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Amazon gains wholesale pharmacy licenses in multiple states

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Re: Amazon gains wholesale pharmacy licenses in multiple states

#81
post #13

Earlier quoted context omitted.

That’s why CVS is trying to buy Aetna. They’re going to be everything from your insurer, to your walk in clinic to your pharmacy. Maybe they’ll buy a hospital chain and go full stack.

so Kaiser Permanente, basically

Kaiser still has the "everything in the same building" advantage. There are some down sides to Kaiser, but seeing my doctor, getting immunizations, having blood drawn for labs, having prescriptions filled and being out the door 45 minutes after I arrived isn't one of them. It's damn convenient.

Re: Amazon gains wholesale pharmacy licenses in multiple states

#83
post #51

Does this imply that Amazon will be in the place to negotiate drug prices? Trying to understand what could change given how a lot of PBMs appear to be wed to insurance groups (and now CVS looking to buy Aetna). What would be the next step, buy an insurance company? Or is it a matter of exposing the true cost of drug prices and drive the market costs down?

> Does this imply that Amazon will be in the place to negotiate drug prices?

Very much so. Amazon is clearly playing the monopsony card here, and has an opportunity to drive prices down.

Up too of course but Bezos has not shown any predilection for that to date.

Re: Amazon gains wholesale pharmacy licenses in multiple states

#84
post #68

Apparently better for consumers in general now that there's more competition. One Industry I really really want them to enter is Consumer Airlines. Service in most airlines sucks, like big time. Can't wait for Amazon Airlines with Prime Video and Internet available for all. But of course I know that's a distant dream unless the Prime Air works great.

Airlines suck because it’s an undifferentiated service. Consumers aren’t willing to pay much extra for better service, and the lowest ticket price wins. It’s a race to the bottom on price, so features and comfort get cut in exchange for cost savings. It’s basically a commodity industry with high capital requirements and high volatility in marginal costs. There’s a reason that most airlines globally are subsidized by…

I've never seen a serious attempt at service differentiation other than the ones that come at 5x cost.

The "quality" difference between most airlines is less than the random noise of getting staff on a good or bad day.

Re: Amazon gains wholesale pharmacy licenses in multiple states

#85

Maybe to compete against Express Scripts and drugs stores, to a degree, but a by-mail pharmacy has a very steep hill to climb in terms of in-person/telepresence pharmacist expertise.

I hope so. Dear god their service is atrocious. First, they wanted me to fill out some 1980s style book order form to get my prescription filled.

Then, for a year, they filled my 1-per-day, 90-pill, 3-month prescription..... every..... 2.... months. Unfortunately it was nothing of any resale or entertainment value.

I called them and waited on hold and someone promised they found and fixed the issue. It was not fixed.

I harangued them on twitter. They promised to reach out to me and fix it. They did reach out to me, claimed they saw the problem with the previous 'fix', fixed it again, delayed my next shipment by X months to get me back on track, and... it wasn't fixed. The delay worked but I was still receiving 90 pills every 60 days.

Ultimately I think it sorted itself out when a prescription had no more refills allowed and had to be renewed and entered as a new prescription number.

Re: Amazon gains wholesale pharmacy licenses in multiple states

#86
post #84
post #68

Earlier quoted context omitted.

Airlines suck because it’s an undifferentiated service. Consumers aren’t willing to pay much extra for better service, and the lowest ticket price wins. It’s a race to the bottom on price, so features and comfort get cut in exchange for cost savings. It’s basically a commodity industry with high capital requirements and high volatility in marginal costs. There’s a reason that most airlines globally are subsidized by…

I've never seen a serious attempt at service differentiation other than the ones that come at 5x cost. The "quality" difference between most airlines is less than the random noise of getting staff on a good or bad day.

Premium economy - a better seat/legroom, but otherwise much the same service as economy (modulo sometimes free drinks or nicer food presentation). It's nowhere near universally available, but where it is, it's often available for around a 50% markup.

Re: Amazon gains wholesale pharmacy licenses in multiple states

#87
post #68

Apparently better for consumers in general now that there's more competition. One Industry I really really want them to enter is Consumer Airlines. Service in most airlines sucks, like big time. Can't wait for Amazon Airlines with Prime Video and Internet available for all. But of course I know that's a distant dream unless the Prime Air works great.

Airlines suck because it’s an undifferentiated service. Consumers aren’t willing to pay much extra for better service, and the lowest ticket price wins. It’s a race to the bottom on price, so features and comfort get cut in exchange for cost savings. It’s basically a commodity industry with high capital requirements and high volatility in marginal costs. There’s a reason that most airlines globally are subsidized by…

> [...] undifferentiated service [...] basically a commodity industry

That's pretty much Amazon's sweet spot.

Re: Amazon gains wholesale pharmacy licenses in multiple states

#88

Earlier quoted context omitted.

Why do they need drones for last mile, they can just use their own existing delivery infrastructure. Drones might be cheaper/better/faster in the long run, but, they aren't required for this to work.

My comment was totally anecdotal from a big data insider who said cvs is already extremely concerned drones remove store visits..

The "technology" required is the same as the postal service have provided for centuries (think pizza delivery for more urgent situations). Sounds like that insider is spending too much time on pop business sci-fi and too little time understanding basic facts about logistics (and, very likely, regulatory restrictions).

Re: Amazon gains wholesale pharmacy licenses in multiple states

#89
post #59

Amazon Basics generic drugs? That could be very interesting.

Not really. FDA approval is already the Amazon Basics of generic drugs. If it says Acetaminophen 500mg, that's what you're getting, nothing more, nothing less, within a very narrow tolerance, entirely regardless of brand.

Not so with batteries or HDMI cables, and thus brands add meaningful value in that space.

Re: Amazon gains wholesale pharmacy licenses in multiple states

#90

Earlier quoted context omitted.

It’s amazing to watch all this happen on the consumer end but how many more industries can they really do this to? Is Bezos not essentially setting up his successor for failure by turning Amazon into a conglomerate with razor margins in so many areas?

This is the thing that I don't understand about the big companies like Google, Apple, Amazon. What's the endgame? Do you just keep going until you accidentally implode? It's not like there is a finish line they can cross to "win the game". It just goes on forever until something implodes.

At some point, I guess, they have to collide with the US government. I don't mean in minor ways (like access to iPhone) but in a big existential way.
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