Amazon buys PillPack, an online pharmacy, for just under $1B(techcrunch.com) |
Amazon buys PillPack, an online pharmacy, for just under $1B(techcrunch.com) |
This was so needed. Can they hasten the paper work doctors and insurance companies require?
Amazon.com "Instant gratification at the speed of UPS." /gBasically the system that pharmacies used to transfer prescriptions isn't secure
Plus they now have plenty of money to hire the best security firms to pen test their systems, plug holes, and run a serious monitoring operation.
Also read the advisory - the issue is not with them - it's with the legacy prescription transfer systems they hook into. That is something they cannot hire someone to pentest without getting all of their competitors to agree.
if people were paying out of pocket these kinds of markup could not survive
fun fact: thanks to lobbyists and congress, it is illegal under federal law for a pharmacist to voluntarily tell you it cheaper to pay cash than use your insurance co-pay, you have to know to ask
It's crazy how competitive Wall Street views Amazon moving into a market; have there been examples of Amazon making a large purchase/move but completely failing? (sure there are, just not coming me off the top of my head)
They tried to make a move into retail registers to compete with Square, and failed. They shuttered Amazon register in 2015: https://bits.blogs.nytimes.com/2015/10/30/amazon-shutting-do...
They tried to take on Etsy with Amazon Handmade which bombed Etsy stock, but Handmade has gone pretty much nowhere, except some re-branding this year.
People just forget Amazon's failed ventures, even fairly high profile ones, because there are so many, and the hits sometimes so large (like AWS).
Quoting myself from April:
> Amazon's ethos of "Announce fast, Release fast, if it fails, oh well" is intentional. From Bezos' point of view, this is actually a feature. In a shareholder letter in 2016, he called Amazon "The best place in the world to fail." He wants lots of teams working on lots of products, and if some of them don't pan out, that's OK. This has lead to a lot of successes, but also a number of small headaches for consumers who use products that are quickly discontinued and (charitably) forgotten.
As a merchant, it was amazing. They offered promotional rate of 1.75%, which is basically impossible to beat for any small business.
For context, Square and most "simple pay per swipe" merchant service providers charge 2.75%. If you go out and get a really good deal from a intrchange+ provider, you might be able to get your rate down close to 2%. But Amazon Register got you below that with significantly less hassle, no subscription fees and a $0 equipment cost.
My wife used it at her small business for a year, and during that year I loved getting proposals from other banks and merchant service providers. Many had an offer like, "Let us audit your merchant fees, and if we can't beat them, we'll give you a $200 gift card."
I always gave them the opportunity to try, but with the caveat that there was no way they could beat our current rates, and I wasn't going to take their money when they failed. Mostly, I just never heard back after they realized I wasn't BS'ing about the fees we were paying.
If Amazon Register had been more widely promoted, they could/should have been able to get every credit-card-accepting small business in the country signed up at least for the promotional period. I'd love to see some kind of post-mortem to explain why they didn't.
Is severely damaging another online vendor really a failure for Amazon? It seems to me at that level, revenue from a venture is not always the only measure of success.
> "If you double the number of experiments you do per year you’re going to double your inventiveness."
> "If you decide that you’re going to do only the things you know are going to work, you’re going to leave a lot of opportunity on the table."
Basically the modern tech titan mantra. The only company out of the big 5 that isn't doing this is Apple.
It may not be failure but I doubt it will kill or disrupt the grocery business.
They fail a lot of the time, but sometimes even when they do, it's a kick in the ass to some of the other competitors in the field, which causes them to depress their margins. So sometimes, even if Amazon's presence in the market fizzles out, they end up still reducing other's prospects.
[1] http://www.macnn.com/articles/09/10/28/google.maps.helps.gps...
[2] http://www.businessinsider.com/googles-free-gps-service-crus...
Garmin's automotive segment revenue has dropped from $2.5-billion in 2008, to $700-million in 2017. [1]
They've been able to largely make up for it with revenue from other sources, [2] (mostly outdoor/fitness) [3], but I'm sure that shift and innovation was driven by the event you mentioned.
[1]https://www.statista.com/statistics/217901/net-sales-in-the-...
[2]https://www.statista.com/statistics/217907/net-sales-of-garm...
[3] https://www.statista.com/statistics/217905/revenue-distribut...
https://glinden.blogspot.com/2006/04/early-amazon-auctions.h...
Amazon is reliable, sure, but what do they have - 99.9% fulfillment, 99% on time, 99% with authentic products, 97% of listed products in stock? Those are guesses, but apply those numbers to delivering vital daily medicines and the problem becomes pretty obvious.
Keeping in-stock rates high and "on time with authentic products" rates near 100% is not an easy task. It's not something pharmacies do perfectly either, but their shortages are generally at a store level rather than national, and they're not asking people to completely switch delivery mechanism to trust a space with online one provider.
Another guess is that changing habits(especially since buying drugs is an infrequent event, and that we're dealing with seniors) and creating trust we're other reasons.
Basically, the largest potential market for you is not tech savvy at all and makes it hard to convert.
http://assets.coolhunting.com/coolhunting/mt_asset_cache/201...
(note: above image is of an already mostly empty PP box, they often come stuffed completely full)
https://cdn.vox-cdn.com/thumbor/Jz4Xw7Xs-Fxnige1c2qnDlez-c0=...
I used PillPack a few years ago, and appreciated the reliable auto-refill (in fact their behavior was borderline insanely aggressive, which was fine by me).
However, the volume of single-use plastic trash created by the way PillPack does packaging was downright excessive, and I felt so guilty about it I deactivated my account. It is less convenient now, but after going back to using typical mail-order and local B&M pharmacies in town the process results in approximately 10-20% of the amount of trash.
See the images linked above as examples of what comes with each shipment - it's a plastic case full of little plastic pouches. There is 1 plastic pouch per dose of medication, and the plastic pouches are wound tightly inside. The volume of single-use plastic adds up rather quickly with PillPack.
EDIT:
Why all the downvotes? "Internet points" are unimportant, but it is curious and unsettling to see information about wasteful high-pollution corporate practices deep-sixed.
But I'm not sure if the plastic problem (a huge one, and I really love nature) will be solved by individual action.
In practice it would require laws, like the anti plastic bag law reduced demand by 70% in the Netherlands.
Or technology, like a better bio-degradable plastic alternative.
Hope it never happens but if they do with pharmaceuticals what they did with everything else they sell, it's only a matter of time before users are physically harmed.
Let's be optimistic though, I hope this helps them finally get their shit together and control the rampant counterfeiting going on right under their nose.
It also doesn't address this really annoying problem I have getting my daughter's ADD meds. These require a paper prescription that must be hand couriered to the local CVS. A giant PITA.
Additionally Pill pack address this on their website for temp. Controlled teams being shipped in a temp controlled way door to door (see Omaha steaks as an example of ‘it’ll be fine)
ExpressScripts is absolutely terrible. What once was a simple problem: Get a Rx from your doctor, go to any pharmacy and get it filled, has now become a painful process of:
- Call doctor's office, ask them to send the Rx to express scripts.
- Call express scripts, verify they have the Rx.
- Two days before you run out of medication, you get an automated call from Express scripts telling you to call them back.
- Call Express Scripts, wait on hold for 30 minutes.
- Someone finally tells you that there's a problem with the Rx, and you need to call your doctor and have him re-send the Rx specifiying dosages, etc. in a a very specific way. This is Friday afternoon, of course, and your Doctor's office is already closed.
- When you explain you're going to a miss a dose of a medication that is dangerous to stop suddenly, they absolutely do not care ("You'll have it in 5-7 days, once we receive all the info we need", click).
It isn't just me. I overhear a lot of angry phone calls between employees and express scripts in the cube farm at work now. Employees are wasting work-time dealing with something that used to be simple - getting their prescriptions filled. Hope the shareholders are happy.
No step in the retail pharmacy supply chain involves routinely putting it in a small black box sitting out in the sun until you get home from work in the evening.
Only problem I've seen is that they often (and I mean OFTEN) forget to apply medication savings cards, which adds up to quite a lot of money. I had to complain about this eight or nine times and ultimately escalated to one of their founders, a guy by the name of Eliot, to get this addressed. However, they may have fixed the problem as they haven't overcharged me so far in 2018.
Prices are set by insurance and shipping is already free so I can't see how Amazon would improve on that. I imagine their margins are razor-thin, but it's pretty clear this sort of service will be how everybody gets their medicine in the next couple of years so the volume makes sense for Amazon.
I’m not overly concerned about their dominance anymore. There are eventually going to be regulated.
No, because that would land them straight in jail.
The UK already has a company that does the government loves to outsource things to: https://www.theguardian.com/business/2013/jul/29/serco-bigge...
So I imagine you'd call about your local trash pickup or a kindergarten and you'd get put in the call center telephone queue.
I think ES does provide a service that people want regardless if it hurts Pharmacies and it doesn't hurt consumers if they want to pay for the service; but maybe it affects drug prices in other ways?
If the Cigna deal fails to go through they both owe some billions, coupled with Amazon in their space, ES looks doomed.
Link describing medication adherence potential health care savings. http://www.heart.org/HEARTORG/Conditions/More/ConsumerHealth...
Link describing medication adherence and Pill Pack. https://www.pillpack.com/healthcare-providers
I wonder what other industries out there can be arbitraged like this. I bet Amazon could shave well over $10b of market cap off of BKNG if they made the right strategic investment.
This means getting in there is going to be very profitable, and if amazon can get in there are use its existing scale they can get quite rich. There's now three benefit management companies that are in charge of altruistically deciding what medications you can afford. On the one hand, Amazon breaking up this pathological oligopoly would be good for consumers, but if it's really a market structure thing we run the risk of there still being on three companies, but with Amazon instead of CVS, ExpressScripts, or United Health.
If Amazon’s warehouses or Whole Foods are any indication of how they’ll approach the unavoidable human work involved at a pharmacy, I have serious doubts about the quality of service. And pill pack is already in a pretty sorry state.
How many pharmacists and pharm techs can be automated away by amazon that pillpack hasn’t already? And this is just a rhetorical question, neither of us are really qualified to address all the tasks to be done, nor current automation levels.
How did Walmart impact CVS and Walgreens? Both continued getting larger. Maybe Amazon will drain some or most of the remaining growth in the segment by taking a slice of market share. More likely it'll just end up being an expensive, terrible business that struggles, like most of Amazon's ventures (they fail far more often than they succeed).
On the other hand imagine what you could do with the data . Lets say you have clinical depression. Maybe it would recommend you a medical food such as Deplin or even the l-methylfoliate.
I had tried to use the mail-order drugs provided by insurance companies and they were a disaster. I couldn't find out what was coming when. Drugs would seemingly-randomly show up in my mailbox.
Edit, Adding source:
https://www.pillpack.com/questions/can-you-ship-prescription...
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. 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. Stock bottle are not allowed to be mixed together. Ever heard of a recall on medications? That is exactly why. When a recall happens, they need tedious records of where every pill went.
When a prescriptions for a schedule II drug is filled, the pharmacy technician has to count the number of pills being filled twice. Then the pharmacist has to count the number of pills, and then backcount the stock bottle to make sure everything is kosher and no pills are missing.
I understand not everyone knows everything about the pharmaceutical industry, my wife is a pharmacist is the reason I know as much as I do, but to think that there is that little oversight on pharmaceuticals is ludicrous.
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.
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?
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 think it's just generally weird that a shipping and commerce company is taking interest in pharma to begin with. I think it SHOULD make users uncomfortable that a single company is potentially exposed to all these different vertices of user information. They know what you buy, soon they'll know what groceries people buy, what they read, what medicine they take which could in turn reveal metadata like sexual habits or genetic patterns.
It's weird.
Good grace. What a load of unnecessary bureaucracy.
The supply chain integrity problems were allowed by Amazon because it benefited their bottom line. If they wanted it perfect, they could have made it perfect.
Remember when the eclipse was happening and they actually did a pretty good job of removing all glasses which weren't safe? They know where integrity counts, and I think when it comes to pharmaceuticals they'll know how to play this game clean. As another user commented: Amazon didn't get this humongous by making silly mistakes like this.
They also recalled a number of good units, which only sowed confusion and anger among buyers.
https://www.usatoday.com/story/money/nation-now/2017/08/14/a...
And it turns out some of the counterfeit glasses did get out to to buyers who thought they were purchasing legitimate units.
https://www.reuters.com/article/us-amazon-com-lawsuit-eclips...
Exploding hoverboard case shows how hard it is to beat Amazon in court
https://www.cnbc.com/2018/06/02/amazon-not-liable-for-explod...
https://news.ycombinator.com/item?id=17216972
> [T]here were so many cases of fires and explosions that Amazon had halted sales. [...] Fox's case was filled with testimony and evidence illustrating that Amazon execs were concerned about the hoverboards sold on its site. [...] [A]n Amazon vice president said the company had decided to halt sales of hoverboards and send a 'non-alarmist' email to existing customers [...] Fox received the email the next day. It referenced 'recent news reports of safety issues' and offered 'safety tips' for using the product as well as an option to return the device for a refund. There was no use of the word 'fire' or 'explosion.' Fox testified that if Amazon had said that 'they knew what they knew, I certainly would have gotten it out of my house.'
Only after people let them know they were not safe and not within a reasonable timeframe for people to order replacements.
PillPack already has an established distribution network and prescription delivery licensing in 50 states. I don't know for certain, but I would assume that fake prescription medicine is a much bigger risk and would threaten the operation more than, say, fake batteries.
I reject specific manufacturers from my CVS and get trusted manufacturers all the time.
Hard to do these days though. Teva is killing off a bunch of generics, Puerto Rico still a mess, weird shortages of common meds, etc. Sometimes I spend an entire day going around the city trying to find the specific generic which I'm used to. And then only get partial fills, etc.
The potential liability they would be exposing themselves to if Amazon treated their drug supply chain the way they treat standard 'Fulfilled by Amazon' products would hopefully prevent something like that from ever happening.
It’s a big infrastructure lift so it’s still being implemented.
[1]https://www.fda.gov/Drugs/DrugSafety/DrugIntegrityandSupplyC...
Amazon isn't stupid: they know _exactly_ where they can play it fast and loose in order to maximize profit and where they must operate under strict regulation. This isn't the former.
You almost certainly have, though you may not be able to tell the difference if you don't actively look for it.
There would be no reason to integrate prescriptions in with their warehouses, so I don't think one is going to change the other.
Do they all ready have a supply chain close to the requirements needed in healthcare ? For what ?
I would love for Amazon to come in and transform this space. There are lot of improvements to be made but all the well established players know those improvements but unless the regulations catch up its hard to innovate.
One thing Amazon might be able to do is to take a hit to their bottom line by essentially selling drugs at a loss and wait it out till they drive everyone out of the market and increase prices. But no one cares when the price of a book/toy increases by x%. Everyone cares when the price of a drug increases by the same amount. (https://www.cnbc.com/2017/04/03/mylan-hit-with-racketeering-...)
I'm not sure anyone thinks Amazon will allow 3rd parties to sell prescription medications. Although if they want to let me cash in on my dead mother's extra chemo meds and pain pills, let me know where to sign up.
They're not, though.
As an example, my wife is allergic to a filler ingredient in one generic manufacturer's version of one of her medications.
This is news to me. Can you link an article about it?
In no way I say it was fine, I'm just saying that Amazon will have time and opportunities to fix whatever counterfeits popup before hammer will go down on them.
It may also be they won't allow 3rd party markets into healthcare, we just don't know yet all the details.
P.S. While we’re on the topic, if anyone’s interested in a libertarian perspective, check out Jessica Flanigan’s 2012 JME paper “Three arguments against prescription requirements”: https://jme.bmj.com/content/38/10/579
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 it becomes simple to take medicine at the correct times and intervals. For relatives it's also simple to check that medicines have been taken as required.
PillPack seems to do that, but 'on the Internet'. shrug
>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."
Does the pillpack have a separate pack for each day with the date clearly labeled? If so I feel that would help a lot with adherence, which in my opinion is a serious problem
The rate seems like it was just imaginary. Their promotion was that Amazon was willing to lose a significant amount of money to gain market share.
"Market manipulation" is dissemination of false information or demand with the express permission of profiting. But there was no false information or demand here.
I could be wrong, as the first article states, Amazon skated by without so much as a warning while bodybuilding.com had to pay fines for selling the same steroids, but I would expect the FDA is able to throw their weight around more with Amazon now by shutting down their official pharmaceutical operation if they continue to make perscription medications available like this on their retail site.
I feel like it's more like Amazon just trying to monopolize everything. There are articles out there talking about getting Amazon-ed. Where Amazon would go in your industry and dominate you out the market. (https://www.forbes.com/sites/jamescahn/2018/04/24/dont-let-y...)
This is just a natural thing or the thing that Amazon does. Their modus operandi.
> what medicine they take which could in turn reveal metadata like sexual habits
They do recommendation system and I believe they sell sex toys so yeah... Alexia knows your kink already.
It's not weird but I think the better question is is this okay for one company to have so much power in so many area. Or at least I believe that's what you are trying to convey.
Sort of depressing, really.
As a bonus, the pharmacy team usually has the meds ready by the time I arrive instead of needing to make a second visit or waiting after handing off the slip.
Abruptly changing that filler could very well send an epileptic into a static seizure.
They’ll invest the resources to ensure that doesn’t happen.
Amazon didn’t get big by being stupid.
Your point stands.
The bogus ones could then have been isolated and recalled, but this is not what happened.
1) Goggles used the existing supply chain. Which, as noted, was designed around the idea that customers would rather have cheaper things from any vendor that things from a specific vendor. Presumably the greenfield / acquired med supply chain is engineered around different desires and regulations.
2) By the time the goggle issue came up, inventory was already in the system. With some presumably co-mingled. I'm just saying I wouldn't want to be the DB analyst who got tasked with untangling that.
EDIT: i'm from outside the US, and after reading all the complains about delivery people throwing packages etc, i thought people don't trust delivery guys enough for medicine.
It appears i was wrong.
That you don't feel safe receiving your medicine being delivered last mile from some random UPS guy?
If this is what you mean -- I get my medicine by mail order from CVS. I cannot imagine now having to go to CVS every single month I get my medicine.
Anyone who could fix this problem will get her business in a heartbeat.
I'll be among the first to switch to AmazonRx.
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 and bottled.
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.
/cdn.vox-cdn.com/assets/3968063/PillPack_Shipment.png){kind=link}
Yes, but is it worth the trouble?
Obviously, the USB drive stuffed in an SSD case is a fake. But that's not the only kind of fake going - printing "Seagate" on off-brand disks happens too, probably with much higher frequency. And cracking down on that would not just be harder, it would be a way bigger threat to Amazon's margins.
Hopefully the PillPack supply chain stays separate or separately monitored, but this wouldn't surprise me either - most cheap online pharmacies are selling real medicine at lower margins, possibly with worse quality control.
The gp merely asked for anecdotal data, nothing rigorous. By disagreeing, you are indirectly implying that the commenter is somehow incapable of telling fakes from the real deal.
How does anyone reliably tell fakes apart?
So in my case, I paid money to Honda who in turn paid it to Garmin for something I'll never use, just so they can say it "comes with Navigation".
I wonder how long that will last before no one cares if a car comes with navigation.
I've already seen high end cars being sold without navigation, and just marketed as "smartphone ready". I suspect in a few years either all the cars will be sold that way, or they will all be self driving and get their navigation elsewhere.
Automakers want to control the quality of the user experience. They can do that better by partnering with a company that specializes in that sort of thing.
But the main issue with drug delivery is the need for reliability; you can't have somebody's heart medication ship out late or get lost in transit, basically ever. And if you change offerings or go out of stock on specific products (which most retailers do often), you'll quickly be seen as an unreliable way to get any kind of regular medication.
Plus, you can't let any fakes or low-quality products into your supply chain - so sourcing new suppliers is hard, but running out of suppliers for any single product is a crisis.
So being an online seller for use-as-needed prescription meds might be easy, but the bulk of the money is in people taking drugs daily, and that stuff is damned hard to offer.
I think there’s a big opportunity for insurers to pick a default mail pharmacy that customers out of. So depending on your insurer, the EMR automatically files with a pharmacy you don’t care about and mails it to you within 24 hours.
My doctor sends short term stuff to a local pharmacy for me to pick up, and my daily long term pills to Optum, who charges my CC and mails them to me. They take about a week to arrive, but you can set it up so they automatically recur, so you always get your next 90 days before your current pills run out.
Looks like it’s already happening, albeit in an opposite direction, with Aetna acquisition by CVS.
Any other medication coming in blister packs wouldn't change a darned thing, unless you expect pharmacies to carry large quantities of sealed 5,10,15,20 etc etc dose packs. If they didn't, they'd still be breaking the sealed packs up and counting to match the perscribed amount.
Fentanyl is commonly carried in pharmacies but it’s not a commonly prescribed medication. Better examples would be adderall, vyvanse, norco and oxycontin.
Disclaimer, I'm long SQ.
If you're following AMZN, SQ, or PYPL, you probably saw the headlines back in April:
Amazon's Next Mission: Using Alexa to Help You Pay Friends
Firm looks to make voice commands the next wave of commerce
SQ and PYPL took a small dive on this news, even though at face value, its quite silly. Amazon would probably have a much better time trying to buy PayPal for Venmo or Square for Cash App but also to compete in the small-biz transaction field that Amazon tried and gave up on. Building out such a service based on Alexa users is wacky, and there doesn't seem to be a pressing need to let loose your wallet via voice.
Personally, I think it's somewhat unlikely that AMZN would acquire PYPL due to a clash of cultures when it comes to customer service. (Amazon's: Very good. PayPal's: Legendarily evil). This reputation may also be the reason PayPal has kept their own name off of their Venmo acquisition product until very recently. I think there is a very slight chance that AMZN would try to acquire SQ. It would allow them to really break into small-vendor retail where they have failed with homegrown solutions before, and give them instant access to a growing P2P transaction market. Everybody loves to speculate about such acquisitions, though.
...But it would certainly be funny if the only reason Amazon made that press release was to butter up one of those two companies for acquisition, either by decreasing their share value or exerting pressure on them internally to agree to a deal before they face Amazon's competition.
Yes because while Etsy stock dropped by 60% to less than $10 it has recovered back 42 dollars about 3 years later.
They’re (Amazon) not faster, I don’t care if they’re cheaper (insurance coverage), and I don’t trust them (supply chain, motivations, etc).
Remember, AMZN is entering the health insurance space as well, so that vertical integration can remove the "is this covered?" question that some with substandard insurance may have.
And with regards to supply chain issues, there's no reason for Amazon to open up their pharmacy service to third party sellers. Yes, they'll get a larger selection faster, but isn't that what this acquisition is for?
Pillpack works proactively with your doc and insurance to handle refills, paperwork, etc -- more so than any other pharmacist I've had.
Having just spent two weeks calling daily to get my daughter's specialty medication sorted out, I'm all for Amazon's customer service approach entering this space.
When Amazon promises a resolution/callback, I trust it. Express Scripts promised me callbacks not once, not twice, but four separate times without ever making one.
Every time I'm subjected to multiple dark patterns simply in the course of checking out (say, for some brand that makes Amazon their official distribution channel), I wonder why so many seem to be singing their praises. I can only think there's just a sizable segment of newly-digital suburban-hipsters, finally discovering online ordering in general and comparing Amazon to say driving to Target.
With amazon it's convenience, and scale. PEople go to amazon.com when they want to buy something (be it vitamins, or electronics, doesn't matter).
This just makes their hands stronger.
And Im concerned about knockoffs as well.
http://www.realfoodfakefood.com/real-food-fake-food-book-by-...
https://www.confectionerynews.com/Article/2017/02/08/Fake-Fe...
If there was any incentive to create and sell a knock off product, it is only increased when Amazon provides laxadasial environment.
That doesn't make sense. They would then need to make sure "Real Good Fakes" products are cheaper than what they send... At anytime "Real Good Fakes" can ask for his stuff back and that has to be "Real Good Fakes" stuff or there may be a big problem (used vs refurbished vs new).
They automate everything, there's no way there's no barcode for this kind of thing.
The parent's concern with direct-to-home delivery is valid - the inside of an in-sun mailbox on a 90 degree day is going to well exceed safe thresholds for many medications in a way the rest of the shipping chain won't.
The real pain is in the pharmacies who love to power trip. The CVS near me got a new pharmacist who decided she didn't want to fill my prescription because I wanted to pay in cash (no insurance at the time). Didn't even offer to call up my doctor's office to confirm. Just a hard no and goodbye. Made me feel awful, like I was trying to cheat the system or something by paying the ridiculous retail price of $850 for a drug that cost me $20 when I had insurance.
Had to go across the road to Walgreens who never let me down.
What a hilariously stupid system we have making everyone feel like a criminal. I get anxiety all day when it's time to refill. A drug I've been taking for 10 years.
As you noted this can be hostile to the people who need to take their meds. You can get stuck in a vicious cycle where being in urgent need is interpreted as suspicious which leads to denials and lack of meds makes you more harried. It's worst for people who are physically dependent on their meds and will who go into withdrawl, pain, or become very unproductive.
Sometimes you have to travel for work, and because methylphenidate is such a threat to society (it isn't) you can't fill prescriptions out of state. So you talk to your doctor to get a special prescription with written instructions to allow it to be filled 4 days early (gasp!) so you can fill it before your trip. The pharmacist then rejects filling it for you, for reasons they refuse to explain.
I see a doctor in my home state, about an hour's drive from where I currently live. I see this doctor once every three months. I've seen him for 10 years. I would like to continue to see him. Recently I was put on a light sleep aid for anxiety reasons, I went to fill this prescription (which I have to do in the state that I see the doctor in). I was told my insurance only allows me to get a 2 week supply, and I'll have to come back in 2 weeks later to fill the rest of the 30 day prescription the doctor wrote. When I asked how much it would cost to just pay out of pocket, it was negligable, 20 dollars or so. When I asked to just pay for it myself to avoid making a long trip again 2 weeks later, the pharmacist decided to deny giving me anything.
It must just be some health systems require it as policy.
[0] https://www.deadiversion.usdoj.gov/ecomm/e_rx/faq/faq.htm
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....
Items are well packed but not excessively (Google Express once sent me a bubble-wrapped bottle in a giant box for when I just ordered peanut butter - talk about waste).
Frozen items have cooling packs that are reusable and recyclable (pure ice + plastic skin) - and (this was actually useful) frozen drinking water bottles (useful packaging!)
The quality of the groceries were good. Unlike Safeway where sometimes I got what looked like older veggies.
My (more extensive) experiences with both Google Express and Safeway were inferior in little ways. I want to hate Amazon, but they're doing great for grocery delivery.
There won't be wide adoption until the customer gets a perfect order with no substitutions or blemishes every time. The psychology of perceived loss at not getting EXACTLY what was ordered is too great. Until then millions of disappointed people will discourage others.
This is pretty much exactly what I would do if I was at a job where: 1) I didn't care at all and it was temporary 2) I'm also getting paid nothing to do it. So I can't really fault the delivery people in this situation.
The TL;DR is that there is just no margin when it comes to food. Grocery, restaurants, meal kits, etc. People keep trying to deliver these experiences to your home, and having spent 5 years cooking in a restaurant and my entire childhood growing up on a farm I've reached the conclusion that it can't be done. Once you add in the cost of human labor for physical delivery, the margins go from slim to negative.
I think you (and I) might be in the minority here and not their intended market. I don't know anyone with experience cooking who would prefer any meal or grocery delivery services over just doing it themselves. They're probably only focused on the market whose only previous alternative is instant/frozen meals or takeout.
To us: Shitty delivery + mediocre quality = Net negative
To their intended market: Delivery on par with take out + quality that's better than take out = Net positive
A very convenient experience, and it gets a lot of people doing the order online.
Once you have that, and if you can convince people to get their orders at a fixed weekly window, you get delivery density, which is key at lowering shipping costs.
And as far making delivery times convenient in this method - you need to loan your customers a passively chilled box they can put on their porch, so they can pick the deliveries when they come home.
Maybe Amazon could have done this while skipping pickup. But since it's less convenient , it's hard to convince people to pay more, and maybe competitors are cheaper.
But going straight away to on-demand deliveries, with 2 hour delivery time? Sure, that's crazy.
Amazon does allow sellers to pay extra to keep their inventory separate. I don't know if the stuff Amazon sells is kept that way, but there's no guarantee it is.
Doctors are typically not experts in medications. Specialists probably know a lot about medications pertaining to their specialty, but asking GPs to know so much about a vast array of diseases AND the medications to treat them all, AND all interactions between medications is unreasonable. Doctors education is primarily in diagnosing disease. Pharmacists go to school just as long as doctors do (I think the major difference is pharmacists don’t typically do a residency after they graduate unless they are not planning to work in a community pharmacy), but their entire education is based around medications. Pharmacists are the medication experts. It’s a good thing that we have both looking after the healthcare of patients.
I got all my product from HP via Synnex, all factory sealed brand new genuine parts. The number of times I got burned by people leaving shitty feedback or returning stuff because what they got when they placed there order for the part I was selling was some knockoff that was close but not exactly it was high enough that I no longer sell on there.
The idea that FBA doesn't actually get me parts from the seller I picked has never crossed my mind. I certainly wouldn't have bought quite a few things if I knew that possibility existed.
Usually it would be many small quantities near me, and then one large one to the other coast which they would then distribute amongst their warehouses on that coast themselves.
So as the number of vendors stocking inventory increases, the cost to amazon to distribute inventory widely enough to hit SLAs goes down because more of the cost is borne by the vendors.
https://www.inc.com/sonya-mann/amazon-counterfeits-no-starch...
Shipped and sold by Amazon.com means that the product is shipped and sold by Amazon Retail (via Vendor Central or Vendor Express) directly. Basically, the manufacturer sends product to Amazon.com at a set price through a traditional PO process. This inventory is commingled with all other FBA inventory.
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Richard added, "[T]he consumer always thinks the chain is: Manufacturer » Amazon » Me. But the reality is that is pretty much never guaranteed. The only way that's guaranteed is if you find the manufacturer's listing on Amazon.com and buy via [F]ulfilled by Amazon directly from them, AND they happen to choose to opt out of commingled inventory. In every other scenario there's a chance that you get inventory that didn't come from the manufacturer."
no, they can't, and it doesn't have to be. that's how the FBA program works - when you send your stuff to amazon, they store it in their warehouse on the understanding that it's identical to any other example of the product it is listed as. You can't then turn around and say "i want all the ones i shipped you back", because you've told amazon that the products are interchangeable.
Ship in a crate of counterfeit widgets to mix into their fulfillment pool. Price them stupidly high so they don't actually sell.
Wait a few weeks, to let the inventory churn. There's a fair chance some of your items will actually be shipped out, and many more will be so mixed with turnover from real sellers that it will be difficult to trace back to you.
Then pull the listing and ask for "your" inventory back. Odds are, you'll get at least some legitimate products back, which you can then sell elsewhere at a significant discount.
The math for it to be economic is interesting and likely varies on product price versus counterfeit price, and the rate at which inventory turns over.
And what about "New" items missing packaging etc.?