Amazon Shelves Plan To Sell Prescription Drugs (cnbc.com)

Major Blud writes: CNBC is reporting that Amazon Business, which considered selling pharmaceutical products last year, has put its plans to do so on hiatus. "The change in plan comes partly because Amazon has not been able to convince big hospitals to change their traditional purchasing process, which typically involves a number of middlemen and loyal relationships," reports CNBC. Amazon was able to gain licensing in 47 out of the 50 U.S. states, but has struggled to land contracts with large hospital networks. "The setback illustrates the challenges of getting into the medical supply and pharmaceutical space, even for a company as big as Amazon," reports CNBC. "Several health-care and pharmaceutical distribution companies saw their stock take a nosedive following recent reports of Amazon potentially getting into the space, but it will likely take some time before those concerns turn into real threats."

Comments

dont take that poison

[Anonymous Coward]

drugs are poison. much better systems like chinese medicine. its work for thousands of years

Re:dont take that poison

[ShanghaiBill]

much better systems like chinese medicine. its work for thousands of years

When an American gets the flu, they get a prescription for antibiotics which work only as a placebo, with deleterious side effects in breeding antibiotic resistance.

When Chinese get sick, they take some ground up leaves, which also only work only as a placebo, but avoid the drawbacks.

The Chinese way is better.

Re:dont take that poison

[gerald.edward.butler]

I've never heard of anyone in the U.S. getting antibiotics for the flu unless they see an incompetent and criminal doctor or they are an idiot who won't quit asking their Dr. for antibiotics, even when he/she tells them it won't help, and finally the Dr. gives in and writes them a script for some simple antibiotic to appease them (but even that is extremely rare and a sign of an incompetent Dr.). So, no, I'd say the American way is better. 'Murica, FUCKYEAH!

Re:dont take that poison

[Anonymous Coward]

The Chinese way is better.

And that’s why they have a life expectancies lower than third would shitholes like Mexico.

Re:dont take that poison

[mrclevesque]

"The study analyzed antibiotic use in doctors’ offices and emergency departments throughout the United States. CDC researchers found that most of these unnecessary antibiotics are prescribed for respiratory conditions caused by viruses – including common colds, viral sore throats, bronchitis, and sinus and ear infections – which do not respond to antibiotics"

https://www.cdc.gov/media/rele...

Re:dont take that poison

[mrclevesque]

Addendum

The study also :states that 30% of prescriptions for antibiotics are unnecessary.

Re: dont take that poison

[AntronArgaiv]

And I'm sure all the offers frm "Amazon Marketplace" sellers will be full potency, guaranteed equivalent generics, and contain absolutely no sawdust, melamine or industrial waste.

Re:dont take that poison

[Known Nutter]

Part of this may be due to antibiotics being used as a diagnostic tool and also because patient expectations may lead to antibiotic prescribing.

Anecdotally, my wife recently had an onset of acute bronchitis, which is, in most cases, a viral infection. Her doctor prescribed antibiotics "just in case" it was bacterial.

Re:dont take that poison

[ArmoredDragon]

I'm doubtful that antibiotics shouldn't ever be prescribed for viral cold or sore throat. The reason why is because in many cases viral infections (especially the more painful variety) cause enough inflammation and coughing that the tissue becomes more susceptible to infection from existing bacteria in the air, so a bacterial illness then follows afterwards. I've had doctors prescribe them to me anyways, even after I brought up the issue of them not working with viral colds, and this was the explanation.

If bad viral infections like that are caught early enough, then prednisone along with maximum strength psuedophedrine can be prescribed to avoid creating the bacterial vector thus negating the need for antibiotics (a situation I've also had happen.) While the first is cheap, unfortunately psuedophedrine is no longer cheap ever since it was pulled from shelves, so people are less likely to use it. And truth be told, the ban on that only worked for a few years until meth-heads found another source.

Re:dont take that poison

[ArmoredDragon]

Anecdotally, my wife recently had an onset of acute bronchitis, which is, in most cases, a viral infection.

This isn't the whole story. Yes, it is quite rare for a bacterial infection to cause bronchitis, but being the "-itis" it is, inflammation often leads to fissures in the bronchi, which bacteria can colonize, regardless of cause (including i.e. dust, cigarette smoke, prolonged coughing from other infection.) If the doc saw a hint of blood, yellow color, or green color in the phlegm (or if your wife told him of it, or sometimes they can tell by looking at your throat,) that means she already had bacterial infection. Even if it passes that test and the phlegm is white, there's still a risk of secondary infection, especially if it has been a while since the first symptoms appeared. If the doc doesn't have the instrumentation to test for harmful bacteria with a throat swab, then antibiotics "just in case" is a reasonable thing to do, especially if there are any comorbidities.

If caught early enough, and harmful bacterial spores are ruled out, then a combination of NSAID or prednisone combined with mucinex will work fine for preventing a bacterial infection, so no antibiotic would be needed. (pred+mucinex cures all of my symptoms, including severe pain, within a day, only leaving behind an occasional cough for lungs to clean up.)

Re:dont take that poison

[ColdWetDog]

If the doc saw a hint of blood, yellow color, or green color in the phlegm (or if your wife told him of it, or sometimes they can tell by looking at your throat,) that means she already had bacterial infection.

Bollocks. That particular pearl has been deprecated for decades. It just means that there is an inflammatory response going on. And viruses are good at getting that pathway going.

Now, there still are lots of practitioners who at least profess to believe that, but they are sadly behind the times.

Re: dont take that poison

[Brockmire]

If you bought from Marketplace instead of from Amazon, you're a fucking idiot who can't be stopped from doing stupid things.

TO

[Anonymous Coward]

Thanks, Obama

Now pay your damn taxes. America is broke.

Big hospitals have no reason to change

[olsmeister]

With the kind of markup they use, the price they pay is really a rounding error.

Hospital is a middle man

[kiviQr]

Hospital is a middle man - they get markup on what they sell. They have no incentive to lower that cost. Your health insurance and you in the end pay for it!

Re:Hospital is a middle man

[Anonymous Coward]

Amazon need not give up yet, that sector is huge with obscene markups.

They are so clever in trying to fix up hospital sales early, meaning lowest price was never their real motive. OK, hospitals are on the take or with 20 year contracts.

The conversation goes, how much is this drug? Salesman says, well, it depends where you live and.. .blah -- exclusive distribution agreement, volume rebates.. free overseas holidays and superbowl tickets..

What Amazon should do now is list EVERY drugs price for all to see, plus prices in other countries and health systems. Just hire a drug economist. Visibility will make hospitals that overcharge, look very bad. Some well educated Americans know the price in Mexico and Canada too. Some Chinese-Americans come back with Chinese made antibiottics for forty cents a box, just in case the need a script here...Naturally, in this first opening, prices should start off high, and reduce to pain levels if the hospitals refuse to join in.

If Amazon employs smart economists, they might even go into manufacturing, as they should now know the cost breakdowns. And get special import dispositions.

In closing, a non-delivery is no big deal, patient just fills it at a chemist at a higher price.
The other thing is expiry dates on drugs is false, mosty they last years longer - and America has a scam there too - not testing expiry dates.

Re:Hospital is a middle man

[Anonymous Coward]

Took an Acetaminophen at the hospital, got billed $80 - for precisely one pill. Bottled water? $10 (the 12 oz size). Sterilized gown? $400. Insurance covers next to nothing, as always (20 to 40% discounts. Yay?). So, be sure to bring your own medicine and drinks to the hospital. Oh, and if they ask you to allow doctors in training in there, tell them no, because the hospital will bill you for their time as well. If you ask them to give you an estimate, they hide behind 'We just can't know for sure how much your stay will cost you.'

Going to the hospital is almost exactly like taking your car to the dealership for repair, except they refuse to give you an estimate, the parts pricing is a protected trade secret (with several middlemen with their hands in the pot jacking the price up 100-200% each time), and each mechanic that lays a hand on your car gets to bill you separately from the dealership. Oh, and one is (well, was) required to purchase insurance that basically covers nothing for roughly $1000/mo. or $12,000/year for what amounts to a 'preferred price discount', and 80/20 after your huge (4 months salary) deductible. Add to this that certain mechanics are independent contractors, and may be out of network (with a higher out-of-network deductible that has no bearing on your in-network deductible) Can you choose your mechanic at the dealership? Nope, you have to go with which ever's on call.

Rather than fix all this, I propose we bring back indentured servitude. Get sick and require hospital? Get ready to work for them for the next seven years. An alternative (that I've heard floated recently) is to decide which people are too expensive to fix, and terminate those that won't be able to pay the bill. I suppose if the patients family can't afford the euthanasia drugs, the hospital can always bill the government... at 1000% markup.

No incentive for the hospital

[nicolaiplum]

Hospitals (for civilian non-veterans) in the USA have no incentive to be efficient. They can put whatever number they like on the invoice and they'll likely get paid.
You people in the USA could get cheaper medical care with cheaper drugs if you would get your hospitals and doctors to find the cheapest supplier - but you seem to think that's some sort of evil socialism and you reject it. You have at least one illness: severe delusion. Maybe you have other illnesses too.

Re:No incentive for the hospital

[93 Escort Wagon]

Hospitals (for civilian non-veterans) in the USA have no incentive to be efficient. They can put whatever number they like on the invoice and they'll likely get paid.

Having dealt with numerous hospital and doctor bills over the past couple decades, I can state with confidence that you're quite wrong.

The hospitals and doctors may bill for a particular amount; but how much they actually receive depends on a rate negotiated with each insurance company. So when you look at a doctor's bill for example, you might see:

2018-02-25 Brain Transplant $100000.00
2018-02-27 Insurance Write-off -55000.00
2018-02-27 Insurance Paid 43000.00

Your Responsibility: $2000.00

And on the insurance statement, rather than the "write-off" amount you'll see "allowed: $45000".

For the most part it's the insurance companies and government programs like Medicaid which decide how much the doctors and hospitals are going to actually get paid. And it's actually pretty rare for the original amount billed to not get adjusted to some degree - sometimes drastically.

Re:No incentive for the hospital

[MMC Monster]

I'm not sure if I believe this.

As a physician employed by a fairly large hospital network, I know that my hospital pinches any penny they can.

If they can get 1 cent less per acetaminophen tablet, they would sell their own mother for the opportunity.

Not that they will pass that savings on to the consumer. But it will increase their margins so that they can afford to buy more stuff.

So I can't believe Amazon.com is giving up on this.

The only thing I can think is that the hospitals have multi-year contracts that need to run out and Amazon wasn't willing to wait.

Re:No incentive for the hospital

[stephanruby]

Also, since Amazon is being targeted by President Trump right now, it's probably better that it waits until he leaves office. Starting a new business venture in pharmaceuticals when a branch of the government is out to get you is a very bad idea.

Re:No incentive for the hospital

[Anonymous Coward]

Hospitals tend to not want to kill their patients. It’s bad for business. Amazon is stocked with fraudulent items. They can’t take the risk that amazon will send cyanide pills instead of the medicine that need.

Re:No incentive for the hospital

[Anonymous Coward]

You might to talk to the drug company reps and see where the corporate sales conference is this year.

Re:No incentive for the hospital

[bestweasel]

And yet,
States consider bringing prescription drugs from Canada to US as costs soar

Sovaldi [a hepatitis C drug], is a good example of how prices can vary between countries. In the US, a course of Sovaldi lasts 12 weeks and costs $90,000 US retail.

American insurers typically negotiate a discount of 41%, according to a Bloomberg News analysis. That puts the cost of the drug at $17,700 a month in the US.

But in the United Kingdom, that drug costs $16,770 a month, and in Canada $14,493.

For an even more dramatic example, consider Gleevec, a leukemia drug. It costs $10,122 in the US, $2,645 in the UK, and $2,420 in Canada.

“Our Medicaid drug prices, particularly for specialty drugs, are way over the top,” said Lyons. “So, we’re trying to identify those drugs where the cost has escalated in the past few years, or the payment per dose is very high as compared with Canada.”

...

Americans pay on average three times more than British people for top-selling prescription drugs.

How many people have to pay the retail price?

Average foreign-to-Canadian price ratio for patented drugs as of 2016

It looks like the drug companies charge what they like because the market in the US is fixed.
Are Canadian Pharmacies the Solution to America's High Prescription Drug Prices?

This is what’s at stake if U.S. drug prices fall — and Europeans don’t pay more

Our calculations suggest that the U.S. market accounts for as much as 78% of all global drug profits. These are the profits that drive innovation, and they are coming out of American wallets.

Why does this happen? Branded prescription drugs are 20% to 40% cheaper in Europe in large part because the national health plans there drive hard bargains. The state-run buyers can impose price caps, or even refuse to allow a drug onto a national formulary if they think it is not worth the cost.

Bargaining does occur in the free-market U.S., but not nearly in such draconian terms. Medicare was expressly forbidden from bargaining when the drug benefit was added during the George W. Bush Administration. If the Food and Drug Administration approves a drug and a physician prescribes it, Medicare will almost always cover it. Private insurers and pharmacy-benefit managers can usually negotiate down from sticker prices, but they typically don’t have the European-style ability to broadly deny access, which is the big bargaining chip.

Re:No incentive for the hospital

[Memnos]

And often if you're not on the approved list for all of the components of a hospital bill, your co-pay is based on the full freight of what's charged.

And if you happen to be uninsured.. well, you're fucked.

Re:No incentive for the hospital

[Anonymous Coward]

If you're uninsured your discounts start at 50% and i've seen some as high as 75%. The overinflated list price is so that we think insurance is saving us a lot of money, the truth is far from it.

Re:No incentive for the hospital

[Anonymous Coward]

Or the fear that Amazon would send the wrong items by mistake, a substitute, get the pictures or description wrong. I have tried ordering dressings/bandages in the past, and I would receive the wrong type. Some dressings are meant for dry wounds and are more like the plastic covers used in boxes of chocolate, others are non-adhesive or have anti-adhesion chemicals added. Some are waterproof silicone. It's not fun having a blister get infected and turn black and purple.

Re:No incentive for the hospital

[wyHunter]

This. Medicare pioneered payment by DRG for CPT and it IS in the best interest of the hospital to be price efficient.

Re:No incentive for the hospital

[tlhIngan]

It looks like the drug companies charge what they like because the market in the US is fixed.

No, it's because in Canada and Europe, the state buys from the drug companies. When an entire country is buying the drugs, they buy in bulk because they're buying for everyone in the country. This sheer buying power means they can demand good pricing for drugs. (In Canada, it's actually bought at the provincial level, but many provinces have joined forces to group buy the drugs, again, because it increases their leverage and buying power).

In the US, pharmacies pretty much have to fend for themselves. Sure, the hospitals often have more buying power, as are chain pharmacies, but when you've got basically no buying power at all (what, you don't want to pay? Well, your customers can go across the street to the pharmacy that carries the drug instead), prices get jacked up.

And let's not forget it's the state that also sets the laws regarding generic drugs and such - it's a very powerful weapon when you can ask, but you can't ask too hard because your monopoly is dependent on your customer. Sure the companies can bitch and whine all they want about withholding drugs and such, but it's a threat they rarely follow through because it means forgoing a lot of money now just to make a point, without saying there aren't going to be other companies willing to fill in the gap and undercut you.

Re:No incentive for the hospital

[Anonymous Coward]

If you're uninsured your discounts start at 50% and I've seen some as high as 75%. The overinflated list price is so that we think insurance is saving us a lot of money, the truth is far from it.

When a Tylenol is $20 after the 75% discount something is very wrong somewhere. That kind of pricing makes a hotel minibar seem reasonable.

Re:No incentive for the hospital

[pnutjam]

No, it's because in Canada and Europe, the state buys from the drug companies. When an entire country is buying the drugs, they buy in bulk because they're buying for everyone in the country.

Canada's entire population is less then the number of people served by Medicare.
And in reality, most of these health systems are actually multiple systems, I know Canada has one for each province, and the UK system is actually 5 systems.

Re:No incentive for the hospital

[pnutjam]

well, you're fucked.

That's the real American Way!

Re:No incentive for the hospital

[pnutjam]

My last insurance bill had discounts of over 90%. Your move.

Re: No incentive for the hospital

[Brockmire]

What the fuck? What is this logic? TFS is basically saying Amazon can't convince hospitals to cut out the middle men to go right to the manufacturers.

Re: No incentive for the hospital

[Anonymous Coward]

...state-run buyers can impose price caps, or even refuse to allow a drug onto a national formulary...

So, you let accountants make potential life or death decisions??? Yea, that sounds like a much better system.

Re: No incentive for the hospital

[bestweasel]

Isn't that the norm in the USA for non-emergency medicine?
Do you have insurance? Does your insurance cover this?

In any case, medical outcomes in the USA are nothing special compared to the rest of the world and very poor value for money.

How is creimer supposed to afford

[Anonymous Coward]

his diet pills now?

McKesson strikes again?

[gerald.edward.butler]

> Amazon was able to gain licensing in 47 out of the 50 U.S. states, but has struggled to land contracts with large hospital networks. "The setback illustrates the challenges of getting into the medical supply and pharmaceutical space, even for a company as big as Amazon,"

More like, McKesson (https://en.wikipedia.org/wiki/McKesson_Corporation) sent over a few goons to threaten to kill and/or maim family members of Amazon owners and executives if they didn't stay out of their business.

So much for draining the swamp

[Applehu Akbar]

If the putative swamp-draiing team in Washington had put John Stossel in charge of the FDA and turned Amazon loose with the ability to buy medications in bulk on the world market and fill US prescriptions for less, Trump's second term would be assured. But apparently, nothing this rompingly popular is even under consideration by the 'populists'.

If anything, the pond scum is getting deeper.

Re:So much for draining the swamp

[tomhath]

This isn't about selling to consumers like Walmart does. Amazon couldn't compete with the companies that have been selling in bulk to hospitals for many, many years.

Re:So much for draining the swamp

[Anonymous Coward]

... putative swamp-draining ...

Anyone who thought a corporatist like Trump would stop the bribery, make officials accountable, or protect the working class, was very stupid indeed. He got in because both parties were so corrupt they couldn't/wouldn't present worthy candidates. So, when it counted, people didn't trust Clinton's war-mongering laziness or did trust Trump's vote-buying propaganda.

Re:So much for draining the swamp

[TechyImmigrant]

This isn't about selling to consumers like Walmart does. Amazon couldn't compete with the companies that have been selling in bulk to hospitals for many, many years.

Which is a shame. Having the doc E-sign a prescription and the meds automagically popping up in my Amazon cart and auto charged against my HSA with prime shipping would be several billion times better than schlepping to Walgreens and waiting while they force you to spend 20 minutes in their store in the hope you buy something.
   

Amazon Silk

[Anonymous Coward]

Amazon Silk

Disappointing

[cascadingstylesheet]

More competition in this space would be good. It's disheartening that such a big player as Amazon can't break in.

Re:Disappointing

[mjwx]

More competition in this space would be good. It's disheartening that such a big player as Amazon can't break in.

The problem isn't the US retail sector. Do you honestly think CVS, Walgreens, et al. wouldn't jump at the chance to sell medications for less. The problem is the US health care industry and laws that end up locking generics out of the market. The whole thing is designed to sell medications for the maximum price. Amazon have taken a look at the razor thin retail margins and said nothankyou.jpg.

GPOs own that business

[tomhath]

Hospitals buy their drugs from Group Purchasing Organizations. GPOs are a very efficient way to get medications and supplies (as Amazon just learned).

Re:GPOs own that business

[bugs2squash]

From your link: In 1986, Congress granted GPOs in healthcare "Safe Harbor" from federal anti-kickback statutes"

I suspect that means they are dug in like ticks regardless of their efficiency

Why would Amazon be good for this?

[Actually, I do RTFA]

Amazon is pretty good at consumer delivery, but they're B2B service for repeated mass deliveries doesn't really exist yet. Nor is it in their area of competency. Those supply chains are already pretty well optimized, the ordering will be done via boring forms (for legal reasons), and there's no upselling/tracking of people's desires, and things are moved by the box, not the item. Also, big hospital chains already get bulk discounts.

My guess is they really just weren't able to compete on price and service, not that "there are longstanding relationships that made hospitals decide to lose money.:

Re:Why would Amazon be good for this?

[Anonymous Coward]

All of that, plus the medical field will not accept a failure in delivery - they need the supply of drugs and material to be very, very, reliable. The consumer market doesn't put so much value on reliability.

Re:Why would Amazon be good for this?

[Anonymous Coward]

"The consumer market doesn't put so much value on reliability." I consider Amazon the reason my local post office delivers on Sundays. I have ordered things on Saturday morning and get them via Prime on Sunday morning. I consider that pretty reliable for single-package delivery. They improved a system that they couldn't buy outright and they did it fairly well. The logistical world has changed pretty dramatically in regards to the end user and how inter-courier trade happens. USPS flies cargo on Fedex's planes. Fedex and UPS use USPS for last mile delivery. Companies getting big enough to warehouse everywhere and use USPS for cheap last mile. Amazon will buy more grocery chains - Wegman's, you ready for a buyout? If they were taking on medical distribution it would make sense to have even more infrastructure involved on the local level, and I am 100% certain it is within Amazon's ability to get that done and do it efficiently. I also think the next logical step is mass production of generic drugs. I would imagine a proposal to a hospital would include something like that. Perhaps Amazon couldn't provide a wider variety of drugs to be available from the start, so hospitals can't take the risk to switch vendors right away. But the time could come. I don't consider a business model built on buddies and kickbacks to be reliable! Amazon could do it. Elon Musk could do it if he put his mind to it, but he doesn't prefer the human interaction, more likely to spend his time with machines. Bill Gates could do it but he's more focused on lower hanging humanitarian fruit elsewhere in the world.

Re:Why would Amazon be good for this?

[Actually, I do RTFA]

Your entire "sunday USPS delivery" think misses the point. Next day delivery is unimportant in drugs. 100% reliability is. With whatever you order on Prime, it arriving in 1 day (or 2 or 2 hours) is the important thing. If something goes wrong 1% of the time, they give you an apology and a free month of Prime. If drugs don't arrive 1% of the time, that can cost people their lives.

I don't dispute Amazon has a great chain for consumers. It's just not who I would order recurring shipments of 55 gallon chemicals for my plant or medicine for my hospital from.

Elon Musk isn't able to reliably deliver cars, including for quality control purposes. He should not get into the medical space, esp. producing generics.

Re:Why would Amazon be good for this?

[jbmartin6]

My prescription drugs arrive via the same X% unreliable carriers who deliver my Amazon orders (with the exception of Amazon's own fulfillment of course). I've missed a shipment once, they just sent it again. No big deal since the replenish is ordered a month before the last shipment runs out. There can't be very many cases of "must have now or die" prescriptions that aren't replenished well before the previous supply runs out.

Re:Why would Amazon be good for this?

[jbmartin6]

You may be right, though I would not agree that a logistical service isn't in Amazon's core competency. Special handling might be an issue though. How is morphine, etc. delivered? Probably not in a truck with one delivery driver. I worked at a hospital some years ago, and I would absolutely believe 'longstanding relationships' would take precedence over considerations like cost. Many hospitals are 'not for profit' entities (not quite the same a non profit), and a cost or service advantage would not necessarily be decisive factors in those decisions. We had non-IT buying all sorts of awful technology due to 'long standing relationships' then handing it to us to make it work.

Re:Why would Amazon be good for this?

[Anonymous Coward]

If drugs don't arrive 1% of the time, that can cost people their lives.

This is a failure of (or intended result of, depending on your perspective) the War on Drugs. Blaming anything else is merely attempting to find a different problem patsy. The War on Drugs is the reason that if you accidentally drop your drugs in the toilet, it is incredibly hard to get more until the month is over. In a sane free society people would choose what to put in their own bodies (the USA is not a free society by any means; you can't call a society with a War against a victimless crime free), this wouldn't be an issue.

Re:Why would Amazon be good for this?

[Actually, I do RTFA]

And you can go to a pharmacy if for some reason you need a drug you weren't expecting. It's great for individuals. It's different for hospitals/major consumers.

You know who probably could get into that business - WalMart. They are excellent at making sure several thousand locations have the materials they need on-site. Amazon has a few dozen fulfillment centers and trucks to UPS. They just don't have the infrastructure to do B2B (yet). And it seems like Whole Foods, etc. are attempts to buy that infrastructure/know how, that will then start expanding into other locations.

I have no doubt Amazon will end up competing there, I just doubt it will be anytime soon.

Re:Why would Amazon be good for this?

[Actually, I do RTFA]

Amazon's B2C logistics are fine. They can get a random piece of crap sold and delivered. However, they aren't great at say quality assurance (look at the eclipse glasses) and have no demonstrated skill at maintaining the appropriate levels at thousands of retail locations (yet, they're developing them.)

As for long-standing relationships, I'm not 100% sure I buy your explanation. While I believe that the MDs/RNs they promoted made bad IT decisions based on relationships, I'd hope their knowledge of medicine/medical products was deeper. I'll also say that "longstanding relationships" means low-risk. It's not that Amazon needed to compete of customer service, it's that they need to prove they are as reliable.

Re:Why would Amazon be good for this?

[jbmartin6]

Hm well stated, I withdraw my objections.

Not all Americans love taking pills

[Anonymous Coward]

or even going to the damn doctor.

Because it's f****ng expensive as hell just to walk in the door and say hello to your Doctor IF you can manage to get an appointment at all because they have such a heavy patient load.

When I go to the Doctor, it's because I'm really f****ng sick. I will then get the lecture about " Why didn't you come in sooner ? " and I have to explain to them that we don't all make Doctor level pay and that $200 co-pay I get to make to just show up after begging for an appointment needs to be productive. Going to get lab work done ? Maybe an MRI or CT Scan ? Get ready to pay obscene amounts of money. The last time I spent ten minutes in a CT scanner cost me $800 :|

Thus do I make sure I'm damn sick before calling them up.

Get diagnosed with a Pseudomonas infection of the sinuses and see how well your Chinese version works towards eradicating it. You don't deal with that by taking some placebo. You hit it with some hard core antibiotics asap or you're really going to be hating life soon after. ( Because, sometimes, folks who ask for anti-biotics really are sick. )

No decent Doctor is going to prescribe an anti-biotic for bullshit reasons because they know the problems it causes.

Re:Not all Americans love taking pills

[boundandgaggedwomen]

I get my antibiotics from the Fish store. Same stuff with no prescription needed. I got sick of having to spend $200 just to get a prescription for my sinus infection.

Yeah, but, ....

[gerald.edward.butler]

'Murica! Fuck Yeah! 'nough said!

Re:Yeah, but, ....

[Anonymous Coward]

:)

Missing nice looking drug reps

[Anonymous Coward]

Amazon doesn't realize they are missing a key business operation of drug reps, having a steady stream of nice looking people. Doesn't matter if it's male or female, all drug reps seems to be of the gym going, model looking type. A website just can't really replace that eye candy that comes by every month offering a nice and pleasant chat.

Middlemen?!?!?!

[mnemotronic]

The change in plan comes partly because Amazon has not been able to convince big hospitals to change their traditional purchasing process, which typically involves a number of middlemen and loyal relationships

How I read that is that there are a whole slew of weasels between my check to the doctor or hospital and the medication provider. I'd have to say that America already has a form of "socialized medicine". It's just not cost sharing between end-users; it's end-users supporting middleman. CORRECTION: Make that "middleman that give kickbacks and handjobs to the hospital purchasing agents but offer no value to the end user".

So here's my suggestion: Every bill has to include an itemized list of where the money goes on it's way from me to the actual service provider. By "provider" I mean the doctor or nurse who took my temp or hooked up my IV or stuck a finger up my toxic backside to check my prostate. The "hands-on" person. Basically I want a list of the weasels.

While we're on the subject of prostate diddling and wet dreams, I'd also like the same itemized list for my tax dollars. That's obviously impossible because the government doesn't know where the moneys going.

Re:Middlemen?!?!?!

[JackieBrown]

Unless Amazon is planning on producing drugs, aren't they just trying to be additional middlemen?

Re:Middlemen?!?!?!

[wyHunter]

Yes. And for the medical industry, McKesson is already in that space, providing almost everything a hospital, ambulance, doctors office, etc. needs.

This is a gross invasion of privacy

[Chrisq]

How did you get hold of my medical records? ;-)

Chinese knockoffs what could go wrong

[Anonymous Coward]

Amazon being laser focused on lowering costs would be a terrible provider of medicines. They can't keep the Chinese knockoffs out of the Rolex market, they would certainly have bad actors jumping into the drug trade.

My insurance doesn't just blindly pay the hospital

[ansizfark]

I just have BlueCross but everyone keeps saying that hospitals can just bill whatever they want and the insurance will pay it, but I've never seen that happen. I've had a few procedures and office visits this year and every time the insurance pays a lower rate then what the hospital tried to bill them. I'll see hospital billed rate, negotiated rate, and what the insurance paid. Even for visits before I met my deductible. In what the article is referring to, the hospitals are just stuck with companies like Cardinal and the like because those companies are monoliths that sell the hospital EVERYTHING. That is where the control is. They threaten the hospital to raise prices on everything else if the hospital tries to stop buying drugs through them.

Middle men could be cutting prices

[DrYak]

Your health insurance and you in the end pay for it!

The story mentions Amazon trying to sell drugs in 47 of the U.S. states. Not Europe.
What is this strange thing called "health insurance" you're speaking about ?~~ :-D

Hospital is a middle man - they get markup on what they sell. They have no incentive to lower that cost.

On the other hand, the pharma companies and middle men upstream along the chain have an ultra-strong incentive to dramatically cut their prices and even sell at a loss some of their prescription drugs when making deals with big hospitals :
- Hospital will be interested in making business with the middle man that gives them the biggest volume sales.
- Middle men and pharma companies are interested in being *the hospital's official drug* that young MD trainee get used to prescribe while doing they hospital interships, because they'll develop a habit/brand loyalty and keep prescribing that drug later in their carrier from their doctor's practice office.
- Middle men and pharma companies are interested in being *the hospital's official drug* that most patient get prescribed at the hospital, because chances are higher they'll ask for the same drug when getting a prescrirbtion from their family doctor.

So middle men and pharmacompany would be losing some money when making deals with hospital, but making it back with all the people which keeps using the exact same drug out of the hospital.

(NOTE: Never investigated the thing in depth. I just noticed less usual and more expensive brands for prescription drugs in hospital settings)

Start with end user delivery in Canada

[Brockmire]

For me, Costco is cheapest, but requires 20 minute drive each way, parking hassle, 10 minute lineups, 2-24 hour wait for prescription fill. Due to the high wait time, usually means two trips. One time when I was in a lot of pain and hurt to stand and Costco had a fill time of next day, the missus said something like "it's best to fill prescriptions a few days in advance so you're not waiting like this". If they weren't the cheapest, I would have had strong words several times I had to wait longer than ETA they provided. Next cheapest option. Real Canadian Superstore is closer, easier parking, less lineups, and 20-45 fill time. About 8-10% more expensive. Then you have someone like Safeway, no lineups and fill time is 5 minutes. But you paid like 25% more than Costco. At $300-$500 every 3 months, that adds up. I'll take the Costco like price delivered to my door for $200, Alex. If Amazon bought the company that prepackaged the daily pills into blister packs for seniors, Amazon would bring another full time cash printer into operation just printing money. Some things you need within hours of seeing a doctor. Other things, like Metformin or other long standing prescriptions, Amazon would be awesome. I imagine the laws that requires pharmacists to speak with the user is likely a showstopper for Amazon delivered drugs.