Amazon launches Amazon Pharmacy for prescription medicine delivery • Hacker News Board

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#121

Post by yourapostasy » Tue, Nov 17, 2020, 8:18 PM UTC

llee37x wrote: post #2

Just a heads up, if you use this service PillPack and Amazon Employees have full access to your entire prescription history. Full name, social everything - it was common for employees to look up the info of celebrities / other employees for fun. Any prescription / healthcare info you give them will be sold back to SureScripts and used to sell you more garbage from Amazon ;) https://www.wsj.com/articles/amazon-mail-or…

Going to need some much stronger proof than hearsay.

My clients in the financial services industry take their PCI and critical risk data access very seriously. Those clients had to share with me the software, controls and training they put into place to enforce those access rules, and I confirmed with long-time employees they've walked staff out of call centers summarily fired for joy-riding the data. I can believe the situation at hospitals can be looser, but financial services being more strict than pharma fulfillment or PBM's would be news to me. I've only had two clients in the PBM space, and they didn't seem to take their infosec lightly either, but that is a much smaller sample space so I'd be interested to hear from those who work in the trenches in PBM's or pharma fulfillment what it is like for them.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#122

Post by canada_dry » Tue, Nov 17, 2020, 8:18 PM UTC

ev1 wrote: post #111

dudus wrote: post #72

Earlier quoted context omitted.

I'm not surprised, there's some serious shenanigans on medicine pricing and insurances. Medicine prices are clearly inflated when you can buy at a huge discount using insurance, but then you can get apps like GoodRX, which is free and give you coupons that far exceed my insurance discount on every single time I had to fill a prescription. To the point that I don't even bother going through insurance anymore. I saved…

I'm curious who or what the end goal of GoodRx is. They pay for expensive ($$$$$$) cloud anti-bot/anti-scraping, captcha you after a few requests if you run adblock, they pay for extensive browser/device (attempting to reidentify a user across multiple devices/multiple browsers) fingerprinting services and Fastly. The site loads a dozen trackers, googletagmanager, branch, segment, what are they doing with this data?…

> what are they doing with this data?

As a company selling via the internet it would be handy to know what drugs/prescriptions a prospective client (via fingerprinting) is taking... it would certainly change what/if I marketed to them.

Of course the concept of retail companies having even the slightest access to a customer's medical/health/drug information for marketing purposes is a compelling plot for Black Mirror.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#123

Post by kodah » Tue, Nov 17, 2020, 8:19 PM UTC

lotsofpulp wrote: post #118

kodah wrote: post #110

Earlier quoted context omitted.

I know what the legal and colloquial definitions of a monopoly are. It obviously needs to change. I cannot fathom how one company with all these varied interests and capabilities are somehow "good for consumers", which is exactly the spirit of anti-trust law. At one point in American history we were far too loose and reckless with what a monopoly was defined as. Now, nothing is a monopoly. I can't imagine how this is…

The appropriate term is conglomeration. https://en.wikipedia.org/wiki/Conglomerate_(company) Arguments should be made about the harmful aspects of those, which Amazon actually is. Perhaps one can make the case that conglomerates inevitably leads to monopolies, and on that basis one can argue against the development of conglomerates.

> Perhaps one can make the case that conglomerates inevitably leads to monopolies, and on that basis one can argue against the development of conglomerates.

You are right and this is precisely my line of thinking. All the parts you need to make a monopoly are already there, so then they either go full tilt or they try to engineer the economy so key businesses don't go down so they can continue to claim a monopoly doesn't exist yet.

It's worth noting I originally referred to it as "monopoly law" but it's actually anti-trust law, which could make some room for conglomerate making.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#124

Post by burnte » Tue, Nov 17, 2020, 8:21 PM UTC

bhupy wrote: post #7

> Amazon claims Prime members will be able to save “up to 80 percent off generic and 40 percent off brand name medications when paying without insurance. This was buried in the article, but is IMO a bigger deal. In the long run, this could really drive down drug prices.

So I signed up to see. As far as I can tell I can't get a quote on my scripts without transferring them. I'm not doing that. Every other pharmacy I can enter my dosages or call someone and get a quote.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#125

Post by burnte » Tue, Nov 17, 2020, 8:22 PM UTC

mhh__ wrote: post #73

NikolaeVarius wrote: post #14

Earlier quoted context omitted.

Instead of the Govt being the price negotiator, we got giant corporations instead. yay

> price negotiator Would you prefer the government to negotiate the price of your car for you? Markets are a powerful tool

Yes, I would. A single buyer for all 300m Americans would get better deals than Amazon or Walmart could dream of.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#126

Post by bhupy » Tue, Nov 17, 2020, 8:23 PM UTC

jacques_chester wrote: post #94

alex_anglin wrote: post #29

Earlier quoted context omitted.

As a Canadian, I believe that the Patented Medicine Prices Review Board [1] does quite a good job, judging from the cost of medication up here (broadly speaking). [1] https://www.canada.ca/en/patented-medicine-prices-review.htm...

Australia has a similar mechanism in the Pharmaceutical Benefits Scheme. Drugs are selected based on cost-effectiveness analysis and subsidised price is negotiated with pharmaceutical companies. If anything, Australia is quite generous to pharmaceutical companies. New Zealand's Pharmaceutical Management Agency has much less negotiating power but still manages to obtain substantially lower prices. For myself I can't h…

> For myself I can't help but wonder if lump-sum licensing might not be more effective. Pharmaceuticals are a bit like software: very high R&D cost, but the marginal cost to manufacture is very small. A one-time payment to sink a large chunk of R&D for a drug might be quicker and easier than guessing at a price.

You're describing "Prizes", and that's a legit point of view -> https://www.mercatus.org/publications/covid-19-crisis-respon...

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#127

Post by lotsofpulp » Tue, Nov 17, 2020, 8:24 PM UTC

bhupy wrote: post #107

dragonwriter wrote: post #47

Earlier quoted context omitted.

Discount programs everywhere focus on the uninsured (the insured have the insurance company also paying discounted rates, generally, but those are individually negotiated; the sticker price is just to have a starting point for negotiations with deep pocket public and private insurers.) In many cases, the discounts in the discount programs are subsidized by the drug companies for uninsured patients.

Yep, for full disclosure, I work in healthcare pricing and payments and adjust claims myself. While discount programs focus on the uninsured, this is the first time I’m seeing the discount being framed in such a way that it effectively incentivizes paying out of pocket. It’s an important incentive if your goal is to decouple routine drugs from the third-party-payer model of insurance. Health insurance in the US is ac…

I would add a 4th service for health insurance in the US to be a way for healthy, young people to pay for the care of sicker, old people due. AKA, a tax, due to the following stipulations of the ACA.

1) Age Rating Factors

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-In...

2) Out of pocket maximums for in network care

3) Elimination of pre-existing conditions, i.e. accepting all lives no matter how costly

4) The recently eliminated mandate to purchase health insurance.

The above conditions mean that premiums from healthy people that don't use healthcare is used to pay for the healthcare for sick people. It gets a little complicated with the ability for employers to silo their employees' lives from the rest of the population, but in general, US health insurance premiums are basically a tax on the healthy to pay for the healthcare for the sick.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#128

Post by hyperdimension » Tue, Nov 17, 2020, 8:25 PM UTC

Red_Leaves_Flyy wrote: post #58

barbecue_sauce wrote: post #19

Earlier quoted context omitted.

Medicine delivery is very common for local mom & pop pharmacies, though it may depend on state/municipality. I know DoorDash was working on getting their pharmacy delivery operations up and running at one point, but I'm not sure what the current status of that is.

Gig drivers delivering meds? WTF wouldn't go wrong?

"Here's your oxymorphone, a 23-day supply."

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#129

Post by kirillzubovsky » Tue, Nov 17, 2020, 8:25 PM UTC

varispeed wrote: post #4

Companies that big should not be allowed to operate. They will have too much personal data and incredible unfair competitive advantage on the market. It's when capitalism doesn't work and where it needs to have emergency stops. Amazon needs to be split into independent companies. Now that Amazon will also know your medical history, know what you are talking about at home, all your preferences, who you meet, what are…

It all depends on your point of view. You can look at the scale and cry wolf, or you can wander about all the possibilities it creates.

If Amazon can listen to my breathing through Alexa, forecast an imminent health issue, and then Prime some pills to me before I even need them, that's a pretty awesome future.

We need to find a way to keep them from becoming evil and shipping me pain meds on subscription if I don't actually need them, sure, but technology has always been making the world better, and Amazon has the power to make it better on steroids.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#130

Post by bird_monster » Tue, Nov 17, 2020, 8:27 PM UTC

Kind of astounded at the responses in this thread insisting on believing Amazon wouldn't do anything nasty or obviously illegal with an individual's healthcare data. They've done nasty and obviously illegal things with all of the other data that passes through their systems, and yet here we are defending and getting excited about them further intruding into our lives.