Amazon buys PillPack, an online pharmacy, for just under $1B • Hacker News Board

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#271

Post by astura » Fri, Jun 29, 2018, 12:23 AM UTC

jeherr wrote: post #229

tombrossman wrote: post #18

This is interesting because Amazon isn't exactly known for supply chain integrity. Who here hasn't received fakes from Amazon? If you rely on a specific medication for your health, is Amazon a brand you trust to deliver it? How long until they start commingling pills and shipping random counterfeit/fake product to users? Hope it never happens but if they do with pharmaceuticals what they did with everything else they…

This is a very ill-informed opinion. The supply chain is very strictly regulated for pharmaceutical medications. Do you really think that Amazon can get their stock medications from just anyone? Do you think there is no oversight on this kind of thing? The DEA doesn't fuck around. They take all of this stuff very seriously. Commingling medications? Really? In a pharmacy, medications are NEVER allowed to be commingled…

Amazon has had drug problems in the past...

http://www.slate.com/articles/health_and_science/medical_exa...

https://abcnews.go.com/amp/Health/amazon-prescription-drug-p...

Everyone knows pharmacies are highly regulated, however Amazon has somehow managed to flaunt regulations so far without much consequences.

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#272

Post by aflessner » Fri, Jun 29, 2018, 12:25 AM UTC

pbarnes_1 wrote: post #239

monetus wrote: post #207

Earlier quoted context omitted.

It doesn't have to be fake to cause harm, at least for epilepsy. The filler in the pills can vary by manufacturer.

Yup. Insurance companies like to pretend all generics are the same, but they are not. Getting them to pay for the brand because all of a sudden your pharmacy switches generic brands is almost impossible.

Can you explain what is different about certain generics?

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#273

Post by jonlucc » Fri, Jun 29, 2018, 12:40 AM UTC

not_kurt_godel wrote: post #250

beenBoutIT wrote: post #248

Earlier quoted context omitted.

In the modern world medicines come in pre-counted blister packs where there is zero room for error. Here in America we have to wait around an hour for some dolt to count and then double count the pills.

It is pretty remarkable how inefficient getting pills from a pharmacist is. The actual dispensing could be easily handled by a glorified vending machine so all the pharmacist would have to do is punch some buttons on a computer instead of having to physically handle anything except dumping packages from the manufacturer in it upon delivery.

Why make a human type it in if the majority of scripts are coming in via E-prescription?

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#274

Post by tzs » Fri, Jun 29, 2018, 12:44 AM UTC

jeherr wrote: post #229

tombrossman wrote: post #18

This is interesting because Amazon isn't exactly known for supply chain integrity. Who here hasn't received fakes from Amazon? If you rely on a specific medication for your health, is Amazon a brand you trust to deliver it? How long until they start commingling pills and shipping random counterfeit/fake product to users? Hope it never happens but if they do with pharmaceuticals what they did with everything else they…

This is a very ill-informed opinion. The supply chain is very strictly regulated for pharmaceutical medications. Do you really think that Amazon can get their stock medications from just anyone? Do you think there is no oversight on this kind of thing? The DEA doesn't fuck around. They take all of this stuff very seriously. Commingling medications? Really? In a pharmacy, medications are NEVER allowed to be commingled…

> In a pharmacy, medications are NEVER allowed to be commingled. If your medication is coming from two different manufacturers, or even the same manufacturer but the pills just look different, the pharmacy must put them in two different bottles to give to you

Are there any exceptions allowed? I'm pretty sure I've had a major nationwide pharmacy give me a bottle with pills from two manufacturers in it. It had pills from the first in the bottom of the bottle, then a cotton wad on top of those, and the pills from the second manufacture on top of the cotton ball.

They opened the bottle when I went to pick it up, and pointed out what was going on inside and made sure I understood. They explained that they did not have enough pills in stock from the manufacturer they had used before for that prescription and refills, so filled out the order from a different manufacturer.

Perhaps it does not count as commingling because they divided the bottle into separate champers with a wad of cotton?

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#275

Post by ndm000 » Fri, Jun 29, 2018, 12:45 AM UTC

tiatia123 wrote: post #266

jeherr wrote: post #229

Earlier quoted context omitted.

This is a very ill-informed opinion. The supply chain is very strictly regulated for pharmaceutical medications. Do you really think that Amazon can get their stock medications from just anyone? Do you think there is no oversight on this kind of thing? The DEA doesn't fuck around. They take all of this stuff very seriously. Commingling medications? Really? In a pharmacy, medications are NEVER allowed to be commingled…

What always seemed odd to me in such a wasteful society as the US: counting pills. Really? In many countries you get blisters. No counting. I suspect in some European countries it would actually be illegal to do this. The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available.

I used to work at a mail order pharmacy. Even though a machine counted the pills a pharmacist had to certify every bottle. This amounted to bottles coming down a conveyor and the pharmacist picking each one up, scanning it, and looking at a picture of the pills on a screen to make sure they are the same. I wouldn’t doubt if Amazon would need to do the same were they to use individual pill counts.

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#276

Post by tiatia123 » Fri, Jun 29, 2018, 1:22 AM UTC

toomanybeersies wrote: post #269

tiatia123 wrote: post #266

Earlier quoted context omitted.

What always seemed odd to me in such a wasteful society as the US: counting pills. Really? In many countries you get blisters. No counting. I suspect in some European countries it would actually be illegal to do this. The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available.

> The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available. This is the exact reason why they count pills. You have a prescription for X pills, you get X pills. It's been a while since I've had a prescription filled, but I think that in New Zealand it's the same. Most prescription drugs like opiate painkillers or antibiotics are counted a…

Yes, but is it worth the trouble?

Also, you may be able to build robots to dispense pills. But have you seen a European automated pharmacy supplier? Everything is automated. They dispense all the blister packs into a small cart that gets delivered to the pharmacy. In the end it does not matter if you supply a pharmacy with 2-20 medicines or a consumer with 1-10.

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#277

Post by URSpider94 » Fri, Jun 29, 2018, 1:42 AM UTC

tzs wrote: post #274

jeherr wrote: post #229

Earlier quoted context omitted.

This is a very ill-informed opinion. The supply chain is very strictly regulated for pharmaceutical medications. Do you really think that Amazon can get their stock medications from just anyone? Do you think there is no oversight on this kind of thing? The DEA doesn't fuck around. They take all of this stuff very seriously. Commingling medications? Really? In a pharmacy, medications are NEVER allowed to be commingled…

> In a pharmacy, medications are NEVER allowed to be commingled. If your medication is coming from two different manufacturers, or even the same manufacturer but the pills just look different, the pharmacy must put them in two different bottles to give to you Are there any exceptions allowed? I'm pretty sure I've had a major nationwide pharmacy give me a bottle with pills from two manufacturers in it. It had pills fr…

Pharmacy is regulated state by state. What they did may be ok in that state, or may be marginally ok. At the least, they didn’t just dump them into the same bottle together.

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#278

Post by not_kurt_godel » Fri, Jun 29, 2018, 1:54 AM UTC

jonlucc wrote: post #273

not_kurt_godel wrote: post #250

Earlier quoted context omitted.

It is pretty remarkable how inefficient getting pills from a pharmacist is. The actual dispensing could be easily handled by a glorified vending machine so all the pharmacist would have to do is punch some buttons on a computer instead of having to physically handle anything except dumping packages from the manufacturer in it upon delivery.

Why make a human type it in if the majority of scripts are coming in via E-prescription?

Baby steps...in order for that to work there'd have to be some kind of interoperable API standard adopted by all doctors in pharmacies that the system understands (I am assuming there is not). In an ideal world there'd be basically no humans involved as soon as the doctor prescribes, obviously...

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#279

Post by racecar789 » Fri, Jun 29, 2018, 2:02 AM UTC

nickthegreek wrote: post #105

mikeatlas wrote: post #90

Earlier quoted context omitted.

Controlled substance and cannot be prescribed more than 1mo supply at a time.

It is a huge pain. Even if your prescriber gives you 3 prescriptions (1 month each, which I think is the maximum amount of time for a controlled substance in a single prescription), the entity that is fulfilling that order is not allowed to hold onto the other 2 for future fulfillment.

Yeah the doc can put a "do not fill before [date]" and schedule scripts out for three months.

Both CVS and Rite-Aid have an arcane system where controlled prescriptions are kept "offline". Their websites will not show the scripts as available to refill even if the doc has prescribed ahead of time. So one has to call to confirm the script was received, then call every month a refill is needed.

But even worse...Rite-Aid requires a mandatory 30 day wait (per 30 day script). So that means on the day of refill...one needs to rush over early in the morning to get the refill, otherwise will risk missing a dose.

CVS is a little better, allowing a 3-5 day early fill. But they also have their secret "offline" system for controlled substances. It's still a royal pain.

So for Amazon...very little effort is required to succeed...simply show scripts that the doctor has sent over on their website...and offer a 2-5 day early fill....CVS/Rite-Aid won't stand a chance....

Re: Amazon buys PillPack, an online pharmacy, for just under $1B

#280

Post by melq » Fri, Jun 29, 2018, 2:03 AM UTC

dingaling wrote: post #125

harshaw wrote: post #81

I interviewed at Pillpack years ago and was very impressed but didn't get the gig. They seemed to be solving a great problem for customers using multiple medicines. I am not sure the solution works well for the millions of us taking one pill every night, e.g the "pillpack" is wasteful. It also doesn't address this really annoying problem I have getting my daughter's ADD meds. These require a paper prescription that m…

> They seemed to be solving a great problem for customers using multiple medicines. Most high-street pharmacies in the UK have offered pill-packs for years; you route all your prescriptions to them and their pharmacists arrange the medication into little time-inscribed compartments on a blisterpack. For them there is benefit in monopolising the medicines of each customer ( more $$ from the NHS ) and for the customer…

>Most high-street pharmacies in the UK

>PillPack seems to do that, but 'on the Internet'. shrug

Leaving aside the fact that 'on the internet' is a huge and important distinction (you should check out this company Uber, it's like a taxi but 'on the internet'), you seem to be saying "there's this great service available to us here in the UK, I can't imagine why a company in the US would want to replicate it shrug."