Live data from Hacker News

Amazon launches Amazon Pharmacy for prescription medicine delivery

theverge.com

261–270 of 276 posts

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#261

Earlier quoted context omitted.

It’s collected (generally speaking) one way or another. Unfortunately right now it’s collected from the lower and middle classes, but no matter what you do drugs, treatments, doctors, hospitals, etc. cost money. It’s never, ever, ever “free”. If a drug costs $2,000/month there are probably some inefficiencies baked into the price, but even if it were $500/month, that $500 has to come from somewhere.

That's not really how it works with drug prices in the US. I don't know exactly how it works behind the scenes, but from the pharmacy perspective, it's basically like this: The "sticker price" of a drug is called the "usual and customary price" (U&C). This is supposed to be what you charge for a drug, and is generally based on the "average wholesale price" (AWP) of the drug plus a dispensing fee to cover other costs.…

Sorry, I’m not sure what you mean here with “that’s not how it works”. Could you explain?

-edit-

I guess what I mean to say here is I'm not commenting on how drug prices work. It doesn't matter. I am commenting on the fact that somebody, somewhere has to pay for the drug, regardless of the price. I want to push back on this idea that drugs are "free" in Europe or elsewhere. Sure the healthcare programs appear to be better managed, higher taxes on the wealthy or corporations (although I don't know for sure) appear to be subsidizing costs for lower and middle classes, but the drugs still aren't free in any sense of the word to the society as a whole.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#262
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.

Huh? Every major pharmacy in the US offers home delivery, including Walgreens, as well as discount pharmacies like Costco and Walmart. None of them even charge extra for it either.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#263
post #161
post #69

Do they mix bins on medicine too?

The bin mixing issue is the result of Amazon's marketplace. Afaik, Amazon Pharmacy doesn't work in a marketplace model.

Even if it doesn’t now, how long util someone there decides to “optimize costs” and use regular delivery infrastructure for this, with bin mixing?

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#264
post #251

Earlier quoted context omitted.

Since when is Amazon interested in following outside regulation?

What laws do they break?

https://www.cnbc.com/amp/2020/10/09/california-osha-fines-am...

https://mobile.reuters.com/article/amp/idUSKBN25Y1C6

https://www.newsweek.com/amazon-fined-us-government-selling-...

https://www.businessinsurance.com/article/00010101/STORY/912...

https://bigthink.com/politics-current-affairs/amazon-dangero...

https://www.insider.com/amazon-selling-toxic-toys-lead-poiso...

https://www.supplychaindive.com/news/amazon-hazmat-faa-ups-f...

https://www.bbc.com/news/technology-36528153

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#265
post #232

Earlier quoted context omitted.

It’s collected (generally speaking) one way or another. Unfortunately right now it’s collected from the lower and middle classes, but no matter what you do drugs, treatments, doctors, hospitals, etc. cost money. It’s never, ever, ever “free”. If a drug costs $2,000/month there are probably some inefficiencies baked into the price, but even if it were $500/month, that $500 has to come from somewhere.

Probably some inefficiencies baked into the price? There are massive inefficiencies at every level. I probably wouldn't share this "it's the way it is because it has to be" reasoning if you've never looked into why US healthcare is as expensive as it is. For a decent overview: https://www.pbs.org/newshour/economy/why-does-health-care-co... "Just to give you one example, Duke University Hospital has 900 hospital beds…

You need context for that because your article is incorrect about Canada. Across all of Canada, on average, there are still 1.1 clerks per bed. (1,100 clerks for every 1,000 beds) [0]

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511963/#:~:tex....

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#266

Earlier quoted context omitted.

That's not really how it works with drug prices in the US. I don't know exactly how it works behind the scenes, but from the pharmacy perspective, it's basically like this: The "sticker price" of a drug is called the "usual and customary price" (U&C). This is supposed to be what you charge for a drug, and is generally based on the "average wholesale price" (AWP) of the drug plus a dispensing fee to cover other costs.…

Sorry, I’m not sure what you mean here with “that’s not how it works”. Could you explain? -edit- I guess what I mean to say here is I'm not commenting on how drug prices work. It doesn't matter. I am commenting on the fact that somebody, somewhere has to pay for the drug, regardless of the price. I want to push back on this idea that drugs are "free" in Europe or elsewhere. Sure the healthcare programs appear to be b…

I was trying to trying to point out the scale of the "inefficiencies" inherent in current pharmacy billing practices (and in my understanding medical billing in general). The prices are literally just made up[0], and then payors have to guess how much they should pay. "That's not how it works", perhaps a poor choice of words was intended to reflect that if a drug costs $2000 per month or even $500/month, often that money doesn't need to come from anywhere.

Now that you've clarified, it sounds like you're arguing against the idea that drugs have no cost of development or production, which is not an idea that anyone actually holds, so I'm sorry for wasting our time. I would point that "free at the point of service" does seem to be one sense of "free".

[0] https://www.rjhealth.com/2019/07/31/drug-pricing-101-reimbur...

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#267

Earlier quoted context omitted.

Sorry, I’m not sure what you mean here with “that’s not how it works”. Could you explain? -edit- I guess what I mean to say here is I'm not commenting on how drug prices work. It doesn't matter. I am commenting on the fact that somebody, somewhere has to pay for the drug, regardless of the price. I want to push back on this idea that drugs are "free" in Europe or elsewhere. Sure the healthcare programs appear to be b…

I was trying to trying to point out the scale of the "inefficiencies" inherent in current pharmacy billing practices (and in my understanding medical billing in general). The prices are literally just made up[0], and then payors have to guess how much they should pay. "That's not how it works", perhaps a poor choice of words was intended to reflect that if a drug costs $2000 per month or even $500/month, often that m…

> I would point that "free at the point of service" does seem to be one sense of "free".

Sure, and my contention (going back to the grandparent) is that is an illusion. I'd be more than happy to give you a car for free and then just charge you later if you thought you were getting it for free. I want people to continue to be aware that even drugs that are sensibly priced do still bear costs to society.

> which is not an idea that anyone actually holds

You'd be surprised. In fact, the language most people use is "healthcare is free in Europe and elsewhere" because they don't understand how things work. It's not free. Never has been and never will be.

> often that money doesn't need to come from anywhere.

I'd love to hear more. How is it that nobody has to pay for the drug? How does the drug come into existence without money?

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#268

Earlier quoted context omitted.

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 fr…

Prizes seem like they'd be even less efficient. Basically trying to guess the cost to R&D a new drug, with the added risk of not receiving the prize if you're to late or not quite effective enough to meet the threshold. I see the benefit for things like a covid vaccine where the economic benefit is so large we can afford to drop exorbinant sums. But what's the right prize for a newer better lipitor or xanax, or a tre…

You have to guess at the return on being first to market anyhow. If anything, if there are multiple tiers of prizes on offer, then the risk is lower overall.

A healthcare system will typically have a good idea what it needs, whereas a pharmaceutical company will rightly enough focus on what will make the most profit.

Put another way: you don't need to set prizes for every drug. A better treatment for malaria is not going to make much money, because most of the patients will be in less-developed countries. But if you produce a side-effect free drug to reverse baldness, you will absolutely mint it by first selling into wealthier countries at very high prices to "skim the market", then lowering it over time.

Prizes would work better for low-profit/high-impact, for the rest you can mostly rely on pharmaceutical companies to rationally pursue their best interests.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#269

Earlier quoted context omitted.

Prizes seem like they'd be even less efficient. Basically trying to guess the cost to R&D a new drug, with the added risk of not receiving the prize if you're to late or not quite effective enough to meet the threshold. I see the benefit for things like a covid vaccine where the economic benefit is so large we can afford to drop exorbinant sums. But what's the right prize for a newer better lipitor or xanax, or a tre…

You have to guess at the return on being first to market anyhow. If anything, if there are multiple tiers of prizes on offer, then the risk is lower overall. A healthcare system will typically have a good idea what it needs , whereas a pharmaceutical company will rightly enough focus on what will make the most profit . Put another way: you don't need to set prizes for every drug. A better treatment for malaria is not…

This is a great discussion. I'd push back on the idea that prizes should be used for treatments like side-effect free drugs to reverse baldness, because the market for that is large enough that even in a regime without patents, R&D costs can be recuperated. There's just so much revenue to be had there.

The real value of medical patents (and this is something we've strayed far from) is in incentivizing expensive R&D for ultra-rare diseases. There are diseases that afflict < 1% of the population, there's hardly any revenue to be made in serving that customer base, especially relative to the R&D input necessary. It's stuff like that which can really benefit from prizes. It also presupposes that the prize-awarding authority knows which types of R&D fall under that bucket and which do not, and you get into a quasi-central-planning territory, but that holds true even in a world where pharma patents were only awarded to inventors of such rare-disease drugs.

Re: Amazon launches Amazon Pharmacy for prescription medicine delivery

#270
post #263
post #161

Earlier quoted context omitted.

The bin mixing issue is the result of Amazon's marketplace. Afaik, Amazon Pharmacy doesn't work in a marketplace model.

Even if it doesn’t now, how long util someone there decides to “optimize costs” and use regular delivery infrastructure for this, with bin mixing?

I believe the pharma supply chain is heavily regulated.
Post reply on HN