Now that Amazon has acquired PillPack, what are the prospects of a retail pharmacy shakeout?

[Kevin.Mero]

Now that Amazon has acquired PillPack, what are the prospects of a retail pharmacy shakeout over the next 5-10 years?

---

Members don't see this ad.

 

[lord999]

The same as they were before, virtually guaranteed. This just gives an opportunity for the Big Three to blame external circumstances rather than their own mismanagement (and in WBA's case, extraordinary debt levels) for their balance sheet woes. What's really threatening though is the changes to reimbursement if Amazon wants to play deny the business like they did with ToysRUs.

 

[Kevin.Mero]

The same as they were before, virtually guaranteed. This just gives an opportunity for the Big Three to blame external circumstances rather than their own mismanagement (and in WBA's case, extraordinary debt levels) for their balance sheet woes. What's really threatening though is the changes to reimbursement if Amazon wants to play deny the business like they did with ToysRUs.

Great points! Is Pharmacy ever going to get their seat at the table when it comes to reimbursement and provider status ... or are they now on the menu? I started an Rx technology company several years ago. Brought on a partner, merged it with another group and sold it for a great profit. But when I look at this PillPack deal I'm blown away! Started in 2013, raised approx. $125M, valued at $360M, 40-50K customers, grossing approx. $50M annually, sold for $1B CASH!!

 

[Chrish]

Amazon can compete with mail order if they invest significant money and resources. However, I don't see them having much impact on traditional retail. I mean they can't possibly destroy chains with over 8000 stores in just few years.

 

[Kevin.Mero]

Amazon can compete with mail order if they invest significant money and resources. However, I don't see them having much impact on traditional retail. I mean they can't possibly destroy chains with over 8000 stores in just few years.

I don't disagree that in the short-term Amazon will have little or no affect on the traditional retail chains. I don't know your age or reference point but if you take a step back and look at things from a high level, the changes pharmacy and pharmacists have had to endure since the salad days of the 1990's are quite amazing. If you're aware as to how Pharmacists were treated back then compared to today you might think we were talking about a different century. Guess we actually are, lol!!

 

[Lnsean]

I think you guys are giving Amazon way too much credit. Healthcare is very unique and weird in the sense that the consumer does not pay for the service directly. It is paid through a 3rd party. This is the crutch of it all. Amazon can buy up all they want, but if CVS/Aetna/Caremark isn't gonna pay up then no one is going to pay cash for a mail order service.

 

[Kevin.Mero]

I think you guys are giving Amazon way too much credit. Healthcare is very unique and weird in the sense that the consumer does not pay for the service directly. It is paid through a 3rd party. This is the crutch of it all. Amazon can buy up all they want, but if CVS/Aetna/Caremark isn't gonna pay up then no one is going to pay cash for a mail order service.

I sure hope you're right but just in case which platitude do you want me to use? Lol! How about, The only thing constant is change! Let's see where this all goes over the next 5-10 years. But again, I do hope you are right!!

 

[Momus]

Amazon can compete with mail order if they invest significant money and resources. However, I don't see them having much impact on traditional retail. I mean they can't possibly destroy chains with over 8000 stores in just few years.

That's what they said about blockbuster with 9000+ stores when Netflix entered the market. Look where blockbuster is now. Many big ass retailers, clothing stores, literally file bankrupcy because Amazon drives the cost down and eat some of their pies.

 

[lane one]

That's what they said about blockbuster with 9000+ stores when Netflix entered the market. Look where blockbuster is now. Many big ass retailers, clothing stores, literally file bankrupcy because Amazon drives the cost down and eat some of their pies.

Ultimately, I think it's quite a bit more complex than Amazon's previous dealings. But I too was reminded of Blockbuster when the chains responded "We aren't particularly worried, no one really likes mail order anyway". I guess only time will tell if Amazon can pull off a total paradigm shift in the way people get their drugs.

 

[Swishers]

I think Amazon can build this up into something way bigger than shipping pills. What if they figured out a way to increase compliance by combining convenience, lower pricing, and some sort of reward incentive to the customer for actually taking their medication?
Plus they have a ton of money and resources that they could use to lobby for updated pharmacy laws in their favor against PBMs.

 

[PharFromNormal]

I think Amazon can build this up into something way bigger than shipping pills. What if they figured out a way to increase compliance by combining convenience, lower pricing, and some sort of reward incentive to the customer for actually taking their medication?
Plus they have a ton of money and resources that they could use to lobby for updated pharmacy laws in their favor against PBMs.

Hope any rewards or favorable pricing comply with any govt rules if they plan to accept Medicare/medicaid

 

[Old Timer]

That's what they said about blockbuster with 9000+ stores when Netflix entered the market. Look where blockbuster is now. Many big ass retailers, clothing stores, literally file bankrupcy because Amazon drives the cost down and eat some of their pies.

Netflix didn't kill Blockbuster. The Internet killed Blockbuster.

I'm not ruling Amazon out of anything as they have demonstrated the patience to loose money in the sort term. But CVS is no small potatoes. They have larger yearly sales than Amazon and almost all of it is involved in the purchase of pharmaceuticals. So Amazon will not have more purchasing power than CVS. It's not like CVS is the local hardware store. It's all about service. If CVS would get their act together and staff their stores they have a no fear of Amazon. If they play the cost cutting game, they will lose out. They need to develop a better, more friendly and cheaper deliver service, staff their stores with adequate help and they will come out on top. If they don't Amazon can take them down. It's a battle of two heavyweights....

 

[Corytrade]

If you work in retail and this doesn't scare you, I wish I had your ignorance. If you aren't trying to push the profession to fill the gaps that the PCP shortage is leaving, then expect to be out of a job in 5-10 years. If nurses could prescribe, we would be doomed.

 

[sunshinefl]

Pardon my ignorance, but wouldn’t amazon or any other mail order still need pharmacists at the places the prescriptions are received and packed? Also, might not be much consolation but that couldn’t replace acute Rx or controlled, paper Rx, could it?

 

[zelman]

If you work in retail and this doesn't scare you, I wish I had your ignorance. If you aren't trying to push the profession to fill the gaps that the PCP shortage is leaving, then expect to be out of a job in 5-10 years. If nurses could prescribe, we would be doomed.

If every “nurse” could prescribe...just kill me.

 

[BidingMyTime]

If you work in retail and this doesn't scare you, I wish I had your ignorance. If you aren't trying to push the profession to fill the gaps that the PCP shortage is leaving, then expect to be out of a job in 5-10 years. If nurses could prescribe, we would be doomed.

Um, nurses are prescribing, they just have to get their NP degree via a few on-line courses.

And any PCP shortage is quickly disappearing, there is a rising tide of NP's & PA's that will hit in a few years. Pharmacists missed the PCP boat years ago, even if they get provider status at this stage of the game, it will be too little, to late.

 

[BenJammin]

Pardon my ignorance, but wouldn’t amazon or any other mail order still need pharmacists at the places the prescriptions are received and packed? Also, might not be much consolation but that couldn’t replace acute Rx or controlled, paper Rx, could it?

What stops Amazon from having technicians run the show and have a pharmacist there to "keep it legal"? The chains have already accepted mistakes as the cost of doing business. What makes this any different?

 

[VictorOfHungerGames]

Netflix didn't kill Blockbuster. The Internet killed Blockbuster.

I'm not ruling Amazon out of anything as they have demonstrated the patience to loose money in the sort term. But CVS is no small potatoes. They have larger yearly sales than Amazon and almost all of it is involved in the purchase of pharmaceuticals. So Amazon will not have more purchasing power than CVS. It's not like CVS is the local hardware store. It's all about service. If CVS would get their act together and staff their stores they have a no fear of Amazon. If they play the cost cutting game, they will lose out. They need to develop a better, more friendly and cheaper deliver service, staff their stores with adequate help and they will come out on top. If they don't Amazon can take them down. It's a battle of two heavyweights....

Key word: "IF" lol IF CVS could get their act together.... lolol I stopped reading after this.

 

[sunshinefl]

What stops Amazon from having technicians run the show and have a pharmacist there to "keep it legal"? The chains have already accepted mistakes as the cost of doing business. What makes this any different?

I don’t know, that’s why I asked. I’m a mere 2nd year DO student. I figured that a pharmacist would still be required at appropriate ratios or something. I can’t picture a warehouse somewhere where 100 techs (hypothetical exaggerated number) process and fill prescriptions under the supervision of only 1 pharmacist.

 

[VictorOfHungerGames]

I don’t know, that’s why I asked. I’m a mere 2nd year DO student. I figured that a pharmacist would still be required at appropriate ratios or something. I can’t picture a warehouse somewhere where 100 techs (hypothetical exaggerated number) process and fill prescriptions under the supervision of only 1 pharmacist.

State law doesn't allow this. I think this may vary state to state but I know each state has a law to limit pharmacist to tech ratio. i.e. Texas' pharmacist to tech ratio is 1:3. Being that pharmacy is highly regulated by state board, there is no way for Amazon to have 100 techs with just 1 pharmacist. Unless they change the law, which i'm sure it's possible with lobbyists using hot hookers to entice state board members, yet I highly doubt we as a nation is THAT morally messed up... wait.. no... we are... so... yay amazon.

 

[sunshinefl]

State law doesn't allow this. I think this may vary state to state but I know each state has a law to limit pharmacist to tech ratio. i.e. Texas' pharmacist to tech ratio is 1:3. Being that pharmacy is highly regulated by state board, there is no way for Amazon to have 100 techs with just 1 pharmacist. Unless they change the law, which i'm sure it's possible with lobbyists using hot hookers to entice state board members, yet I highly doubt we as a nation is THAT morally messed up... wait.. no... we are... so... yay amazon.

Yikes lol. But really you are addressing what I thought, that it wouldn’t mean the end of employment opportunities for pharmacists, it would just mean a different employer and setting.

 

[AlPacino]

Start differentiating your CV and finding some special skills because if all you have is retail, you're going down a bad path. Retail pharmacist salaries wont decrease but they will find other ways to cut cost like slashing hours which is already happening in CVS.

If you dont have any specialized skills that differentiate yourself from the pack, I wouldnt feel safe at any retail work.

 

[PharFromNormal]

State law doesn't allow this. I think this may vary state to state but I know each state has a law to limit pharmacist to tech ratio. i.e. Texas' pharmacist to tech ratio is 1:3. Being that pharmacy is highly regulated by state board, there is no way for Amazon to have 100 techs with just 1 pharmacist. Unless they change the law, which i'm sure it's possible with lobbyists using hot hookers to entice state board members, yet I highly doubt we as a nation is THAT morally messed up... wait.. no... we are... so... yay amazon.

Not all states have rph:tech ratios...

 

[VictorOfHungerGames]

Yikes lol. But really you are addressing what I thought, that it wouldn’t mean the end of employment opportunities for pharmacists, it would just mean a different employer and setting.

Ya I don't think it will. Only difference is that Amazon would be making deliveries. Which means other retails would have to do the same in order to compete, maybe? not sure. We would have to see how this works out. People go to pharmacies for multiple reasons, not just to pick up meds. Quality of people Amazon hires would make a difference too. If they're cutting cost by lowering the salaries, I imagine the quality of people they hire would be affected as well. It's all speculation at this point obviously just like speculating that Demarcus Cousins going to the Warriors would make them the greatest basketball team ever assembled. lol

 

[zelman]

Not all states have rph:tech ratios...

Yup. Hawaii has neither ratio nor tech registration.

 

[VictorOfHungerGames]

Not all states have rph:tech ratios...

Did not know this... haha well, Amazon bout to ruin pharmacies in some states...

 

[pyxisdust]

State law doesn't allow this. I think this may vary state to state but I know each state has a law to limit pharmacist to tech ratio. i.e. Texas' pharmacist to tech ratio is 1:3. Being that pharmacy is highly regulated by state board, there is no way for Amazon to have 100 techs with just 1 pharmacist. Unless they change the law, which i'm sure it's possible with lobbyists using hot hookers to entice state board members, yet I highly doubt we as a nation is THAT morally messed up... wait.. no... we are... so... yay amazon.

omg..could you imagine being that 1 pharmacist that has to check like 2000 scripts a day plus do the final check. Better be a good pharmacist or a good bunch of pharmacists. Quality over quantity always wins in pharmacy.

Also I've been thinking about the millions of errors that could and will pop up. Not human but machine errors and the millions of ways the system can be compromised purposefully( i.e, hacked med profiles, terrorisim, etc..) or not. Delivery is a whole other issue...there is no way delivery can be promised. There will be traffic jams, weather related issue temp issues that are not under amazon's control. Brick and mortar amazon pharmacy locations will be a necessity in my opinion ...BUT...who knows???!! Either way, my goal is to start moving away from retail pharmacy

 

[BenJammin]

State law doesn't allow this. I think this may vary state to state but I know each state has a law to limit pharmacist to tech ratio. i.e. Texas' pharmacist to tech ratio is 1:3. Being that pharmacy is highly regulated by state board, there is no way for Amazon to have 100 techs with just 1 pharmacist. Unless they change the law, which i'm sure it's possible with lobbyists using hot hookers to entice state board members, yet I highly doubt we as a nation is THAT morally messed up... wait.. no... we are... so... yay amazon.

1:4 but nothing stops PillPack from operating in a state with no ratio and shipping to a state where they're licensed. All you gotta do is find one pharmacist willing to put his initials on every Rx and you're set!

 

[VictorOfHungerGames]

1:4 but nothing stops PillPack from operating in a state with no ratio and shipping to a state where they're licensed. All you gotta do is find one pharmacist willing to put his initials on every Rx and you're set!

True but think of all the misfills! Lol

 

[OXYFORALL]

The big chains in nj get around the tech ratio laws. One of the ways is having front end managers get tech licenses. I've never seen the tech ratio laws enforced.