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Amazon launches Amazon Pharmacy for prescription medicine delivery

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Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#131

Post by yourapostasy »

Simulacra wrote: post #15
sytelus wrote: post #13

Just wondering why couldn’t Walgreens do this? During covid, Walgreens is still one store that you must visit physically to get your prescription. I always thought there was some crazy health care regularization that prevented medicine delivery.

Not neccessarily. There has been a push in the past ten years for mail order handled by Pharmacy Benefit Managers. PBM's are entities that work directly with the drug manufacturer to purchase in bulk, then delivering straight to the consumer at a lower cost than the pharmacy. The retail pharmacy industry, both chain and independent, absolutely despise PBM's and fight vociferously against them because it gives consume…

> I contend most people don't even speak to a pharmacist anymore.

While compounding pharmacists are still useful for those esoteric formularies, I would wager "normal" US pharmacists are still relied upon by the vast segment of the US population who are near-functionally illiterate and innumerate, on a big combination of drugs (don't get me started on how unhealthy swathes of the US population are), and cannot be bothered to work out for themselves drug interactions (much less how to get off of the drugs if possible). The disjointed nature of the US healthcare system promotes such inefficiencies.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#132

Post by BurningFrog »

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

Do people remember that someone like Donald Trump would be in charge of that program?

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#133

Post by jacques_chester »

bhupy wrote: post #126
jacques_chester wrote: post #94

Earlier quoted context omitted.

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/covi…

I think they're similar but not quite the same. A prize is offered in advance of a solution, a lump-sum license is after the solution is developed.

On reflection I like prizes better, especially if there are multiple tiers (first to reach the target gets the most prize money, second gets less, etc). You want to ensure that multiple pharmaceuticals are developed independently, in case one of them needs to be pulled from the market.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#134

Post by bduerst »

babypuncher wrote: post #92
BooneJS wrote: post #75

Given the issue with counterfeit material in their warehouses, I don’t even know what they could do to make me trust their control of the drug supply chain.

The counterfeit merchandise is a problem caused by Amazon having third party sellers ship their inventory to Amazon warehouses for faster delivery to customers. Unless something has gone horribly wrong, I doubt Amazon Pharmacy is looking to be a "marketplace" with third party sellers like that.

Yeah, if Amazon is doing this right, they're basically channeling the big three pharma wholesalers (AmerisourceBergen, Cardinal Health, McKesson) and no one else.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#135

Post by bhupy »

lotsofpulp wrote: post #127
bhupy wrote: post #107

Earlier quoted context omitted.

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…

That’s captured by (1) risk sharing. Pooled risk sharing is great for things like fire departments where out of 1000 homes, one might catch fire every few months. It’s also great for societies where out of 1000 people, a small handful suffer from chronic illnesses or tragic accidents and the remaining are healthy. The problem is that it’s just a hammer, and not everything in healthcare is a nail.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#136

Post by Dirlewanger »

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

In the case of the US, the "free market" have utterly failed us with regards to healthcare.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#137

Post by ev1 »

canada_dry wrote: post #122
ev1 wrote: post #111

Earlier quoted context omitted.

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…

Amusingly, right as I read this reply, I get a chain of heavily-obfuscated JS loading with the text

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Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#138

Post by anonuser123456 »

kodah wrote: post #93
MikeKusold wrote: post #89

Earlier quoted context omitted.

How is this a monopoly? Walmart is a competitor and they also have a pharmacy.

Hell, let's make a list of what Amazon's business interests are: - Colocation and managed data center services - Managed technology services - Ecommerce (in just about every category including food) - Satellites - Space flight (Blue Origin) - IOT Devices - Government services (managed infrastructure etc) - Home internet (Kuiper Systems) - Autonomous vehicles - Investing - Pharmacy services I'm just going to stop here…

That is called a conglomerate, not a monopoly.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#139

Post by lotsofpulp »

kodah wrote: post #123
lotsofpulp wrote: post #118

Earlier quoted context omitted.

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 doe…

It's not as simple as writing a law that says "Conglomerates are illegal."

How do you define conglomerate? Amazon started selling books. Then it started selling other things. Now it's starting to sell medicine. At what point should the line have been drawn?

Obviously, the goal is to prevent harm to the consumer, but can one demonstrate that the consumer has been harmed? As a consumer, I know it was very hard for me to get such quick delivery of random items before Amazon. I especially remember getting ripped off on HDMI cables and other cables by Best Buy as a kid, and Amazon was amazing for enabling me to purchase them so cheaply, and with such huge selection I never would have found at Best Buy.

(I personally use Amazon.com sparingly now due to their commingling policies and disinterest in providing me with a quality product).

But the point is that demonstrating consumer harm isn't simple. Conglomerates can deliver goods and services at lower prices, which is good for buyers. Conglomerates can also engage in practices which helps buyers in the short term, but harms them in the long term.

Before grocery stores, there were produce stands, butchers, delis, bakers. Then a giant grocery comes into town, and now, as a buyer, I can save time and money going to one place and getting all I need. Should this be illegal?

The purpose of my comment is to illustrate that the situation is not as simple as screaming "monopoly". There are even geo-political risks to consider, where having conglomerates on your side can be helpful, if not help counteract the effects of conglomerates of other countries.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#140

Post by friedegg »

Shivetya wrote: post #11
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.

It will be very interesting to see their insulin prices and which types of insulin they sell.

I took a look, and didn't see any huge price breaks.
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