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Could Amazon fill your next prescription?

By Jason Poquette, BPharm, R.Ph

The online mega-business that virtually owns the book and e-reader markets, now has its eye on pharmacy. According to reports, Amazon is in the process of developing a mail-order pharmacy services which could offer consumers another option for filling their monthly prescriptions. In a recent article, USA Today wrote that “Amazon has been holding annual meetings on whether it should consider going into the pharmacy business for the last several years.” A couple months ago they hired Mark Lyons, an executive formerly with Premera Blue Cross in Washington. Some are seeing the writing on the wall.

For the average consumer, it is hard to say what the advantage or draw would be to filling your prescription through Amazon. If you are using mail-order already, this might simply be another option, but hardly an improvement. For patients who like to see their pharmacist face-to-face (my preference of course), then getting medications from Amazon would feel rather impersonal and mechanical.

But maybe I’m underestimating the joy of 1-click shopping and the modern attraction to doing virtually everything online. I mean, we’re now dating and finding future spouses online (successfully I might add)! Getting your prescription filled online is pretty unspectacular compared to that. And they can offer speedy service too. According to an article in Motley Fool “with same-day shipping in many markets, it could win away a lot of business from traditional mail order pharmacies.”

At the very least, Amazon has 128,000 of its own employees to think about. Today employers buy health insurance and have to pay (in part) for other businesses (hospitals, doctors and pharmacies) to provide services to their own employees. By getting into the pharmacy business, Amazon could steer some of its own employees away from their local pharmacies to their own mail-order pharmacy. In doing so they could potentially save money because they may be able to buy the drug cheaper and not have to pay a markup to a competitor.

But personally I think the venture into pharmaceuticals is a mistake for Amazon. After they factor in the expense of running the operation: staffing, software, licensing, inventory, security and other overhead, they will come to realize pharmacy is a very low margin business. They probably make more money selling a copy of MacBeth than a bottle of metformin, and there are fewer side effects from Shakespeare.

In my opinion Amazon would be smarter to pursue doing business as a PBM (Pharmacy Benefit Manager). There are just 3 major PBM’s in the U.S. (CVS, Express Scripts and Optum Rx) which control about 80% of all prescription plans in the nation. And these business are making huge profits, sadly at the expense of many patients. Express Scripts, for example, according to online sources, made over $3 billion in profit in 2016. PBM’s traditionally have a bad reputation with pharmacists, as they interfere with patients getting the medication they need in attempts to drive their own revenues higher.

But really I just wish Amazon would stay out of the pharmacy business overall. I’m a big proponent of the “know your pharmacist” way of thinking. As a pharmacist I believe in having a relationship with my patients, knowing who they are and striving to help them with their medication needs, questions and concerns. I just don’t think an anonymous online bookstore is the best place to buy your drugs. And as for speed? I can still fill most prescriptions in under 20 minutes.  I’m sorry Amazon, you can’t beat that.