[HN Gopher] Amazon launches Amazon Pharmacy for prescription med...
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Amazon launches Amazon Pharmacy for prescription medicine delivery
Author : leothekim
Score : 141 points
Date : 2020-11-17 13:42 UTC (9 hours ago)
(HTM) web link (www.theverge.com)
(TXT) w3m dump (www.theverge.com)
| say_it_as_it_is wrote:
| This is great news! I let Amazon medical care choose my general
| physician because it saves me the hassle of researching doctors.
| They have a large network of physician microservices that I can
| just search through, click one button, and I've got a doctor
| ready to be spun up when it's time for my annual exam. Amazon
| Insurance seems to dispute every physician fee, oddly, as if
| doctors seem to over-bill every line item possible. Soon, Alexa
| is going to handle medical coding for doctors, and that ought to
| help clear up these cost discrepancies (it's the admins fault,
| right?).
| [deleted]
| TMWNN wrote:
| I've been a PillPack customer for the past six months, since my
| local pharmacy closed (apparently for good) because of COVID19.
| It would be nice to be able to fine-grain adjust the monthly
| delivery date, and/or get more than a 30-day supply at a time,
| but I have no complaints.
| sytelus wrote:
| Just wondering why couldn't Walgreens do this? During covid,
| Walgreens is still one store that you must visit physically to
| get your prescription. I always thought there was some crazy
| health care regularization that prevented medicine delivery.
| Red_Leaves_Flyy wrote:
| My local pharmacy ships all my meds overnight at no additional
| cost and they're cheaper than Wal-Mart. If it's got a DEA #
| then I need to show my ID and sign for it. It's usually shipped
| USPS but they also have couriers. I haven't had any meds that
| required refrigeration but I imagine they just use a courier
| for that too.
| Simulacra wrote:
| Not neccessarily. There has been a push in the past ten years
| for mail order handled by Pharmacy Benefit Managers. PBM's are
| entities that work directly with the drug manufacturer to
| purchase in bulk, then delivering straight to the consumer at a
| lower cost than the pharmacy. The retail pharmacy industry,
| both chain and independent, absolutely despise PBM's and fight
| vociferously against them because it gives consumers the option
| not to go to the pharmacy. I predict Amazon will face the same
| attacks.
|
| Much to a larger issue, though, is the question: Do we really
| need pharmacists that much anymore? Vending systems would
| accomplish the same task, for less money. I contend most people
| don't even speak to a pharmacist anymore.
| yourapostasy wrote:
| _> I contend most people don 't even speak to a pharmacist
| anymore._
|
| While compounding pharmacists are still useful for those
| esoteric formularies, I would wager "normal" US pharmacists
| are still relied upon by the vast segment of the US
| population who are near-functionally illiterate and
| innumerate, on a big combination of drugs (don't get me
| started on how unhealthy swathes of the US population are),
| and cannot be bothered to work out for themselves drug
| interactions (much less how to get off of the drugs if
| possible). The disjointed nature of the US healthcare system
| promotes such inefficiencies.
| Nasrudith wrote:
| Just because you don't speak to them or see them doesn't mean
| they don't do work. They still have the responsibility of
| spotting known complications.
|
| Theoretically it could be replaced with a large database but
| that is a major undertaking to encode once, let alone keep it
| up to date. In practice there are also trade-offs and
| judgement calls like "Yeah this may cause kidney failure but
| living on dialysis is better than dying of cancer."
| jedimastert wrote:
| Nope, just inelastic demand. They didn't need to to be
| competitive, and gig economy wouldn't work because...well,
| yikes.
| whoknew1122 wrote:
| Oh, don't you worry. The gig economy is coming for
| prescriptions, too. Uber Eats gave me a push notification
| about it the other day.
|
| https://www.mobihealthnews.com/news/uber-health-launches-
| pre...
|
| Absolutely no way mixing the gig economy with PHI ends well.
| barbecue_sauce wrote:
| Medicine delivery is very common for local mom & pop
| pharmacies, though it may depend on state/municipality. I know
| DoorDash was working on getting their pharmacy delivery
| operations up and running at one point, but I'm not sure what
| the current status of that is.
| Red_Leaves_Flyy wrote:
| Gig drivers delivering meds?
|
| WTF wouldn't go wrong?
| hyperdimension wrote:
| "Here's your oxymorphone, a 23-day supply."
| [deleted]
| eli wrote:
| Walgreens does delivery.
| https://www.walgreens.com/topic/pharmacy/prescription-delive...
| sct202 wrote:
| I've gotten pharmacy delivery from Walgreen before. I don't
| think they publicize it very much, but like a couple months ago
| I called into check the status of a prescription and they just
| brought it.
| ShakataGaNai wrote:
| My local CVS is .75mi from me, but if I can avoid standing in
| line (see also: COVID)... I will. They mail my meds.
|
| Once a month they text me saying "hey, your 'script is ready",
| I click the link, put in my CCV... and 2 days later my meds
| show up at my house. Every month, like clockwork.
| jacques_chester wrote:
| > _I always thought there was some crazy health care
| regularization that prevented medicine delivery._
|
| Nope. Both major pharmacy chains (Walgreens, CVS) and pharmacy
| startups (Capsule, Alto) have been around for years.
|
| I used to collect from CVS in person because they were
| downstairs from my office, but they nagged me constantly to
| switch to mailed pharmaceuticals. Now that I'm WFH I use Alto,
| who deliver.
| garmaine wrote:
| Any way to look up costs for a specific drug?
| chaostheory wrote:
| Are they going to commingle inventory on medicine too or do they
| already do this with OTC meds?
| sithlord wrote:
| unsure how they would with cold stuff, and laws about pain meds
| and such
| rdtwo wrote:
| Do they mix bins on medicine too?
| ganoushoreilly wrote:
| Let's hope not. I bet they're flush with Generics though.
| throwaway201103 wrote:
| That's my question, and no way in hell I'm buying meds or
| supplements on Amazon. Nothing that goes in my body. They blew
| their trustworthiness on that a long, long time ago.
| TheAdamist wrote:
| Sterile medical supplies listed as "new" that I have ordered
| were delivered open box & repackaged instead, so it wouldn't
| surprise me to see that with medication too.
| petra wrote:
| The bin mixing issue is the result of Amazon's marketplace.
|
| Afaik, Amazon Pharmacy doesn't work in a marketplace model.
| nerdjon wrote:
| I personally already use PillPack, but what I am more curious is
| this line that so far I can only find on the verge and not any of
| the Amazon pages.
|
| "Prime members will also be able to save on medication bought in
| person from over 50,000 pharmacies across the US, including Rite
| Aid, CVS, Walmart, and Walgreens."
|
| I assume that means that Amazon actually worked with all of these
| companies? Does anyone see that on any of the Amazon pages?
| exhilaration wrote:
| It sounds to me like they're creating their own drug discount
| card, like GoodRX.
| pppp wrote:
| I tried to go to their site to look up a drug that my spouse
| takes - you can't look up prices without signing up and you have
| to give them your phone number...NOPE!
| mfer wrote:
| There is a lot to wonder about here like...
|
| Should people be comfortable with Amazon tracking their drug
| purchases alongside all the other tracking they do of them?
|
| How will Amazon use the tracking information from drug purchases?
|
| Amazon has copied many patented products to sell under their own
| brand. Would they do that with drugs and use the same tactics?
| SamuelAdams wrote:
| > How will Amazon use the tracking information from drug
| purchases?
|
| Likely not at all. HIPAA comes into play here. Typically any
| information provided under a HIPAA context cannot be used for
| solicitation or marketing purposes. For non-USA amazon users,
| I'm sure other laws apply.
|
| Source: used to work at a big retailer and had to remind
| managers of this frequently when they wanted to "integrate data
| from all these systems".
| mfer wrote:
| Amazon has a history of taking patented designs, copying
| them, selling them for less with better visibility, and
| threatening patent holders. This is an element that speaks to
| the character of the organization.
|
| So, that makes me wonder...
|
| > Typically any information provided under a HIPAA context
| cannot be used for solicitation or marketing purposes.
|
| I wonder if they could put in their terms & conditions that
| you give them permission to do it.
| pkaye wrote:
| > Amazon has a history of taking patented designs, copying
| them, selling them for less with better visibility, and
| threatening patent holders
|
| Can you provide an example?
| kodah wrote:
| This is common knowledge:
|
| https://www.wsj.com/articles/amazon-tech-startup-echo-
| bezos-...
|
| When I worked in startups this was long rumored with
| little proof. After years it's become quite clear what's
| happened.
|
| Amazon Show is a knockoff of a Nucleus
| (https://www.vox.com/2017/5/10/15602814/amazon-invested-
| start...)
|
| Amazon Echo https://gizmodo.com/did-amazon-rip-off-the-
| echo-show-from-a-...
|
| This trend goes on
| fuzxi wrote:
| >I wonder if they could put in their terms & conditions
| that you give them permission to do it.
|
| ToS agreements and EULAs are not legally binding. You can't
| sign away your rights.
| dazc wrote:
| Copying prescription drugs and selling under their own brand is
| likely more difficult than buying generic staplers and putting
| a Basics label on them?
| mfer wrote:
| Notice, I didn't stay buying generic staplers.
|
| One of the things recently brought up is Amazon copying the
| designs of patented things (not generic). Then selling copies
| of the patented items.
|
| Drugs are going to be a different animal and there is
| regulation there which may stop it.
| petra wrote:
| I believe patent protection on medicine is strong - because
| it's possible to write strong patents , because those
| companies have big pockets and because, like you said,
| regulators(FDA) will in all likelihood won't be happy.
| varispeed wrote:
| Companies that big should not be allowed to operate. They will
| have too much personal data and incredible unfair competitive
| advantage on the market. It's when capitalism doesn't work and
| where it needs to have emergency stops. Amazon needs to be split
| into independent companies. Now that Amazon will also know your
| medical history, know what you are talking about at home, all
| your preferences, who you meet, what are your problems, probably
| they know even more that Google. This should be stopped. We
| shouldn't be trading freedom for a notion of convenience.
| kirillzubovsky wrote:
| It all depends on your point of view. You can look at the scale
| and cry wolf, or you can wander about all the possibilities it
| creates.
|
| If Amazon can listen to my breathing through Alexa, forecast an
| imminent health issue, and then Prime some pills to me before I
| even need them, that's a pretty awesome future.
|
| We need to find a way to keep them from becoming evil and
| shipping me pain meds on subscription if I don't actually need
| them, sure, but technology has always been making the world
| better, and Amazon has the power to make it better on steroids.
| spir wrote:
| You're probably right, and I agree with you.
|
| However, in this case, the US healthcare system is so terrible
| and, in some respects, evil that I'm glad Amazon is working to
| disrupt (what'll probably end up being) large portions of it.
| varispeed wrote:
| That's a problem right there that a small company couldn't
| challenge it. Healthcare also is in a desperate need of a
| reform, as currently is just a gravy train for fat cats
| meanwhile people are suffering and going bankrupt.
| theplague42 wrote:
| And Amazon isn't just a gravy train for Amazon executives
| and some employees, while people are suffering and going
| bankrupt?
| theplague42 wrote:
| US healthcare is terrible _because_ it's for-profit. Won't
| this just entrench it further?
| anonuser123456 wrote:
| US healthcare is terrible because of system effects, not
| the profit motive. Most hospitals are run as non-profits
| and yet their spending is INSANELY out of control.
| harrylepotter wrote:
| Amazon has more fingers in pies than a leper in a bakery.
| spir wrote:
| I wonder if AMZN stock has priced in the possibility, perhaps
| likely outcome, of tens of millions of Americans getting a
| substantial portion of their healthcare through "Prime Health"
| within ten years.
| betimsl wrote:
| Hah, I mean...what can go wrong here really? :D
| varispeed wrote:
| Such knowledge could tempt some hostile action - for example
| some disgruntled employee could pull a list of people with nut
| allergy and the same day send them a box of peanuts. With the
| delivery so quick, nobody could stop such attack.
| RemoteComm wrote:
| turn existing small pharmacies into associate stores and then use
| them as a distributed fulfilment centre..
| bird_monster wrote:
| Kind of astounded at the responses in this thread insisting on
| believing Amazon wouldn't do anything nasty or obviously illegal
| with an individual's healthcare data. They've done nasty and
| obviously illegal things with all of the other data that passes
| through their systems, and yet here we are defending and getting
| excited about them further intruding into our lives.
| Nasrudith wrote:
| HIPAA fines are large and per violation, and downright strict -
| "reasonable cause" is a category of violation.
|
| And what do you mean by "obviously illegal"? What is "obvious"
| or "common sense" about the law can be very wrong with a little
| research. Cocaine is obviously illegal! Except for the fact it
| is Schedule 2 and has niche legitimate medical uses and is
| important enough emergency rooms keep it on hand.
| kgin wrote:
| It's not about trusting Amazon except to trust the company
| wants to stay in business and not commit regulatory suicide
| right out of the gate
| bird_monster wrote:
| Since when is Amazon interested in following outside
| regulation?
| newbie578 wrote:
| Amazon is like the bogeyman, in whichever industry you work in,
| you just hope Amazon doesn't enter your domain and crushes you...
| BooneJS wrote:
| Given the issue with counterfeit material in their warehouses, I
| don't even know what they could do to make me trust their control
| of the drug supply chain.
| babypuncher wrote:
| The counterfeit merchandise is a problem caused by Amazon
| having third party sellers ship their inventory to Amazon
| warehouses for faster delivery to customers.
|
| Unless something has gone horribly wrong, I doubt Amazon
| Pharmacy is looking to be a "marketplace" with third party
| sellers like that.
| throwaway201103 wrote:
| That may all be true, but for me the trust is long gone.
| That's the price they pay for not taking the counterfeiting
| problem seriously. They've literally demonstrated that they
| prioritize sales and shipping efficiency over honesty.
| Kalium wrote:
| What actions could they take, today, that would demonstrate
| to your satisfaction that they take counterfeiting and
| honesty seriously?
| ceejayoz wrote:
| Removal of the algorithmic "Amazon's Choice" label.
|
| Human review of all listings, including changes to them.
|
| Drastic reduction in number of sellers, show the seller
| company's age w/Amazon as well as the age of the listing
| and revision history.
| bduerst wrote:
| Yeah, if Amazon is doing this right, they're basically
| channeling the big three pharma wholesalers
| (AmerisourceBergen, Cardinal Health, McKesson) and no one
| else.
| fweespeech wrote:
| Yeah, I'd rather use a real pharmacy to mail my pills. They
| have online ordering at several.
| pen2l wrote:
| Amazon didn't get to where it is by being idiots. They will
| enforce the rules when they know they need to enforce the
| rules.
| penthi wrote:
| Truepill.com has api's for pharmacy fulfillment (including
| pharmacy transfers) https://docs.truepill.com/#introduction
|
| [disclosure : I work there]
| randompwd wrote:
| what's that got to do with the article? pointless.
| RobRivera wrote:
| It seems like an alternative solution to the problem the amzn
| product aims to solve for the consumer.
|
| I think it isn't pointless.
| sithlord wrote:
| This sounds interesting; Would be interested in knowing more
| about what you all do, and if you all hire remote :D
| penthi wrote:
| We do : https://jobs.lever.co/truepill?team=Engineering
| kodah wrote:
| This is absurd. At what point do normal people start calling this
| a monopoly?
| MikeKusold wrote:
| How is this a monopoly? Walmart is a competitor and they also
| have a pharmacy.
| kodah wrote:
| Hell, let's make a list of what Amazon's business interests
| are:
|
| - Colocation and managed data center services
|
| - Managed technology services
|
| - Ecommerce (in just about every category including food)
|
| - Satellites
|
| - Space flight (Blue Origin)
|
| - IOT Devices
|
| - Government services (managed infrastructure etc)
|
| - Home internet (Kuiper Systems)
|
| - Autonomous vehicles
|
| - Investing
|
| - Pharmacy services
|
| I'm just going to stop here.
| anonuser123456 wrote:
| That is called a conglomerate, not a monopoly.
| lotsofpulp wrote:
| The above situation does not fit the definition of
| monopoly:
|
| https://en.wikipedia.org/wiki/Monopoly
|
| > A monopoly (from Greek monos, monos, 'single, alone' and
| polein, polein, 'to sell') exists when a specific person or
| enterprise is the only supplier of a particular commodity.
| This contrasts with a monopsony which relates to a single
| entity's control of a market to purchase a good or service,
| and with oligopoly and duopoly which consists of a few
| sellers dominating a market.[1] Monopolies are thus
| characterized by a lack of economic competition to produce
| the good or service, a lack of viable substitute goods, and
| the possibility of a high monopoly price well above the
| seller's marginal cost that leads to a high monopoly
| profit.[2]
|
| For example, almost everyone can get their medication at
| Costco, Walmart, CVS, and Walgreens.
| kodah wrote:
| I know what the legal and colloquial definitions of a
| monopoly are. It obviously needs to change. I cannot
| fathom how one company with all these varied interests
| and capabilities are somehow "good for consumers", which
| is exactly the _spirit_ of anti-trust law.
|
| At one point in American history we were far too loose
| and reckless with what a monopoly was defined as. Now,
| nothing is a monopoly. I can't imagine how this is much
| better.
| s1artibartfast wrote:
| Monopoly is not a synonym for "bad for consumers" or
| "company that should be broken up". Using it this way
| only confuses the issue.
|
| I think it is more productive to advocate for a point in
| plain english.
|
| Why argue that:
|
| 1) The existing definition of a monopoly is wrong
|
| 2) Your definition is right
|
| 3) companies that meet your definition should be broken
| up
|
| 4) Amazon is a monopoly by your new definition
|
| 5) Therefore, Amazon should be broken up
|
| When you could just say:
|
| 1) Amazon is too big and bad for consumers
| lotsofpulp wrote:
| The appropriate term is conglomeration.
|
| https://en.wikipedia.org/wiki/Conglomerate_(company)
|
| Arguments should be made about the harmful aspects of
| those, which Amazon actually is. Perhaps one can make the
| case that conglomerates inevitably leads to monopolies,
| and on that basis one can argue against the development
| of conglomerates.
| kodah wrote:
| > Perhaps one can make the case that conglomerates
| inevitably leads to monopolies, and on that basis one can
| argue against the development of conglomerates.
|
| You are right and this is precisely my line of thinking.
| All the parts you need to make a monopoly are already
| there, so then they either go full tilt or they try to
| engineer the economy so key businesses don't go down so
| they can continue to claim a monopoly doesn't exist
| _yet_.
|
| It's worth noting I originally referred to it as
| "monopoly law" but it's actually anti-trust law, which
| could make some room for conglomerate making.
| lotsofpulp wrote:
| It's not as simple as writing a law that says
| "Conglomerates are illegal."
|
| How do you define conglomerate? Amazon started selling
| books. Then it started selling other things. Now it's
| starting to sell medicine. At what point should the line
| have been drawn?
|
| Obviously, the goal is to prevent harm to the consumer,
| but can one demonstrate that the consumer has been
| harmed? As a consumer, I know it was very hard for me to
| get such quick delivery of random items before Amazon. I
| especially remember getting ripped off on HDMI cables and
| other cables by Best Buy as a kid, and Amazon was amazing
| for enabling me to purchase them so cheaply, and with
| such huge selection I never would have found at Best Buy.
|
| (I personally use Amazon.com sparingly now due to their
| commingling policies and disinterest in providing me with
| a quality product).
|
| But the point is that demonstrating consumer harm isn't
| simple. Conglomerates can deliver goods and services at
| lower prices, which is good for buyers. Conglomerates can
| also engage in practices which helps buyers in the short
| term, but harms them in the long term.
|
| Before grocery stores, there were produce stands,
| butchers, delis, bakers. Then a giant grocery comes into
| town, and now, as a buyer, I can save time and money
| going to one place and getting all I need. Should this be
| illegal?
|
| The purpose of my comment is to illustrate that the
| situation is not as simple as screaming "monopoly". There
| are even geo-political risks to consider, where having
| conglomerates on your side can be helpful, if not help
| counteract the effects of conglomerates of other
| countries.
| missedthecue wrote:
| "big ass company" is not a synonym for monopoly. There are
| dozens of competitors in the pharmacy business
| llee37x wrote:
| Just a heads up, if you use this service PillPack and Amazon
| Employees have full access to your entire prescription history.
| Full name, social everything - it was common for employees to
| look up the info of celebrities / other employees for fun.
|
| Any prescription / healthcare info you give them _will_ be sold
| back to SureScripts and used to sell you more garbage from Amazon
| ;)
|
| https://www.wsj.com/articles/amazon-mail-order-pharmacy-face...
| peter303 wrote:
| HIPAA makes this a crime. The employee and Amazon would be
| subject to fines and perhaps prosecution.
| Someone1234 wrote:
| Please go ahead and report the multiple HIPAA violations here:
|
| https://www.hhs.gov/hipaa/filing-a-complaint/index.html
| jedimastert wrote:
| I feel like if this were true HIPPA/HHS would have asses in
| slings. I've worked in a couple of places that worked with
| HIPPA-adjacent data and boy howdy you don't not mess with them.
| dragonwriter wrote:
| It's HIPAA, and there's no such meaningful category as HIPAA-
| adjacent data. Data is either PHI held by HIPAA covered
| entities or it's not, and consumer health and wellness data
| that one would see as being equally sensitive but that
| involves consumer transactions with an entity which is not a
| "covered entity" as defined in HIPAA (including where the
| consumer takes information from a covered entity and provides
| it to the service, so that the service is engaged by the
| consumer but has no business relation to the covered entity)
| is simply not PHI protected by HIPAA.
|
| On the other hand, the information you describe from a
| pharmacy customer isn't "HIPAA adjacent", it's just plain
| HIPAA PHI. on the gripping hand, lots of places have fairly
| weak internal controls on access to PHI; there is no required
| independent certification of practices, only after-the-fact
| enforcement when an unauthorized use occurs, is reported, and
| is investigated. And lots of places that haven't been caught
| out yet have training in what your not allowed to do with
| data, but inadequate controls on what you can do and
| inadequate auditing of what you have done.
| bovermyer wrote:
| Minor quibble - HIPAA and HITECH are not the same thing,
| but many people lump the two together.
|
| HIPAA is the general policy. HITECH is what regulates how
| that policy can be implemented in technology.
| dragonwriter wrote:
| > Minor quibble - HIPAA and HITECH are not the same thing
|
| They are separate legislative actions, but HITECH is
| largely amendments to HIPAA, and can't really be
| considered in isolation. References to what HIPAA
| requires generally refer to not only the original HIPAA
| enactment but subsequent amendments (such as, but not
| limited to, those in the ACA and HITECH), and regulations
| and guidance adopted under HIPAA (as amended).
| Distinguishing HITECH from HIPAA makes sense in terms of
| discussing _legislatibve history_ , but less so in terms
| of discussing _current rules_.
|
| It is also not accurate to draw the division as HIPAA
| being "general policy" and HITECH being "how that policy
| can be implemented in technology." Its true that HITECH
| (more precisely, guidance/regulation mandated by and
| adopted subsequently to HITECH's amendments to HIPAA)
| provides more technical specificity in some areas,
| particularly privacy/security, than was in HIPAA (and
| regulations under HIPAA) prior to HITECH, but HITECH also
| amended aspects of HIPAA that fall into the general
| policy area (for instance, direct liability of Business
| Associates), and there were specific technical standards
| adopted under HIPAA prior to HITECH and also under
| mandates stemming from post-HITECH (notably, ACA)
| amendments to HIPAA.
| kgin wrote:
| >Any prescription / healthcare info you give them will be sold
| back to SureScripts and used to sell you more garbage from
| Amazon ;)
|
| Literally illegal
| _alex_ wrote:
| Citation needed
| marcod wrote:
| I worked for amazon for 10+ years. Sure, in the beginning, a
| lot of people had access to customer accounts. However, all
| that was locked down, I wanna say before 2010. Strictly need to
| know and every access logged.
|
| So, if I wasn't able to look what book a customer purchased, I
| highly doubt I could see anyone's RX, especially since HIPAA is
| very clear on those points.
|
| TL;DR: I think your claim is full of it.
| mysticllama wrote:
| What is your source for the claim that Amazon - PillPack
| employees commonly accessed prescription info "for fun?"
|
| I worked at PillPack for over 3 years, and while I haven't been
| there for a while this seems like a very bold claim that is
| wildly inconsistent with the sort of practices I saw followed
| in my time there.
|
| I don't think using a throwaway to throw shade like this is the
| right way to handle such a serious matter, but whatever -- if
| you do legitimately want to address this issue let me know; I
| could point you to a contact at the company and/or outside of
| it that would take it seriously and investigate it, as this is
| very alarming and unacceptable (speaking also as a customer
| whose data is there).
| throwawayfppcmt wrote:
| I lived in Manchester back in 2017 and even though I never
| worked at PillPack somehow I know names of celebrity clients
| they had at the time.
| yourapostasy wrote:
| Going to need some much stronger proof than hearsay.
|
| My clients in the financial services industry take their PCI
| and critical risk data access very seriously. Those clients had
| to share with me the software, controls and training they put
| into place to enforce those access rules, and I confirmed with
| long-time employees they've walked staff out of call centers
| summarily fired for joy-riding the data. I can believe the
| situation at hospitals can be looser, but financial services
| being more strict than pharma fulfillment or PBM's would be
| news to me. I've only had two clients in the PBM space, and
| they didn't seem to take their infosec lightly either, but that
| is a much smaller sample space so I'd be interested to hear
| from those who work in the trenches in PBM's or pharma
| fulfillment what it is like for them.
| baskire wrote:
| I'm a fan of giving the belief of innocent until proven guilty.
| You have a firm who's aligned to cvs making accusations. A firm
| who's likely long term going to loose money if Amazon succeeds
| here.
|
| From that article, "Surescripts did, however, inform CVS and
| Express Scripts ahead of time about its plans to go public with
| its decision, the spokesmen said."
| part1of2 wrote:
| New account & misinformation?
|
| > if you use this service PillPack and Amazon Employees have
| full access to your entire prescription history
|
| That's not what the article you linked says
|
| > Any prescription / healthcare info you give them will be sold
| back to SureScripts and used to sell you more garbage from
| Amazon ;)
|
| That's not what the article you linked says
| whoknew1122 wrote:
| Far be it for me to dispute the knowledge of a random
| throwaway, but I'd be surprised if there Amazon didn't have
| access controls to prevent looking up customer prescription
| history.
|
| I know the hoops I have to go through just to access customer
| resource metadata in AWS Support. There are multiple, auditable
| checks that force you to provide access justification to
| resources -- and the process is routinely modified to make it
| more onerous and restrictive.
|
| If we have dual control mechanisms to access routine
| information about a customer's VPC, I'd be shocked if Amazon
| didn't have auditable controls on Amazon Pharmacy.
| finnthehuman wrote:
| If we're just widely speculating about the kind of access
| control Amazon would institute, I can speculate in the other
| direction. They weren't always owned by Amazon, they were a
| startup without Amazon level resources and much bigger
| immediate threats to the business than high quality database
| audit trails for people who's jobs are to do nothing but work
| with PHI all day.
| [deleted]
| atlas_shrugged wrote:
| Just curious what are the state limitations preventing launch in
| Hawaii, Illinois, Kentucky, Louisiana and Minnesota
| JosephHatfield wrote:
| When trying to signup to buy meds from the Amazon Pharmacy
| service, I was surprised to see the app pull up medical insurance
| info for me based on the last four digits of my ssn. Too bad it
| appeared to be for someone else!
| bergstromm466 wrote:
| Got Pills?(tm)
|
| Yay, Venture Capital x the Pharmaceutical industrial complex.
| What could go wrong?
| bhupy wrote:
| > Amazon claims Prime members will be able to save "up to 80
| percent off generic and 40 percent off brand name medications
| when paying without insurance.
|
| This was buried in the article, but is IMO a bigger deal. In the
| long run, this could really drive down drug prices.
| Shivetya wrote:
| It will be very interesting to see their insulin prices and
| which types of insulin they sell.
| friedegg wrote:
| I took a look, and didn't see any huge price breaks.
| NikolaeVarius wrote:
| Instead of the Govt being the price negotiator, we got giant
| corporations instead.
|
| yay
| lbacaj wrote:
| You really believe the government will do a better job?
| smeyer wrote:
| Don't they do a better job in lots of other countries? I'm
| not an expert, but my understanding is that a lot of the
| countries with socialized medicine such that their
| government is the one negotiating with drug manufacturers
| pay substantially less for drugs than customers in the US.
| mfer wrote:
| I've been reading some books on the medical industry and
| one of the things pointed out is that the price controls
| will often not provide enough profit to R&D new drugs.
| That the US ends up subsidizing a lot of R&D cost that
| everyone benefits from.
|
| If this is the case, I wonder what would happen to drug
| development if that goes away.
|
| Note, I'm not saying there's not too much profit from
| drugs. These statements don't have anything to do with
| that.
| AuryGlenz wrote:
| That's why we should tie our drug prices to the prices
| other countries pay. I believe Trump did that (or talked
| about doing it?) for Medicare, but it's absolutely insane
| we haven't done it across the board.
|
| Republicans would be hesitant due to "regulations bad,"
| and Democrats don't want to improve our current system
| because they'd rather throw it out. And of course both
| sides get donations from pharma.
| lostcolony wrote:
| So that assertion is only sorta true.
|
| Initial discovery research is pretty much entirely tax
| payer funded. There's then a second phase, moving from
| that discovery to POC, that is extremely underfunded, and
| which a lot of charity and such funding goes toward. It's
| only the last phase, taking POCs -> product, that
| companies really invest in.
| https://www.ncbi.nlm.nih.gov/books/NBK50972/
|
| Now, that capital investment is not a trivial amount of
| money (about 80 billion in 2018 -
| https://www.statista.com/statistics/265085/research-and-
| deve... ), but it still is only 17% of drug company
| revenues -
| https://www.investopedia.com/ask/answers/060115/how-much-
| dru...
|
| Note, too, that private companies tend to fund research
| toward extremely common diseases, since they're profit
| driven. So not only do they not fund early discovery
| (government does that), nor generally moving those
| discoveries to POCs ('valley of death', and charitable
| foundations and the like do that), they also leave plenty
| of potential meds untouched, since the likely
| profitability is low.
| pkaye wrote:
| If this is true, what is the point of US consumers
| subsidizing the R&D is they themselves cannot benefit
| from it.
| lazyasciiart wrote:
| The rich ones can benefit from it, and then it gets added
| to the claims that the US has the world's best healthcare
| system that helps convince the rest that the system
| should be kept.
| SuoDuanDao wrote:
| I've heard that argument, not sure how much I buy it.
| Seems the drugs that get developed tend towards niche
| applications, while common diseases that affect mostly
| uninsured people are addressed by places like the Gates
| foundation.
| bhupy wrote:
| In other countries, government "negotiation" is just a
| euphemism for price controls. An example of this is
| Canada's Patented Medicine Prices Review Board, which
| regulates drug prices. This isn't "negotiation", this is
| just centralized policy-driven price control.
|
| The US could very well institute their own price controls
| on drugs, but it wouldn't invalidate the value in
| services like Amazon's, especially if the price controls
| in question do not create a lower bound on prices, but
| instead focus on setting upper bounds.
| toomuchtodo wrote:
| I support price controls in the US, and the government
| manufacturing generics if necessary (stepping in if the
| private sector won't due to it not being profitable
| enough).
|
| EDIT: I removed an unrelated paragraph about Planned
| Parenthood and drug supply chain I thought was out of
| scope.
| bhupy wrote:
| > stepping in if the private sector won't due to it not
| being profitable enough
|
| That's effectively what government-enforced drug patents
| are for. I think it's debatable whether that's the best
| implementation of what you're describing. Government
| sponsored "Prizes" are another approach that sounds
| promising -> https://marginalrevolution.com/marginalrevol
| ution/2020/03/pr...
|
| I donate to Planned Parenthood as well, and decoupling
| drug purchasing from insurance is a reliable way to make
| sure that everyone can get access to birth control or
| contraceptive, even if their employer feels strongly
| opposed to it (eg Hobby Lobby).
| [deleted]
| [deleted]
| mikeyouse wrote:
| The US Pharma market is full of "found $20 bills" that
| just shouldn't exist if markets were as efficient as
| people wishcast they would be. I'd love for someone to
| rationalize PBMs in the same manner they rationalize
| every other horrible inefficiency in US health care.
| Frost1x wrote:
| Better than the farce that is "competitive market forces."
| I have more faith in government than corporate structures
| delivering optimal cost pricing to consumers as opposed to
| optimizing their profit margins.
|
| Competive forces only work while there's competition, the
| second competition declines, rest assured consumer pricing
| is the first to take a hit.
| efitz wrote:
| Competitive forces in the health care market in the US
| don't function (pretty much at all) because of government
| induced market distortions and regulatory capture. FDA
| certification enormously drives up the cost of medicines
| and medical devices; government bureaucrats have no
| incentive to balance safety with time to market, price,
| availability, supply, or diversity of sources; most of
| these represent risk to the people making the decisions.
| Most US consumers don't pay for their own medical care,
| they pay for insurance that pays for their medical care.
| Often their employer pays some of the costs of insurance.
| Insurance usually fixes the cost that the consumer has to
| pay, e.g. a $10 copay. So there's little incentive for
| consumers to shop around for medical care, meaning that
| consumers can't drive prices down with normal market
| decisions. States and the federal government put enormous
| restrictions on insurance, driving up the cost of
| insurance. Health insurance doesn't function as in other
| sectors, where payouts are rare- most insurance is a bet
| - I'll bet you $3000 a year my house burns down - I'll
| bet you $400000 it doesn't. Health insurance is more like
| a discount plan, kind of like a CostCo membership. AMA
| and insurance companies lobby for limiting supply of
| doctors and hospitals, respectively, which drives costs
| up. They do this under state licensure laws purporting to
| improve quality or safety. Bottom line is that almost
| every single aspect of the US health care market has had
| government intervention effectively disable any market
| based control. The situation would fix itself quickly if
| we deregulated EVERYTHING regarding healthcare, and
| restricted insurance to catastrophic event coverage.
| Businesses would quickly come up with ways to serve the
| market in a market-friendly fashion. Worried about pre-
| existing conditions? We'd see businesses like "diabetes
| maintenance organzations" where you pay a monthly fee and
| you get all the treatment you need related to that
| condition. Accidents would still be covered by insurance.
| You'd pay privately for things like doctor visits for the
| flu, etc., but supply and consumer choice would drive
| those costs down, e.g. if I have a sprained ankle I could
| just use an app on my phone to summon a military vet who
| was a battlefield medic to treat it, rather than pay for
| 15-30min of time of someone with 24 years and half a
| million dollars worth of education. What about
| quacks/frauds? We know how to deal with them - reputation
| (AngiesList, Consumer Reports, Google Reviews) on the
| front-end, courts on the back-end.
| failuser wrote:
| Good luck ending up with homeopathy kick off working
| drugs of the market. If reputation could destroy those,
| it already would have.
| EliRivers wrote:
| Governments certainly can do, although the US government
| seems to be permanently hobbled by about half of its
| leaders having built their identity on the idea that
| government is incompetent and a bad idea; I'm not surprised
| it's dysfunctional when the people inside it have their
| sense of self wrapped up in being shit at their own jobs.
| LanceH wrote:
| > the idea that government is incompetent and a bad idea
|
| To be fair, the other side frequently tries to prove them
| right.
| jvanderbot wrote:
| IMHO, this is the _massive_ problem in the USA. We have one
| side dug in against corporations, and the other side dug in
| against the government.
| redisman wrote:
| Seems to work in every other country with a modern medical
| industry.
| alex_anglin wrote:
| As a Canadian, I believe that the Patented Medicine Prices
| Review Board [1] does quite a good job, judging from the
| cost of medication up here (broadly speaking).
|
| [1]https://www.canada.ca/en/patented-medicine-prices-
| review.htm...
| jacques_chester wrote:
| Australia has a similar mechanism in the Pharmaceutical
| Benefits Scheme. Drugs are selected based on cost-
| effectiveness analysis and subsidised price is negotiated
| with pharmaceutical companies.
|
| If anything, Australia is quite generous to
| pharmaceutical companies. New Zealand's Pharmaceutical
| Management Agency has much less negotiating power but
| still manages to obtain substantially lower prices.
|
| For myself I can't help but wonder if lump-sum licensing
| might not be more effective. Pharmaceuticals are a bit
| like software: very high R&D cost, but the marginal cost
| to manufacture is very small. A one-time payment to sink
| a large chunk of R&D for a drug might be quicker and
| easier than guessing at a price. On the other hand, I
| have no experience in health economics, so it's possible
| this is a terrible idea.
| bhupy wrote:
| > For myself I can't help but wonder if lump-sum
| licensing might not be more effective. Pharmaceuticals
| are a bit like software: very high R&D cost, but the
| marginal cost to manufacture is very small. A one-time
| payment to sink a large chunk of R&D for a drug might be
| quicker and easier than guessing at a price.
|
| You're describing "Prizes", and that's a legit point of
| view ->
| https://www.mercatus.org/publications/covid-19-crisis-
| respon...
| jacques_chester wrote:
| I think they're similar but not quite the same. A prize
| is offered in advance of a solution, a lump-sum license
| is after the solution is developed.
|
| On reflection I like prizes better, especially if there
| are multiple tiers (first to reach the target gets the
| most prize money, second gets less, etc). You want to
| ensure that multiple pharmaceuticals are developed
| independently, in case one of them needs to be pulled
| from the market.
| xtracto wrote:
| I think the USA Military branch of the government does a
| very good job managing their resources.
|
| Why would it be different in other branch?
| peoplenotbots wrote:
| Next up Renaissance style guild wars between rival companies
| Amazon endorsed candidate vs Walmart endorsed candidates
| mhh__ wrote:
| > price negotiator
|
| Would you prefer the government to negotiate the price of
| your car for you? Markets are a powerful tool
| bduerst wrote:
| Not everyone needs a car.
|
| I absolutely want the government to negotiate the cost of
| water, and electricity.
| burnte wrote:
| Yes, I would. A single buyer for all 300m Americans would
| get better deals than Amazon or Walmart could dream of.
| dave5104 wrote:
| If the difference between affording a car and not being
| able to afford a car would kill me, then maybe I would like
| the government to step in to negotiate on behalf of all of
| its citizens.
| [deleted]
| bhupy wrote:
| Not being able to afford food can also kill you (you
| would starve to death). Is that a sufficient
| justification for the government to step in to negotiate
| food prices on behalf of its citizens?
|
| There are merits to government price controls and there
| are certainly countries that have employed them
| successfully. That said, it isn't the only solution to
| bending the cost curve, and there are also downsides to
| price controls. It's complicated.
| ineedasername wrote:
| The government does in fact step into the food production
| industry in such a way that food prices are kept low. And
| for people who still can't afford it, has another layer
| of safety net in the form of SNAP.
|
| It may not directly negotiate the prices of food, and
| that's fine: If there's another form of intervention that
| would provide healthcare to people without directly
| negotiating the price, I'd be fine with that too.
| LatteLazy wrote:
| I agree on the wider point but in case you or some other
| reader were unaware...
|
| Government does that in the US (and the EU and Canada and
| basically every first world nation that's not a city
| state). The department of agriculture and others spend
| somewhere between 10s and 100s of billions every year to
| make sure that food (and other crop) prices stay within
| carefully set, tightly defined limits.
| claudeganon wrote:
| > Is that a sufficient justification for the government
| to step in to negotiate food prices on behalf of its
| citizens?
|
| Yes? We already do this? For many years directly in the
| postwar period and now indirectly through agriculture
| subsidies and programs like SNAP. Making sure everyone
| has enough to eat is step one of having any kind of
| functioning society and why it's always been a source of
| massive government intervention in the economy.
| bhupy wrote:
| Yes, that's the whole point. SNAP and directed subsidies
| are decidedly NOT the same as government prices-setting.
| The analog in healthcare is targeted subsidies for poor
| people that cannot afford care, not government
| negotiation and price setting.
|
| Making sure everyone has access to healthcare is, for the
| most part, a universally held goal. The disagreement is
| whether the only way to achieve that is through
| government price controls.
| burkaman wrote:
| > The analog in healthcare is targeted subsidies for poor
| people that cannot afford care
|
| Food subsidies aren't targeted at the poor. The US
| government spends many billions of dollars subsidizing
| corn and soybeans and other crops that lower food prices
| for huge portions of America.
| claudeganon wrote:
| "Access" in this context is just a weasel-word cooked up
| by hospitals and insurance companies to protect their
| bottom lines. Almost every other wealthy, developed
| country guarantees healthcare itself, not the right to
| get surprise billed or screwed by your insurance company.
| And even those countries that are closer to the American
| model (e.g Germany and the Netherlands) don't let these
| industries get away with egregious abuse of people at
| their most vulnerable.
|
| SNAP and ag subsidies are also just price controls with
| extra steps. We can argue about their efficacy, but
| they're far closer to price controls than anything like
| markets.
| mhh__ wrote:
| You can guarantee universal healthcare (and medication)
| without top-down control of pricing, or at least not
| total control. Most drugs aren't making headlines, so you
| can control the _x_ % that matter while still getting
| cheaper prices for most consumers by letting the outlets
| compete.
|
| Your website suggests you are American, so I recommend
| taking a look at the various healthcare systems on
| display in Europe, they're not all made equally (i.e.
| Some do more _on behalf_ of their citizens than most). In
| my experience of watching American discussing healthcare
| in the EU, the subtleties are often lost, sadly.
| AndrewUnmuted wrote:
| I do not think this is the best smell test for government
| involvement.
|
| Not being able to afford health care in no way condemns
| one to being killed. And, interestingly, given how many
| each year die in traffic accidents, it's not such a
| stretch that being _able_ to afford a car would kill you.
|
| We all have really different reasons for wanting health
| insurance and owning a car. We have different components,
| considerations, and properties, which we value about
| these decisions. Given this, it seems ludicrously
| complex, inefficient, and cruel to subject all citizens
| of a nation to the same exact process of obtaining and
| using health care.
|
| We all know how bad of an idea it is to centralize
| services, but because some linguistic jokesters have
| gotten the phrase "healthcare is a human right" to be
| passed around the globe enough times, people seem to drop
| context when it comes to this discussion.
|
| As soon as youtube-dl got hit with its recent DMCA
| takedown request, GitHub obliged and the whole dang HN
| community lost their collective minds. "Decentralize your
| git repos" we all saw people writing - and they weren't
| wrong. But for reasons that continue to escape me during
| these awful lockdowns we're all facing, people don't seem
| to think that their government-provided healthcare
| workers and price negotiators will do anything of the
| sort.
| BurningFrog wrote:
| Do people remember that someone like Donald Trump would be
| in charge of that program?
| burkaman wrote:
| Yes, the government has a stronger negotiating position
| than me, for obvious reasons.
|
| The concept of "markets" is not useful in a discussion
| about healthcare, because unlike other markets, a
| participant will often die unless they immediately purchase
| a good from the seller physically closest to them,
| regardless of price.
| ineedasername wrote:
| The free market has a tendency to optimize for profit, and
| fairly often short-term profit. Yes, that necessarily means
| companies must have customers willing to pay them, and so a
| certain amount of quality of product & service must be
| present, but it does not optimize for everyone to own
| specific product even if everyone wants that product.
|
| Saying the market can solve the problem of healthcare for
| everyone is a bit like saying it should be able to solve
| the problem of providing flagship-quality phones for
| everyone. But in fact, given the "law" of supply & demand,
| a product like healthcare which is in demand by literally
| every single person, yet constrained by supply, the
| solution the market converges on is going to extract the
| most amount of money it can from however many customers can
| be served by the available supply.
|
| Supply constraints are also one of the problems I would,
| given complete faith in market forces, expect the market to
| solve but it has not done that either. Market forces did
| not prevent or resolve the dumping of cancer-causing
| chemicals, or known cancer-causing product like cigarettes
| to be removed, or any number of other undesirable things
| whose costs end up being paid by society as a whole rather
| than a given individual(s) responsible for the problem.
| When the market fails to solve a problem, some other force
| needs to intervene.
|
| Maybe a free market purist would say we didn't give it long
| enough to solve these problems. I don't believe that, but
| let's say it's true: Saying the market will eventually
| solve a problem, when human lives or suffering are at risk,
| is a bit like saying evolution will eventually solve a
| problem. It may be true, but the timescales involved are
| sufficiently long to render their eventual solution
| irrelevant to the people who die or suffer before it
| materializes.
|
| I don't claim to know the best way to do this, and perhaps
| my analysis above is incomplete or over-simplified, but the
| point stands that the market has not solved this problem,
| and does not show signs of doing so.
| Dirlewanger wrote:
| In the case of the US, the "free market" have utterly
| failed us with regards to healthcare.
| mhh__ wrote:
| Most US healthcare is neither free nor particularly a
| market. Most healthcare in the EU has a significant
| market element to it, and it works just fine (and usually
| costs less per capita)
| burnte wrote:
| So I signed up to see. As far as I can tell I can't get a quote
| on my scripts without transferring them. I'm not doing that.
| Every other pharmacy I can enter my dosages or call someone and
| get a quote.
| eli wrote:
| Doesn't Walmart already do this?
| caturopath wrote:
| Time will tell how this compares to other pharmacies. Big
| savings off MSRP are common.
| sithlord wrote:
| They say that, but then I looked up Insulin price, and it was
| astronautical. Even compared to normal drug stores.
| hourislate wrote:
| You can probably save more at Walmart
|
| https://www.walmart.com/cp/4-prescriptions/1078664
|
| _Prescription Program includes up to a 30-day supply for $4
| and a 90-day supply for $10 of some covered generic drugs at
| commonly prescribed dosages._
| Red_Leaves_Flyy wrote:
| Or a local pharmacy. Wal-Mart is more expensive than my local
| pharmacy.
| bhupy wrote:
| This is very similar (and really interesting) though I'm not
| sure if Walmart has a special condition on use of insurance.
|
| Amazon appears to be incentivizing customers to not use
| insurance to pay for their drugs. I'm not sure if Walmart
| does the same. If so, that's also noteworthy.
| dragonwriter wrote:
| Discount programs everywhere focus on the uninsured (the
| insured have the insurance company also paying discounted
| rates, generally, but those are individually negotiated;
| the sticker price is just to have a starting point for
| negotiations with deep pocket public and private insurers.)
|
| In many cases, the discounts in the discount programs are
| subsidized by the drug companies for uninsured patients.
| bhupy wrote:
| Yep, for full disclosure, I work in healthcare pricing
| and payments and adjust claims myself.
|
| While discount programs focus on the uninsured, this is
| the first time I'm seeing the discount being framed in
| such a way that it effectively incentivizes paying out of
| pocket. It's an important incentive if your goal is to
| decouple routine drugs from the third-party-payer model
| of insurance.
|
| Health insurance in the US is actually 3 different
| services bundled into one: (1) risk sharing for
| catastrophic care, (2) access to low prices (called "fee
| schedules"), and (3) tax advantaged pre-payment for non-
| catastrophic care. 40-80% discount on drug prices
| essentially competes with insurance company fee
| schedules, i.e. service (2). By offering what amounts to
| insurance rates without charging insurance premiums,
| Amazon is essentially decoupling the fee schedules from
| risk sharing. That's a really underrated side effect of
| this product offering, and can have long run impacts on
| the industry (IMO for the better).
| lotsofpulp wrote:
| I would add a 4th service for health insurance in the US
| to be a way for healthy, young people to pay for the care
| of sicker, old people due. AKA, a tax, due to the
| following stipulations of the ACA.
|
| 1) Age Rating Factors
|
| https://www.cms.gov/CCIIO/Programs-and-
| Initiatives/Health-In...
|
| 2) Out of pocket maximums for in network care
|
| 3) Elimination of pre-existing conditions, i.e. accepting
| all lives no matter how costly
|
| 4) The recently eliminated mandate to purchase health
| insurance.
|
| The above conditions mean that premiums from healthy
| people that don't use healthcare is used to pay for the
| healthcare for sick people. It gets a little complicated
| with the ability for employers to silo their employees'
| lives from the rest of the population, but in general, US
| health insurance premiums are basically a tax on the
| healthy to pay for the healthcare for the sick.
| peter303 wrote:
| You will get old
| lotsofpulp wrote:
| I know. I wasn't complaining about it being a tax.
| bhupy wrote:
| That's captured by (1) risk sharing. Pooled risk sharing
| is great for things like fire departments where out of
| 1000 homes, one might catch fire every few months. It's
| also great for societies where out of 1000 people, a
| small handful suffer from chronic illnesses or tragic
| accidents and the remaining are healthy. The problem is
| that it's just a hammer, and not everything in healthcare
| is a nail.
| lotsofpulp wrote:
| Taxes are basically risk sharing across the whole
| population. But I wanted to specify that it's not risk
| sharing like your auto insurance is, or home insurance,
| or term life insurance. Those are infrequent, random
| events for the most part.
|
| Whereas, healthcare is a guaranteed expense, so the
| premiums are just prepaying for the coming expenses. But
| today, you're not paying for your healthcare expenses,
| but for the older, sicker person's healthcare, just like
| FICA taxes are paying for healthcare for those 65 years
| and older.
| [deleted]
| dudus wrote:
| I'm not surprised, there's some serious shenanigans on medicine
| pricing and insurances.
|
| Medicine prices are clearly inflated when you can buy at a huge
| discount using insurance, but then you can get apps like
| GoodRX, which is free and give you coupons that far exceed my
| insurance discount on every single time I had to fill a
| prescription. To the point that I don't even bother going
| through insurance anymore.
|
| I saved thousands on medicine by just checking on GoodRx before
| buying it.
| ev1 wrote:
| I'm curious who or what the end goal of GoodRx is. They pay
| for expensive ($$$$$$) cloud anti-bot/anti-scraping, captcha
| you after a few requests if you run adblock, they pay for
| extensive browser/device (attempting to reidentify a user
| across multiple devices/multiple browsers) fingerprinting
| services and Fastly. The site loads a dozen trackers,
| googletagmanager, branch, segment, what are they doing with
| this data? How much money are they spending handing out
| coupons?
|
| The coupons aren't unique or require a login, why go through
| all of this? All the services they use are "request demo /
| contact us for enterprise pricing", not free-to-sign-up SaaS
| either. Just who is paying for all this and with what?
| ineedasername wrote:
| Their end-game is collecting user data & collecting a
| referral fee when people use their "insurance". (The
| coupons generally are not actual coupons, they present as
| an insurance coverage policy & code that pharmacies use the
| same way they would your normal insurance card). That's how
| they make their money.
|
| Personally, for me, the data they can collect off of me
| when I go to their site is worth the ~$2,000 I save every
| month. (actually I don't have to use them: I am prudent,
| and part of my contingency planning for losing my job is to
| know exactly what expenses I could strip away, and how (and
| for how long) I could continue to pay for the bare
| essentials. GoodRx is part of that planning for the
| healthcare end of things)
| canada_dry wrote:
| > what are they doing with this data?
|
| As a company selling via the internet it would be handy to
| know what drugs/prescriptions a prospective client (via
| fingerprinting) is taking... it would certainly change
| what/if I marketed to them.
|
| Of course the concept of retail companies having even the
| slightest access to a customer's medical/health/drug
| information for marketing purposes is a compelling plot for
| _Black Mirror_.
| ev1 wrote:
| Amusingly, right as I read this reply, I get a chain of
| heavily-obfuscated JS loading with the text
|
| Please verify you are a human
|
| Access to this page has been denied because we believe
| you are using automation tools to browse the website.
|
| Please make sure that Javascript and cookies are enabled
| on your browser and that you are not blocking them from
| loading.
| gruez wrote:
| Weird. I don't get it even though I use VPN + firefox w/
| resistfingerprinting
| dageshi wrote:
| Usually coupon sites are very profitable because they
| signal immediate intent to purchase, I assume they have
| affiliate links for whoever they're providing coupons for,
| any kind of coupon site is usually in fierce competition.
|
| As for all the bot countermeasures, the reason for that
| isn't immediately obvious to me, I assume it must be due to
| that competition.
| ev1 wrote:
| These are not clickable affiliate links; when you pick
| your pharmacy it gives you a PDF to print out and hand
| the pharmacist at time of (IRL) payment.
| jedberg wrote:
| Walgreens has an insurance plan too. It was cheaper for me to
| buy Walgreen's insurance and then my drugs than it was to just
| use my own insurance, and I had Platinum+ insurance at the
| time.
| buttersbrian wrote:
| I am all for competition, but i really think there should be some
| government oversight on prices, even if private services handle
| the delivery etc.
|
| I wonder what items can't be delivered. I suspect a large uptick
| in the theft of Amazon deliveries with this news.
| tyingq wrote:
| >I wonder what items can't be delivered.
|
| _" Notably, the pharmacy will not sell Schedule II
| medications, which includes many common opioids like
| Oxycontin."_
|
| But, that does still leave expensive meds, like diabetes drugs.
| buttersbrian wrote:
| Exactly. I read the part about opioids, but there are SO many
| more drugs of high street value out there.
|
| Beyond insulin, schedule 3 or lower designated drugs include:
| Suboxone, Ketamine, Klonopin, Xanax, and Valium.
| theplague42 wrote:
| This has been coming since 2018. Is there no end to Amazon's
| dominance? I seriously worry that it's becoming a real threat to
| democracy.
| bergstromm466 wrote:
| Is there no end to Amazon's dominance?
|
| Check out the Boots Riley directed movie _Sorry To Bother You_
| , they have a big company in that movie, called WorryFree, that
| is similar to Amazon where they offer lifetime labour
| contracts, it's a very promising future! /sarcasm
|
| https://youtube.com/watch?v=XthLQZWIshQ
| pb7 wrote:
| Can you list some ways it is a real threat to democracy?
| Nasrudith wrote:
| Threat to democracy and monopoly have been so bastardized by
| propaganda that they essentially colloquially mean "I don't
| like their speech/influence and want them to be illegal." and
| "They are big and I don't like them and think they shouldn't
| be allowed to exist!" respectively. They are soft
| eliminationism essentially.
| amelius wrote:
| Amazon is becoming a public utility.
| kgin wrote:
| Where is the line for a public utility?
| seneca wrote:
| This strikes me as a tone deaf move for Amazon. They're
| increasingly losing consumer confidence and are starting,
| anecdotally at least, to be regarded as closer to a flea market
| or eBay than a trustworthy retailer. They really need to shore up
| the issues with tainted supplies in their core retail business
| before I would ever consider them for something as sensitive as
| pharmaceuticals, regardless of how much they promise its handled
| differently.
| kgin wrote:
| I don't think this is a common perception outside of super a
| super plugged-in crowd that reads tech news.
| asim wrote:
| I'm waiting for the moment when they say Amazon launches on
| another planet. They seem to be doing everything. It's only time
| before they cover quite literally every product and service on
| the earth. At which point there's nothing to conquer except
| space.
| akadruid1 wrote:
| This is the back story of the film Wall-E:
| https://pixar.fandom.com/wiki/Buy_n_Large
| mabbo wrote:
| https://en.wikipedia.org/wiki/Blue_Origin
| modeless wrote:
| There's also Project Kuiper which is going to be actual
| Amazon owned satellites:
| https://www.aboutamazon.com/news/company-news/amazon-
| receive...
| dbbk wrote:
| As a British citizen, this is so disturbing to me.
| spir wrote:
| As an American resident, I couldn't be more excited for Amazon
| to disrupt the reprehensible anti-customer practices endemic to
| the US healthcare system.
|
| Recently, I had a runny nose and no fever and thought, "what
| the heck, let's get a COVID test", and found out they are $200+
| here in Austin.
| theplague42 wrote:
| Pharmacy is such a small part of healthcare... they are only
| going to make it worse anyways. They're still for-profit.
| throwaway201103 wrote:
| The market puts a price on things to prevent people from
| frivolously wasting resources and to improve availability to
| people who actually need them.
|
| Edit to remove snarky tone.
| renewiltord wrote:
| The market would do that if you removed the regulatory
| monopoly guarantees.
| SirYandi wrote:
| What if someone who genuinely needs it can't afford the
| price set by the market?
| joncrane wrote:
| Your county isn't doing free COVID testing?!?! In my county
| in Maryland every day there are about 10 sites you can get
| free testing (though they are not all open all day, but at
| any given time between 7a-6p you can get tested at least one
| or two places). There are also private practices where you
| can pay extra to get the results back 1-2 days earlier.
| whoknew1122 wrote:
| I had a secondary exposure and my rapid test was $400.
| Thankfully I have really good insurance and didn't pay
| anything.
|
| My alma mater has an endowment of multiple tens of billions
| of dollars and was forcing students to pay for COVID tests
| after having on-campus lectures.
| anonuser123456 wrote:
| >Thankfully I have really good insurance and didn't pay
| anything.
|
| For the lolz.
|
| You are paying for it, you just don't get an itemized
| bill. It comes at the cost of extremely high 'insurance'.
| And if you think you're employer just absorbs that cost,
| realize that the extra cost would be in your pocket as
| wages if it weren't going towards healthcare.
| whoknew1122 wrote:
| Yes, if you want to get pedantic, I pay $300 a month
| (pretax) for very good insurance that covers both me and
| my wife. Given that we both got tested, that $300 seems a
| bit cheaper than $800.
|
| > And if you think you're employer just absorbs that
| cost, realize that the extra cost would be in your pocket
| as wages if it weren't going towards healthcare.
|
| lolz. This is quite the assumption. Wages have been
| holding steady despite massive corporate tax breaks. Why?
| Because corporations pocket the saved money without
| passing the savings onto employees. If I didn't get
| health insurance, it's quite unlikely that the savings
| would be passed onto me in the form of wages.
|
| And even if I was given the wages:
|
| 1.) Wages are taxable. My healthcare is pre-tax.
|
| 2.) There's absolutely no way I could get the healthcare
| I currently enjoy for $300 a month on the open market.
| The risk pool for my company (Amazon) is so large that it
| effectively subsidizes my insurance.
| dazc wrote:
| Why? We have prescriptions here and it's a service that needs
| disrupting. My Dad has a monthly prescription he has to pick up
| from Boots because no delivery service he has ever used has
| been reliable. The branch he goes to is 10 miles from his home
| because every other branch nearer to him has let him down badly
| in the past with missing items he has had to chase up for days
| afterwards.
|
| We're talking about picking 6 labelled items from a shelf and
| putting them in a paper bag. How someone can get that wrong
| over and over again baffles me?
| gadders wrote:
| You can get similar services in the UK. EG
| https://www.echo.co.uk/
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