Amazon has made several recent moves including hiring new health IT experts, and physicians to make a big foray into health. Amazon’s recent disclosure that it wants to enter the pharmacy world. Its recent acquisition of Pillpack has made us question their role in a post-Amazon pharmacy environment, and if there will be a reduced need for pharmacists.

As Global Positioning Satellites (GPS) became increasingly popular, the demand for cartographers dropped significantly. Digital maps began to be automatically created and updated in real time. They even compared your current location to your desired location and told you how to get there. As a result, classically trained cartographers began to worry about their jobs and livelihood. Similarly, Amazon’s overtures into pharmacy have concerned pharmacists.

However, since the concerns are similar, maybe the results will be too. There is a projection that between 2016 and 2026, the demand for cartographers will increase by 19%. This increase in demand has been attributed to an increased use of maps by government planning organizations and the realization that there are some responsibilities that cannot be automated and delegated away. Similarly, pharmacists who hope to operate like they did 20 years ago are unlikely to survive. However, those who adapt would likely be very much in demand.

What Amazon taketh away, Amazon may also giveth

Amazon has rarely been a manufacturer. Amazon typically connected businesses with potential clients and served as a marketplace. The marketplace originally started as being a place for them to sell their wares, but eventually expanded to become the Amazon Marketplace where anyone can use Amazon as a virtual store and sell their goods. As most know, goods sold by sellers on Amazon often compete against goods sold by Amazon itself, and the orders may often even be fulfilled by Amazon. Amazon has been happy to do this because they still make a profit with such an arrangement. So, one must wonder whether the pharmacy of the future will become a competitor to PillPack or will instead partner with them.

Pharmacists may be able to compete in a post-PillPack pharmacy in one of the following ways:

1. Amazon Marketplace

Competing against Pillpack in the near future will likely require demonstrating specialization and knowledge. Cartography grew because of the creation of Hyper-Local Communities. These communities looked at the location of the nearest Dairy Queen but also looked for shops surrounding the Dairy Queen. This was unable to be achieved by automated large mapping companies and required individuals. In the case of pharmacy, pharmacists could develop a specialization by connecting with unique providers or providing unique services or simply products that cannot be easily mailed. This may include veterinary prescriptions, schedule II drugs, specialty drugs, emergency antibiotics, compounding or providing uniquely personalized care.

2. Delivering Services

While Amazon has excelled at delivering goods, it has not demonstrated expertise in delivering services. As a result, providers like Walgreens are looking to capitalize by partnering, hiring nurse practitioners or other mid-level professionals and enabling them to engage with patients. The pharmacies believe that since these providers may be more likely to educate their patients at the pharmacy, diagnosed patients may find fulfilling their prescriptions on site to be more convenient.

3. New Partners

Pharmacists traditionally find themselves combating Prescription Benefit Managers (PBMs). However, despite PBMs and Group Purchasing Organizations (GPOs) who are all supposed to theoretically help patients by keeping costs down, pharmacists feel squeezed and don’t have enough of a margin. With a new Amazon entrant, a pharmacy may now effectively assert that PBMs, GPOs, and pharmacies are all likely to perish if they don’t survive together. Accordingly, this may enable better pricing opportunities and better opportunities for patients.

4. Branded Prescriptions

Being a pharmacist in the Amazon Marketplace may enable prescription fulfillment across the state if not the country. Amazon Marketplace may enable a pharmacist sitting in New York City to sell a prescription to a patient in Albany. In some cases, the pharmacy itself may deliver to the new patient, or create a new category of “celebrity pharmacists” who simply are trusted to provide appropriate care, while a Pillpack may do the actual fulfillment and delivery of the prescription.
While Amazon’s entry may provide interesting partnering opportunities, it is important that pharmacists consider relevant laws. The stark, anti-kickback, False Claims Act and civil monetary penalties law will each come into play. Accordingly, pharmacists hoping to partner with other providers, but should be careful with such endeavors since it may expose them to potential legal liability.

Where do we go from here?

It seems likely that a push by Amazon into pharmacy may impact individual pharmacists who may see a decrease in patient volumes. This is likely to scare pharmacies and pharmacists. However, it seems that such a temporary decrease in demand is likely to eventually lead to more opportunities in the future.
If you are interested in hearing more about how Amazon affects pharmacists, the implications of an Amazon Pharmacy and patient centricity, or how Amazon’s Prime membership discounts might work with medications, search for the Pharmacy Podcast Network wherever you listen to your favorite podcasts.