In addition to presiding over our food, the supply chain, and acting as a rent-seeking middleman for retail while quietly picking off the competition, Amazon will now oversee drugs. Today, the behemoth launched Amazon Pharmacy, which is certain to leave more small business owners out in the cold.
Amazon Pharmacy expands on PillPack, a monthly medication delivery service which Amazon acquired in 2018. As an Amazon spokesperson explained to Gizmodo, PillPack is more oriented toward people with chronic health conditions on multiple medications, which the service bundles and pre-sorts into packets marked with the time of day at which they’re meant to be taken. Amazon Pharmacy is instead gears towards refilling as-needed regular medications, like asthma inhalers.
Unlike local services like the New York City-based online same-day medication deliverer Capsule, the fastest Amazon Pharmacy turnaround is two days for Prime members. But also unlike Capsule, it’s available in 45 states, via the Amazon app and on Amazon dot com. (For now, Amazon Pharmacy does not send out vaccines.)
Amazon is also using Amazon Pharmacy to make a play at undercutting the entire concept of insurance, it seems. While customers input their current insurance plans and see the cost of medications before they buy them, Amazon Pharmacy will also show the non-insurance cost, which it repeatedly, and prominently hard sells as a bargain. “Prime members save on prescriptions when paying without insurance,” the service’s pricing page states. The option to save “up to 80% off generic and 40% off brand name medications” via a non-insurance pharmacy card administered by Inside RX, LLC is now, apparently, “included with your Prime membership at no additional cost.”
Inside RX is a subsidiary of Evernorth, which is a subsidiary of the health insurance company Cigna—and these non-insurance cards are accepted at a number of participating chain pharmacies like Rite Aid, Walgreens, and CVS.
Whichever option Amazon Pharmacy customers choose, it involves providing Amazon of all companies with a list of what drugs they currently take. The list of parties to which PillPack can “use and disclose your Protected Health Information without your written authorization” is quite long. Amazon also has a long, documented history of subsidizing the cost of desirable goods just long enough to fuck over their competition.
“The Privacy Promise language reflects concepts in HIPAA, which requires an individual’s permission if information is disclosed outside the covered entity for purposes beyond those that relate to care, treatment, payment, and other listed uses,” an Amazon Pharmacy spokesperson told Gizmodo. “To be clear, we do not currently ask for a customer authorization to disclose their Protected Health Information for advertising or marketing outside the pharmacy as part of customer sign-up or onboarding, and because of that customers can be confident we do not share information with any entities outside the pharmacy for those purposes. If that ever were to change, we would ask explicit permission in a clear and transparent way.”
Mom and pop stores have long lamented that pharmacy conglomerates have been putting them out of business. Lawmakers in some states have been battling CVS for wielding market dominance to get better reimbursements from health insurers and drug companies. A merger with health insurer Aetna further ensured that Aetna customers get railroaded into CVS clinics, where they can get cheaper services than at a doctor’s office. But CVS, check your neck—this morning, as CNBC pointed out, major pharmacy stocks are down. (Not that the markets are an indication of much beyond the whims of the wealthy few.)
Amazon will find a way to drive prices down, which it always does, and will make the choice even harder for local pharmacy loyalists who need the savings during a recession. If Amazon succeeds, everyone else loses.
Updated to include comment from Amazon.