How Amazon’s entry into the pharmacy business could improve patient care

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Amazon’s plan to buy online pharmacy PillPack, widely seen as a move that will disrupt the pharmacy business, could have a positive impact on patient engagement and care.

PillPack focuses on a narrow segment of patients who are on many different medications. It packages pills in individual packets that help people remember when to take their drugs every day, a common challenge for people taking, for example, drugs for diabetes, high cholesterol and blood pressure.

Analysts expect Amazon with its information technology and retail prowess will improve PillPack’s customer service and drive drug prices down.

“Consumers are excited about ordering prescriptions online,” says Griffin Myers, MD, chief medical officer at Oak Street Health, a Chicago-based network of physician offices specializing in the care of older adults.

According to results from the 2018 Walker Sands Future of Retail report, 29 percent of consumers say they’re excited about the convenient experience Amazon provides, and that they’re already used to using it to make purchases. Some 61 percent of respondents say they want to order prescriptions from Amazon because of its ability to ship quickly, and 54 percent said they would do so because of their existing trust in it.

PillPack has the basic infrastructure that Amazon needs: mail-order pharmacy licenses in all 50 states, multiple pharmacy locations and a call center.

“Amazon’s acquisition of PillPack could address the rising number of ‘pharmacy deserts’ in the U.S. today,” says Myers, “About 75 percent of doctor visits end with a prescription, yet consumers who live in rural or low-income urban neighborhoods don’t have the options or resources to fill those prescriptions. In the future, I anticipate we’ll see increased efforts to help distribute prescription drugs to patients who need it most and increase medication adherence.”

Amazon-PillPack and its ubiquitous order distribution technology could also have an impact on consumer adherence to physicians’ medication orders, and that’s where digital health and other technology could come into play, says Areielle Trzcinski, a senior analyst at Forrester Research.

For patients with chronic conditions, as many as 50 percent don’t take their medications as prescribed, she says, and as many as 20 percent to 30 percent of prescriptions are never filled. “With Amazon and PillPack, this eliminates the need to stand in line at the pharmacy, which may help overcome past barriers,” Trzcinski adds.

Also, prescriptions filed directly to Amazon electronically could enable it to know if patients didn’t get their original order or refills, she says, and it could use Alexa, its consumer communication device, to reach out to remind patients to get orders filled.

“We are already seeing Alexa and other voice-enabled devices engage with patients at home,” Trzcinski says. “From medication reminders to gathering data on a patient’s health, Alexa could remind a patient to take their medications, therefore knowing when it is time for a refill and automatically submit the order. Or, if a patient shares information back about how they are feeling, Alexa may be able to determine potential side effects to a therapy and report that information back to a provider.”

The use of automated in-home communication technology also could be pass information back to healthcare providers, with patient feedback alerting the need for a care manager or pharmacist to call the patient to discuss and potentially change a patient’s therapy, which then could be automatically updated through Amazon, she suggests.

Amazon’s same-day distribution also could be tied into virtual care, such as telemedicine, she adds. “A patient would be able to see a provider over video chat and receive a prescription, cough drops, and tissues hours later—without ever having to leave the comfort of their own couch.”

However, much of this speculation about the future will take time to achieve, contends Jitendra Waral, an analyst with Bloomberg Intelligence, a market research firm.

“Amazon is still in the early stages of figuring out the best way to tackle the healthcare retail market,” Waral contends. “Longer term, Amazon will become a key player in healthcare, but the timeline is likely longer than most expected, given last-mile delivery infrastructure needs to scale first.”

But the PillPack acquisition has implications demonstrating the future direction of healthcare, says Nathan Ray, a senior manager in the healthcare practice of West Monroe Partners, a Chicago-based management and technology consulting firm based in Chicago.

“People are still stuck in the frame of mind that they need a doctor to treat their mild conditions, but technology is already enabling them to self-treat for things like sinus infections, with places like, and it will keeping moving toward that,” he contends. “This acquisition could bring eventual disruption of in-person visits for mild conditions via Amazon.”

The acquisition could have other long-term implications for traditional care providers, by adding another factor that can provide care management capabilities—offering a technological link that can ensure patients get the right treatment at the right time and in the right place, Ray contends. “PillPack’s format adds ‘care management’ value by improving adherence and convenience.”

Mixing in more use of technology and virtual care will likely diminish the use of some traditional approaches to care delivery, Ray emphasizes.

“A significant amount of physician work is seeing patients and prescribing for everyday things like sinus infections, rashes, sore throat and the like,” he says. “Many of these could be more easily addressed by patients who know their symptoms, so the traditional players that I see impacted long-term are primary care physicians, possibly urgent care centers, other retail clinics and pharma retailers like CVS.”