of chickens roosting. CVS Caremark is the pharmacy benefit manager + mail service provider whose abuse & deceit have nearly crippled me; Walgreens refused to add sanitary wipes for their shopping carts after I complained that was the only possible source for my bronchitis last August. I no longer enter either retail establishment. Bring it on Amazon, they have only themselves to blame.
2
Privacy, privacy, privacy. Not the first thing than comes to mind when Amazon’ name comes up.
6
Amazon does its work really well. They are fast, efficient, well-priced and deal well with returns. I, for one, am really exhausted from dealing with retail pharmacy chains that match none of Amazon's standards. These pharmacies are poorly operated, have terrible customer service, and make error after error constantly. I'm looking forward to using the Amazon pharmacy.
5
I've been picking up the same prescriptions from Walgreens for 15 years. Every month, between me and my insurance company, they make over $200. Do they remember my name? nope. Do I even look familiar to them? nope, not even when the same people have been behind the counter for years. If I go to a new pub 3 times the bartenders remember my name, what I like to drink and greet me. Why can't Walgreen's even pretend to appreciate my business? If service is going to be anonymous, why not order drugs from Amazon?
37
And yet, I am always remembered at my Cosco pharmacy!
The monolith that is Amazon continues to work its way into all aspects of our society.
I for one can't wait for the day when these "insurance" companies fall by the wayside.They are nothing more than investment vehicles for the people who run them. They collect outrageous premiums, invest those premiums and purchase members of Congress to make their policies for them.
Each of the largest "insurance" companies aren't even run by doctors or those who hold medical degrees.They are run by businessmen and businesswomen who are making decisions on who pays for our healthcare.
19
Many are run by doctors who have sold out to corporate greed and have forgotten what it means to care for patients.
Be careful what you wish for.
1
To become a pharmacist now takes 6 years of college. If I were a young person thinking about a career in pharmacy, I would be very careful. If possible, go 8 years and become an MD. Physicians will be a lot harder to replace with robots.
18
Being an MD isn't what it used to be. Ask any retiring MD today if they would enter medicine today, and often the answer is "no".
5
Amazon will dominate the completely inefficient and illogical prescription drug business. No will miss the old ways, just as no one really misses the treks to shopping malls. The entire medical delivery system is in for a shock treatment by a behemoth. Once the pitch is made to company benefit managers for employee drug coverage and medicare part D, game over for walgreens, aetnas, cignas, united healthcare and cvs. Amazon can make a huge profit with a sliver of the overhead that these legacy companies are charging. Big pharma will be the next target for Amazon.
Next in line is the medical record - blockchained of course - so you own it. AI will help solve the drug interaction issues
23
Eric of sc wrote, “No will miss the old ways”
If you think you will own your medical record think again. In the future your medical record is a commodity to be bought and sold on the open market just like mortgages. If you utilize too many healthcare dollars you are a liability and will be sold to the worst rated health insurance company.
You will miss the good old days more than you think. The only people who think this is a good idea have absolutely no idea what the health insurance industry and health delivery systems are about.
BTW, AI has already solved the drug interaction problem.
2
Wow, got to get you on the scriptwriting team for Armageddon, that was great! The terror I felt was palpable, just what God wants to make an impression that lasts this time.
Not thrilled about one company allowed to have so much control of retail markets, but this is a great way to rid us off all of the way too many pharmacies that our townships and boroughs have allowed to over run our neighborhoods. Who needs 8 pharmacies in a one mile radius? Maybe Amazon will force the pharmaceutical companies to provide better pricing too.
9
Amazon buys a little obscure pill dispenser and the drug chains quake in their boots. Glad I have a few Amazon shares in my retirement account. Wish I had more.
5
Just wait until you realize the implications of this buyout. Everyone’s personal health information is up for auction. Doctor - Patient confidentially will be a relic of the past.
6
Is the amassing of gargantuan businesses taking over our world?
At what point will anti-trust investigations and actions be appropriate for our new business behemoths?
And will it ultimately hurt or help the little guy, the customer?
7
Will drugs be checked for interactions with other medicines? Will there be qualified pharmacists available at Amazon to answer questions? Will a doctor be called if there is an issue? Medications are a tricky business and errors can have dangerous consequences. There is no replacement for a good pharmacy.
11
With all due respect, if the pharmacist were going to really check for interactions, they would do a real medicine reconciliation each time they dispensed a prescription. This is what doctors, NPs and PAs do each time they see a patient. It is the only way to check for drug interactions and I have never ever seen a retail pharmacist do this.
IMHO, retail pharmacy is an outdated and expensive means of medication distribution.
18
Bill,
It's generally a very unpleasant experience too.
I now get all my routine prescriptions filled through Humana online. Works well.
Kurfco,
Yes, online retail pharmacies are great until they misinterpreted a prescription and refuse to correct their error. I know this because Express Scripts chose to fill a three month prescription with six weeks of medication. A medication that must be tapered. But because of their error I was almost abruptly withdrawn from a dangerous medication. Fortunately my husband and I were able to afford the difference and pay out of pocket for their mistake.
If you think this is an isolated case think again. I’m a retired nurse. This type of occurrence happens more often than you think.
9
What happened to antitrust?
Amazon is taking over everything. It's really just not okay.
Will Amazon begin to dictate policy for drugs? Choose who will live or die through access to them?
Will Amazon dictate prices for peanuts and shampoo and soon electricty (now that they're deregulated?)
Our banking? Investments?
How about our real estate market?
Babysitting?
Dog walking?
Is there anything that Amazon won't take control of?
10
Well, I guess the Trump administration is safe from a takeover by Amazon, at least for now. If Trump and consorts really go after Amazon (Jeff Bezos, really), we might see finally see an epic battle with uncertain outcome. Could Trump do the right thing for all the wrong reasons, and reign Amazon in? Or will he have a "Kim" epiphany, and change Jeff Bezos' status to BFF? Top tip for Jeff: Push lot's of Ivanka merch on Amazon's homepage.
2
I live in Seattle and rarely buy anything from Amazon. I do not need to. I have access to large stores close to me and can get stuff now, not two days from now or same day if I go Prime. I can just walk to the store and get what I want. And the shopkeepers know me.
But if a person lived in Concrete, Washington they would have one stop light and I think a coffee shop to choose from. That means quite a drive across to the next county and back (with screaming kids) or order it online just like back in the old Sears & Roebuck catalogue days.
5
:) He is one of a handful of companies that still advertise on Breitbart which is Trump central:)
Can Amazon be legally regulated?
9
bezos bought the WaPo. he is also member of some DoD board. bezos is part of establishment.
can you regulate the 'establishment'.
2
With this move, Amazon goes wild into the pharmacy space and this will be a real threat to other drugstore companies like Walgreens, Rite Aid, CVS, etc... Already, Amazon has killed a lot of brick-and-mortar retail stores. Now, this move will slowly make the physical drug stores shut down their doors. https://bit.ly/2KtlykI
5
I live in Seattle and have not seen book stores or little stores going out of business because of Amazon. Its easier for me to go to the store and buy something than to order it from Amazon and have to wait for the delivery man or worry that my package will be stolen.
Nor did I see little coffee shops go out of existence due to Starbucks. Quite the opposite.
4
And more and more people are losing their jobs, homes life savings and businesses!
2
There won’t be any true competition until I can easily move my prescription to the lowest cost provider each refill. Services like GoodRX can tell you who is the cheapest to fill a prescription today, but there is no guarantee that the price will be the same 90 or 180 days from now. If someone else is cheaper, I need to get my doctor involved in the transfer. Portability of prescriptions will be the holy grail that will allow the prices to come down.
In many cases, employer insurance prevent you from using the lowest cost provider because of what their pharmacy benefit manager is making on the back end of the deal. know people who’s generic drugs would be half the price paying cash instead of going through the PBM, but then the insurance company wont give the employer any credit towards the out of pocket annual deductible.
16
If you ever need to transfer prescriptions, you simply call the pharmacy you would like to get them at and they will call your old pharmacy for your remaining refills. No need to get your doctor involved.
1
"About 90 percent of all prescriptions are filled at a pharmacy counterAbout 90 percent of all prescriptions are filled at a pharmacy counter"
It would be important to hear how this system will flag potentially dangerous drug combinations and subpopulation (re.g elderly, diabetic)-associated side effects
3
Why wouldn't Amazon have the same drug interaction software as any other pharmacy? In fact, Amazon's other software seems to know an awful lot about me otherwise.
20
My pharmacist knows me by name and also my doctors. Its not a matter of software but a seasoned professional who knows what I should or should not be taking. He has known me for years.
Lynn,
You can do check yourself with an online drug catalogue.
www.drugs.com/drug_interactions.html#
Charles,
They in all likelihood do, a reason I steer clear of Amazon.
Yes, this move could be good for increased competition in the mail-order pharmacy sector, which needs it badly. However, in order to really have increased competition, we would need to disentangle pharmacy benefit management and mail order pharmacy companies from health insurance plans. Right now, most of us don't have a choice where we can order our prescription meds from, unless one is willing to pay large sums out-of-pocket. Recent mergers and ongoing intentions for merger of health insurers with pharmacy benefit management companies and pharmacy chains such as CVS are clear attempts to lock in the considerable profit margins inherent to being the sole choice for mail-order prescriptions for the members covered by an insurer.
And, guess who pays for those large profit margins: we do. These arrangements are one of the reasons why our health insurance rates keep going up and up. I hope that some politicians out there at the State and Federal level have the guts to look into this, have hearings on these currently entirely legal lock-ins, and maybe draft legislation that allows for more transparency and open competition. Right now, our choice is to grin and bear it, or pay fully out-of-pocket.
16
The appeal to most will be convenience, but convenience isn't everything. I will continue to use my brick and mortar pharmacy because I like the personal connection I have with the staff members. When you are ill, or managing a chronic condition, that human-to-human interaction with a tech or pharmacist can be invaluable.
6
What's up with this fascination with the "personal connection" with the pharmacist? She is probably getting a bit over the minimum wage and your beloved pharmacy wouldn't think twice about laying her off .
Are you buying medicine, or trying to contract a communicable disease from the pharmacist.
If you are desperate for human connection, make a friend.
21
My pharmacist knows more and has more time than my doctor.
1
@Krish..Pharmacists average about $120,000/year starting.
1
I take quite a few medications. Some of the same pills are taken morning and night.
It can be a bit difficult to remember 'Did I take my pills this morning?" Plus, what a hassle getting them out of the different containers. Or cutting them up because I take 50 mg doses and the pharmacy only stocks 100mg.
Since using PillPak all the pills from many different manufacturers are packaged together and labeled, taking a bunch of meds using PillPak is a breeze.
And I have a visual reminder that will confirm that I took my meds and thanks to PillPak, I know I took everything my doctor prescribed.
Walgreens and CVS could have thought of this, but either didn't and didn't want to invest the money into the necessary technology.
I love to see innovative technology companies solve everyday human problems and get rich while putting the laggards out of business, be it taxis or drug stores.
Evolve or die.
87
I already buy OTC drugs from Amazon since it’s cheaper. I’m not sure how this would work for high end drugs. Morphine scripts would still have to be thru a local.
3
I was sad when Amazon broke the book retail industry over its knee by frontloading costs among other brutal tricks, but if it does the same thing to the pharmaceutical industry, I might actually cheer... at least until it gets its monopoly and drives up prices again.
13
The benefits of capitalism work better when there are many players. Concentration on megaenterprices
is not good for capitalism, the market and society. It is only a question of time to have market distortion and monopolies . Authorities should prevent this coming situation
2
Yes, the book business was so much better with price-fixing and limited inventory.
Amazon has been a blessing to the American reader and consumer. I welcome them to the pharmacy business.
31
Go to the Library.
I am old enough to remember when the telephone company was a national monopoly. It provided a reliable service at a fair price, was profitable and was considered a "blue chip stock" . Blue chip meant it was a good stable investment for people who held the stock.
The only reason why it worked so well is because it was thoughtfully regulated by our government. The rules were sensible and in the national interest. An example...you want to serve the big profitable cities you also must serve the less profitable rural areas. The list is long and I don't want to make this comment too wordy.
What I am saying is that certain services can be run well by a monopoly but only if they are well regulated by a thoughtful government. Absent regulation, these monopolies will always become abusive. Unfortunately we do not have a thoughtful government at this time.
93
Another contrast between Amazon and the phone companies of old that were dominant is the treatment of employees. The phone companies offered stable lifetime employment with comfortable retirement packages for all employees regardless of seniority. Amazon churns and burns its employees at all levels. Per The NY Times article a few years ago, highly paid knowledge workers put in insane hours while their souls are crushed. Anecdotal, but the stories one ex-Amabot told me sounded like something from ‘The Devil Wears Prada’. At the other end of the spectrum are warehouse workers and couriers who barely make enough to afford a place to live and raise a family. How times have changed.
17
We also no longer have unions with enough power to stand up to the large corporation. In the telephone era you describe, we had the Communication Workers of America (CWA). My mother was a long-distance operator for one of the baby Bells. Even with the union, working conditions weren't great. Her company ran its own psychiatric hospital for employees who cracked under the pressure of supervisors standing over them and/or listening in on call transactions with customers, etc. Nonetheless, without union representation these workers would have been even worse off. Today? Fuggitaboutit. We have Saint Ronnie to thank when he fired the PATCO air traffic controllers. Union power and membership has declined since that time and with yesterday's SCOTUS decision it's going to be WORSE!!
6
It's bizarre we're not distributing drugs like countries such as France. All my prescriptions come in bubble packaging--no more time wasted on a pharmacist counting pills and possibly making an error. There's never a wait--you hand them the prescription, they tap it into the computer, the boxes shoot out the autodispenser, and you leave. Traveling with your prescriptions no longer means big round bottles that take up tons of room--just throw in the prescription and a few bubble sheets, stamped with the drug name. After nearly two years on this system, I can't imagine going back to the US one.
38
This works because in European pharmacies all the drugs cost the same price for everyone. In American pharmacies, it would be hard to simplify logistics in this way, because pharmacists are also forced to deal with thousands of insurance plans charging every single person a different price.
U.S. health "care" is more absurd than anything the Soviets could have invented.
It's laughable that Americans don't realize this and just accept the abuse.
72
I agree with all you've said. I'm talking about dispensing. If you need 60 pills, you get 60 pills--either in bubble packaging really fast in France, or counted out by hand in the US. What happens after that--insurance, charging, etc.--wouldn't affect dispensing. It's certainly a tiny aspect of the US' very broken system, but it strikes me as one that would benefit consumers.
"After nearly two years on this system, I can't imagine going back to the US one." No wonder, everything is Free. Now, if the French could only afford it...
A merger I can actually get behind. Now, hopefully, Amazon can use its considerable clout to drive down prescription drug prices. Can Amazon start running hospitals next?
35
If this means Amazon Prime members can get 2-day free shipping on RX drugs, I'm in. I stopped mail order drugs when the "free" shipping from my drug benefit provider took a week or more. Amazon can do better than that -- and they will. I now get same-day delivery from my local drug store, but their prices are higher so it's not really "free."
36
Pillpack will overnight mail any prescription with no shipping fee. Also, they have staff available 24/7 for questions.
1
While I’m no fan of Amazon, I applaud any action that will reign in the drug manufacturers gouging of the American public.
53
@Paulie: Not sure why you think Amazon will be able to rein in drug costs. Do you see Amazon as the mafia - do you think Amazon will threaten any company that doesn't provide drugs at a cost Amazon thinks is good?
2
If you want to terrorize the pill industry, just start pushing for a central Rx repository so that the next refill can be fulfilled by whoever the cheapest provider is. The way it works now, you have to get a new Rx from the physician directed to the new pharmacy such as PillPack... terribly inconvenient. And the PBMs with their pharmacist gag clauses and other less obvious methods of suppressing competition definitely don't want anything that might reduce costs to consumers.
15
I think Bezos is a genius and if he can shake up the drug companies....GOOD!! We are tired of overpricing. CVS has almost got a monopoly on prescriptions as it is. Good to see Amazon getting into the business.
9
@Philip W
Ever hear of Walgreens?
2
Will Amazon/Pillpack allow their pharmacists to refuse to fill prescriptions based on their religious beliefs like Walgreens just did?
1