
Amazon is in exploratory talks with generic-drug makers - ehllo
https://www.cnbc.com/2017/11/30/amazon-holding-exploratory-talks-with-generic-drug-makers.html
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ProAm
I do not trust Amazon with this type of product at all. Their lack of ability
or interest in stopping counterfeits now fills me with wary about products
that are important to me.

~~~
8ytecoder
That's insane. I don't see Walgreens or CVS to be any more competent than
Amazon. It's the regulations that's keeping them straight. I'm really really
hoping that this brings down the cost of medicines. The pricing of drugs in
the US is ludicrous.

~~~
gknoy
When I go to a pharmacy, I trust that they will make the medication that
matches my prescription.

Amazon is _notorious_ for having counterfeit items commingled with the same
bin code (I might be using the wrong term), e.g. for cellular phone chargers,
and even things like t-shirts.

Because of this, I share the GP's concern that Amazon would to a terrible, un-
trustable job at preventing such commingling of pharmaceutical products. Sure,
their pharmacy suppliers might make them right, but that doesn't prevent some
random jerk (or just someone w/ crappy safety practices?) from posting a
counterfeit with the same labeling.

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fny
Thankfully, pharmaceuticals are regulated, whereas chargers and t-shirts
aren't...

Do you really think Amazon is going to let anyone sell any drugs?

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solotronics
that was called Alphabay and already exsists /s

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InternetUser
There is now the Dream Market:

[https://en.wikipedia.org/wiki/Dream_Market](https://en.wikipedia.org/wiki/Dream_Market)

[https://www.reddit.com/r/Dream_Market/comments/6pp9oi/dream_...](https://www.reddit.com/r/Dream_Market/comments/6pp9oi/dream_market_guide_for_new_users/)

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jlkjasldk
AmerisourceBergen and Cardinal Health have current contracts with Walgreens.

Amazon is trying to reach a 1:1 relationship with generic producers so they
can skip purchasing from a vendor, reducing costs. In this effect they would
have an advantage over Walgreens, CVS, or Rite-Aid.

If Amazon really wanted to they could distribute for one of the aforementioned
pharmacy chains as well, provided they are approved by the FDA & DEA.

~~~
refurb
The interesting thing is that some drug manufacturers contract directly with
pharmacies cutting out the wholesalers.

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conductr
It’s all about volume. Wholesalers pool volume but even using a wholesalers
does not prevent you from going direct on certain drugs

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xefer
I'd be interested in knowing what different pharmacies ultimately charge the
various insurance companies for generic drugs.

During a job switch I had a couple of weeks were I was covered, but before I
got my new insurance ids I paid full price (then reimbursed in full
afterward.)

A very common generic drug I had a $10 co-pay for, was $139 without insurance
at the chain pharmacy I went to. Is this ultimately what the insurance company
is paying out?

I was shocked. I thought the generic would be mass-produced and only cost,
maybe, a few dollars over my $10 co-pay. I suppose of that $139 dollars, only
a tiny fraction was the actual drug price; the rest goes into salaries for the
pharmacists, business costs and profit. It still seemed pretty outrageous to
me.

If a company like Amazon ends up only charging back to the insurance company a
lot less, on a mass scale, it would hopefully reduce overall insurance costs.

~~~
conductr
> Is this ultimately what the insurance company is paying out?

No not at all. “Self pay” was your status and those people pay the highest
rates. This is true for almost all US healthcare. Being self pay is basically
like going to a car dealer and paying MSRP with no negotiation or rebates,
etc.

The pharmacy has agreements with wholesalers (sometimes directly with
manufacturers) that determines their cost structure of inventory. This
includes discounts and rebates and a lot of other cost reductions but All
these drugs have sticker price. Insurance companies drive volume and can
decide which pharmacies their patients use, thus they can negotiate prices as
well. The pharmacy<>insurance transaction is usually going through a PBM,
another middle man, that can tell them pretty much instantly what you owe
based on your coverage (this is why a pharmacy can give you accurate pricing
but doctors offices can’t). There’s a lot of intricacies but the difference
between self pay and insured rates can significant. For a generic, I’d be
surprised if the pharmacy paid more than 5-20$ but billed you what they could.
When insured and you pay 10$, the insurance company has done the math that
they will profit on their total generic base even if they lose a little on
your purchase (but they probably didn’t).

I work in healthcare finance currently at a pharmacy

~~~
solotronics
why is this legal? there should be one price no matter who is buying. This
would be like charging a certain demographic a different price for food or
gasoline.

~~~
refurb
But remember who the payer is for drugs, it's generally the insurance company
not the patient. Insurance companies negotiate different costs to n behalf of
their members.

If you don't have insurance you just default to the list price.

However that is changing. I can't remember the company, but one pharmacy is
starting a cash pay discount program.

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deegles
Looking forward to it. Amazon will eventually be the only middleman needed for
commerce. Consumers will only benefit.

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srathi
Looks like the sarcasm is lost here. I assume you were being sarcastic!

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stuffedBelly
ah I see. Didn't think it was sarcasm at first because there are definitely
people around me who think that's a good idea, e.g. all my friends who work at
Amazon

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donarb
Wonder if this would be able to solve the problem of price fixing, which has
lately become an issue. People think that generic drugs equal cheaper drugs
but companies can still manipulate prices to benefit themselves.

[https://www.reuters.com/article/us-usa-generics/u-s-
states-a...](https://www.reuters.com/article/us-usa-generics/u-s-states-
allege-broad-generic-drug-price-fixing-collusion-idUSKBN1D0201)

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ungzd
Warning: TV with sound embedded into page.

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jenkstom
I can only hope that they take steps to control "additives" in pills. My
mother (and probably her mother) are allergic to some of the additives in the
pill, to the utter disbelief and dismay of many doctors.

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amelius
Are these drugmakers located in China?

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WillPostForFood
I'd take Chinese manufactured drugs if it breaks the current hegemony. I
already buy stuff from India from sketchy online pharmacies, having some semi-
trustworthy body providing any oversight would be a an improvement.

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manmal
I would not. They had the melamine-in-baby-formula incident, in some regions
they have poisoned tap water, and corruption is omnipresent. I‘m too selective
about what I put into my body to take any chances there. Eg if they don’t
filter water, pills might contain lead.

~~~
jstarfish
This is xenophobic nonsense. China _executed_ or sentenced the executives
behind the melamine debacle to life in prison, so there's already been greater
accountability than we'd see for the same supply line issues in the US.

Flint, Michigan has lead-poisoned tap water.

Look at the salmonella cases that pop up every few years and kill handfuls of
people. Look at the infants accidentally being given methadone prescriptions.
There's never any real consequence for mishaps in the US. Maybe a fine at
worst.

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j4ship
I completely trust Amazon with this product. They have shown the ability to
run complex systems at a high quality. I think they can only improve the
availability of medicine.

Just because counterfeits still happen doesnt mean they are not trying to stop
nor does it mean they are doing a bad job.

And Im sure there will be further regulations around this then there is for
nockoff plastic goods.

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madamelic
Yeah no.

I am not normally a conspiracy theorist but Amazon manufacturing things to spy
on me with audio, video, being able to unlock my doors and now know my
prescriptions, naaah.

