Amazon will bypass PBM to lower pharmaceutical costs?

[PikminOC]

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CVS just laid out a big reason why health companies are worried about Amazon

Health-care companies claim they are not threatened by Amazon's potential foray into the space. A recent lawsuit suggests otherwise.

www.cnbc.com

Are pharmacies very concerned about Amazon entering the pharmaceutical market? Isn't this a good thing If it decreases costs?

 

[Old Timer]

How happy will you be when even the crappy chain retail jobs disappear..... Here comes $30.00/hr pharmacy.....

 

[Mr. Corporate Pharmacist]

CVS just laid out a big reason why health companies are worried about Amazon

Health-care companies claim they are not threatened by Amazon's potential foray into the space. A recent lawsuit suggests otherwise.

www.cnbc.com

Are pharmacies very concerned about Amazon entering the pharmaceutical market? Isn't this a good thing If it decreases costs?

I'm all for market disruption.

Keeps everyone honest with business. If Amazon can increase price transparency like they do for other goods, I'm all for a healthcare system that cuts out or changes the current PBM dealing methods.

I think all businesses should be concerned about Amazon, no matter what industry. They have such huge power and reach.

Ultimately, the consumer (patients) will benefit and I look forward to a better business model for healthcare.

What I'm curious about is corporate strategy to respond and adapt. We're all already struggling in market of declining reimbursements.

To compete against someone that can profit without having to deal with PBMs on top of all that makes me ponder.

The barrier to entry just decreased for Amazon.

The only times I don't use Amazon are for high-touch services or products that I would rather deal with in person.

Community pharmacy must become more high-touch to have a fighting chance.

 

[BMBiology]

CVS just laid out a big reason why health companies are worried about Amazon

Health-care companies claim they are not threatened by Amazon's potential foray into the space. A recent lawsuit suggests otherwise.

www.cnbc.com

Are pharmacies very concerned about Amazon entering the pharmaceutical market? Isn't this a good thing If it decreases costs?

It is not like Amazon is reinventing the wheel. They will become the new PBM

 

[Mr. Corporate Pharmacist]

It is not like Amazon is reinventing the wheel. They will become the new PBM

I can see that. Where contracts and business go exclusively through them.

Curious to see how this will play out.

 

[Old Timer]

It is not like Amazon is reinventing the wheel. They will become the new PBM

Maybe. Or maybe they develop a network of shady independent pharmacies that are willing to work for nothing and cut corners. The amount of counterfeit crap on Amazon is amazing. You have to be careful. Will they do the same with drugs?

 

[BenJammin]

Wasn't this the original prediction or just me? Amazon wasn't going to work with CVS and Walgreens. Why the hell would you use your insurance to get a $50 advair diskus when Amazon will sell it you for $15 with no insurance involved?

 

[MatCauthon]

That's actually great news. These PBM companies all need to get some competition. there is no reason why PBMs should maintain. the profit margins they do.

Amazon could theoretically make a platform, kind of like the Amazon cloud services, where they negotiate rates directly with the insurers and drug companies. if they get better rates, they can use that in their own pillpack, but they can also share this network for independents and other small chains to use. they could conceivably rent some of their contracts out to other pharmacies and allow them to bypass the pbms.

that might be a great thing.... just like many other tech companies rent on Amazon cloud, the pharmacy network could enable other companies as well. everything is great if it takes away margins from greedy insurers and pbms. I also love anything taking away from the dominance of cvs and wags.

 

[Old Timer]

In theory it would be good. But reality will be less pharmacist jobs and lower pharmacist wages. Many lost jobs and much lower wages........

 

[SoylentGreen]

The only times I don't use Amazon are for high-touch services or products that I would rather deal with in person.

Community pharmacy must become more high-touch to have a fighting chance.

Good luck with that. At Walmart the customers hate the forced counseling.

Maybe we could double down on things that require face to face - shots, tests, in some states they allow a pharmacist to do something like a nurse practitioner, etc.

 

[Mr. Corporate Pharmacist]

Good luck with that. At Walmart the customers hate the forced counseling.

Maybe we could double down on things that require face to face - shots, tests, in some states they allow a pharmacist to do something like a nurse practitioner, etc.

IMO most patients would be more than happy with a "forced talk" to a pharmacist who is passionate about medicine and genuinely shows they care about their patient. Same with adherence outreach calls.

Key word: shows

But how many times are we rushed and robotic, compelled to skip counsels, or look and sound plain miserable to even be there, let alone wear our white coat proudly?

Value doesn't have to be only out of the box services, but rather filling the fundamental need for genuine compassion. That's the real challenge for the future of healthcare.

Some people want WebMD and robotic outcomes at a discount.

But many people will pay substantially more money to preserve human connection and acquire high quality healthcare.

 

[Old Timer]

IMO most patients would be more than happy with a "forced talk" to a pharmacist who is passionate about medicine and genuinely shows they care about their patient. Same with adherence outreach calls.

Some yes, and some no. The average patient doesn't know good counseling from bad.

Key word: shows

But how many times are we rushed and robotic, compelled to skip counsels, or look and sound plain miserable to even be there, let alone wear our white coat proudly?

This is partly true. Many pharmacists don't want to "waste the time" counseling, but for those of us who it's a mixed bag. I can say I probably have been advocating counseling and patient care for longer than you have been alive. But unfortunately, pharmacy has given away our knowledge for free. Once that is done, it's hard to take it back. Back in the day when you could fill 600-700 scripts a week and make a nice living you could afford to give away your time for free. At AWP-18% + $1.50 and MAC pricing, not so much.

Value doesn't have to be only out of the box services, but rather filling the fundamental need for genuine compassion. That's the real challenge for the future of healthcare.

Some people want WebMD and robotic outcomes at a discount.

But many people will pay substantially more money to preserve human connection and acquire high quality healthcare.

Nobody will pay substantially more. How will you collect it? Pharmacy as we know it is done and finsihed. The number of pharmacist jobs is going to collapse intro nothingness. There will be a great deal of clinical services offered by pharmacists, just a lot less of them.....

The real problem is we have a ******ed health care system that is 1/2 socialist and 1/2 capitalist. That's a bad mix


They have converted all of healthcare into piece work........

 

[PikminOC]

Some yes, and some no. The average patient doesn't know good counseling from bad.

Key word: shows



This is partly true. Many pharmacists don't want to "waste the time" counseling, but for those of us who it's a mixed bag. I can say I probably have been advocating counseling and patient care for longer than you have been alive. But unfortunately, pharmacy has given away our knowledge for free. Once that is done, it's hard to take it back. Back in the day when you could fill 600-700 scripts a week and make a nice living you could afford to give away your time for free. At AWP-18% + $1.50 and MAC pricing, not so much.


Nobody will pay substantially more. How will you collect it? Pharmacy as we know it is done and finsihed. The number of pharmacist jobs is going to collapse intro nothingness. There will be a great deal of clinical services offered by pharmacists, just a lot less of them.....

The real problem is we have a ******ed health care system that is 1/2 socialist and 1/2 capitalist. That's a bad mix


They have converted all of healthcare into piece work........

I have patients that love their community pharmacies. Even though they are closed on Sunday. They are willing to overlook that and give their business to the small pharmacies due to the personal touch and human connection.

 

[PikminOC]

From the article "In April, CVS filed a lawsuit against John Lavin, a former senior vice president in charge of CVS Caremark's retail pharmacy network, after Lavin told the company he was leaving to take a job at Amazon's pharmacy arm, PillPack. The judge this week ruled in CVS' favor, preventing Lavin from taking immediate employment at PillPack."
==
Does anyone know the grounds on which CVS won this?

 

[PharFromNormal]

From the article "In April, CVS filed a lawsuit against John Lavin, a former senior vice president in charge of CVS Caremark's retail pharmacy network, after Lavin told the company he was leaving to take a job at Amazon's pharmacy arm, PillPack. The judge this week ruled in CVS' favor, preventing Lavin from taking immediate employment at PillPack."
==
Does anyone know the grounds on which CVS won this?

Non-compete agreement he signed for a stock bonus.

 

[alpha12]

Non-compete agreement he signed for a stock bonus.

Those are hard to enforce. Eventually I believe this guy will win.

 

[PharFromNormal]

Those are hard to enforce. Eventually I believe this guy will win.

http://drugchannelsinstitute.com/files/CVS-Amazon-1-19-cv-00204-order.pdf

Looks like the judge has ruled in favor of cvs. Who knows if there will be an appeal.

 

[alpha12]

http://drugchannelsinstitute.com/files/CVS-Amazon-1-19-cv-00204-order.pdf

Looks like the judge has ruled in favor of cvs. Who knows if there will be an appeal.

I think there was another case that went the other way. In thsi case it was amazon that was suing.

 

[SoylentGreen]

IMO most patients would be more than happy with a "forced talk" to a pharmacist who is passionate about medicine and genuinely shows they care about their patient. Same with adherence outreach calls.

Key word: shows

But how many times are we rushed and robotic, compelled to skip counsels, or look and sound plain miserable to even be there, let alone wear our white coat proudly?

Value doesn't have to be only out of the box services, but rather filling the fundamental need for genuine compassion. That's the real challenge for the future of healthcare.

Some people want WebMD and robotic outcomes at a discount.

But many people will pay substantially more money to preserve human connection and acquire high quality healthcare.

There are people who want that and we tend to remember them because we know their names, etc, but they are vastly outnumbered by the forgettable people who blankly stare at the counter as we speak to them, whose money is just as good.

The majority of front end customers at Walmart prefer the self check now that they've gotten used to it. If there was such a thing for pharmacy, I'm sure 80+ percent of them would use it too. That's not counting the mail order customers who we never see in the first place.

 

[sakigt]

I have patients that love their community pharmacies. Even though they are closed on Sunday. They are willing to overlook that and give their business to the small pharmacies due to the personal touch and human connection.

Because their cute and fuzzy PBM-run insurance companies make them pay the same copay.

 

[Old Timer]

I have patients that love their community pharmacies. Even though they are closed on Sunday. They are willing to overlook that and give their business to the small pharmacies due to the personal touch and human connection.

Until their insurance says pay $5.00 at CVS and $25.00 at your local independent or worse $5.00 at CVS and full cash price at your local independent.

 

[Amphetamine Salts]

i've been hearing about amazon and pharmacy for years. yet they are still not involved. amazon has no pharmacy, no pbm, no nothing. they just have fairy tales and rumors. "beware amazon in pharmacy!! beware!!". yet here we are, years and years later, and still no amazon in pharmacy. probably will be dead and still no amazon in pharmacy

 

[pezdispenser]

i've been hearing about amazon and pharmacy for years. yet they are still not involved. amazon has no pharmacy, no pbm, no nothing. they just have fairy tales and rumors. "beware amazon in pharmacy!! beware!!". yet here we are, years and years later, and still no amazon in pharmacy. probably will be dead and still no amazon in pharmacy

www.pillpack.com

 

[beautifulrobot]

IMO most patients would be more than happy with a "forced talk" to a pharmacist who is passionate about medicine and genuinely shows they care about their patient. Same with adherence outreach calls.

Key word: shows

But how many times are we rushed and robotic, compelled to skip counsels, or look and sound plain miserable to even be there, let alone wear our white coat proudly?

Value doesn't have to be only out of the box services, but rather filling the fundamental need for genuine compassion. That's the real challenge for the future of healthcare.

Some people want WebMD and robotic outcomes at a discount.

But many people will pay substantially more money to preserve human connection and acquire high quality healthcare.

Another issue is bias. I hate to say this as a pharmacist, but I don't trust most of my fellow pharmacists to provide competent, accurate, and nonjudgmental, counseling on most issues related to LGBT health, HIV prevention and treatment, addiction treatment, contraception, and several other "controversial" medical issues. I have several friends who go out of their way to utilize pharmacies affiliated with LGBT health centers, or greatly wish they had access to a pharmacy that had a reputation for being well-informed on LGBT health and providing nonjudgmental care. They have had enough bad experiences with pharmacists that they generally don't trust the information pharmacists tell them, and would rather avoid having to interact with the pharmacist altogether. Although they would love to have a conversation with a well-informed and compassionate pharmacist (as evidenced by the many questions they have for me as their pharmacist friend), the risk of being burned by a rude pharmacist that "doesn't agree with their lifestyle" is usually too high. Robots and self-checkout machines won't judge you (well, depending on how they are programmed...).

Essentially, I agree with you that people value genuine compassion, and that it is a real challenge for the future of healthcare. The challenge is not just figuring out how to charge people money for genuine compassion, but also how to actually develop genuine compassion among health care professionals.

 

[BenJammin]

Sounds like self inflicted pain to me. The state requires me to counsel patients on all brand new prescriptions. If they don't want to talk to me and miss out on my "compassion" then that is their choice. But when you make your bed, you must lie upon it.

 

[genesis09]

Wisconsin requires counseling for each and every prescription; new or refill. You just learn how to manage it

 

[lgrw16]

Good luck with that. At Walmart the customers hate the forced counseling.

Maybe we could double down on things that require face to face - shots, tests, in some states they allow a pharmacist to do something like a nurse practitioner, etc.

Ha, you got that right! My dog’s been on the same med since 2017. I switched from the Walmart $4 list to another pharmacy, and am happily paying 5-6x more, just so I don’t have to be counseled.

 

[Lexington2012]

People keep saying Amazon is gearing up to buy Rite Aid. I suspect it is to get the PBM.