It's crazy how competitive Wall Street views Amazon moving into a market; have there been examples of Amazon making a large purchase/move but completely failing? (sure there are, just not coming me off the top of my head)
They tried to make a move into retail registers to compete with Square, and failed. They shuttered Amazon register in 2015: https://bits.blogs.nytimes.com/2015/10/30/amazon-shutting-do...
They tried to take on Etsy with Amazon Handmade which bombed Etsy stock, but Handmade has gone pretty much nowhere, except some re-branding this year.
People just forget Amazon's failed ventures, even fairly high profile ones, because there are so many, and the hits sometimes so large (like AWS).
Quoting myself from April:
> Amazon's ethos of "Announce fast, Release fast, if it fails, oh well" is intentional. From Bezos' point of view, this is actually a feature. In a shareholder letter in 2016, he called Amazon "The best place in the world to fail." He wants lots of teams working on lots of products, and if some of them don't pan out, that's OK. This has lead to a lot of successes, but also a number of small headaches for consumers who use products that are quickly discontinued and (charitably) forgotten.
As a merchant, it was amazing. They offered promotional rate of 1.75%, which is basically impossible to beat for any small business.
For context, Square and most "simple pay per swipe" merchant service providers charge 2.75%. If you go out and get a really good deal from a intrchange+ provider, you might be able to get your rate down close to 2%. But Amazon Register got you below that with significantly less hassle, no subscription fees and a $0 equipment cost.
My wife used it at her small business for a year, and during that year I loved getting proposals from other banks and merchant service providers. Many had an offer like, "Let us audit your merchant fees, and if we can't beat them, we'll give you a $200 gift card."
I always gave them the opportunity to try, but with the caveat that there was no way they could beat our current rates, and I wasn't going to take their money when they failed. Mostly, I just never heard back after they realized I wasn't BS'ing about the fees we were paying.
If Amazon Register had been more widely promoted, they could/should have been able to get every credit-card-accepting small business in the country signed up at least for the promotional period. I'd love to see some kind of post-mortem to explain why they didn't.
Is severely damaging another online vendor really a failure for Amazon? It seems to me at that level, revenue from a venture is not always the only measure of success.
> "If you double the number of experiments you do per year you’re going to double your inventiveness."
> "If you decide that you’re going to do only the things you know are going to work, you’re going to leave a lot of opportunity on the table."
Basically the modern tech titan mantra. The only company out of the big 5 that isn't doing this is Apple.
It may not be failure but I doubt it will kill or disrupt the grocery business.
They fail a lot of the time, but sometimes even when they do, it's a kick in the ass to some of the other competitors in the field, which causes them to depress their margins. So sometimes, even if Amazon's presence in the market fizzles out, they end up still reducing other's prospects.
[1] http://www.macnn.com/articles/09/10/28/google.maps.helps.gps...
[2] http://www.businessinsider.com/googles-free-gps-service-crus...
Garmin's automotive segment revenue has dropped from $2.5-billion in 2008, to $700-million in 2017. [1]
They've been able to largely make up for it with revenue from other sources, [2] (mostly outdoor/fitness) [3], but I'm sure that shift and innovation was driven by the event you mentioned.
[1]https://www.statista.com/statistics/217901/net-sales-in-the-...
[2]https://www.statista.com/statistics/217907/net-sales-of-garm...
[3] https://www.statista.com/statistics/217905/revenue-distribut...
https://glinden.blogspot.com/2006/04/early-amazon-auctions.h...
Amazon is reliable, sure, but what do they have - 99.9% fulfillment, 99% on time, 99% with authentic products, 97% of listed products in stock? Those are guesses, but apply those numbers to delivering vital daily medicines and the problem becomes pretty obvious.
Keeping in-stock rates high and "on time with authentic products" rates near 100% is not an easy task. It's not something pharmacies do perfectly either, but their shortages are generally at a store level rather than national, and they're not asking people to completely switch delivery mechanism to trust a space with online one provider.
Another guess is that changing habits(especially since buying drugs is an infrequent event, and that we're dealing with seniors) and creating trust we're other reasons.
Basically, the largest potential market for you is not tech savvy at all and makes it hard to convert.
http://assets.coolhunting.com/coolhunting/mt_asset_cache/201...
(note: above image is of an already mostly empty PP box, they often come stuffed completely full)
https://cdn.vox-cdn.com/thumbor/Jz4Xw7Xs-Fxnige1c2qnDlez-c0=...
I used PillPack a few years ago, and appreciated the reliable auto-refill (in fact their behavior was borderline insanely aggressive, which was fine by me).
However, the volume of single-use plastic trash created by the way PillPack does packaging was downright excessive, and I felt so guilty about it I deactivated my account. It is less convenient now, but after going back to using typical mail-order and local B&M pharmacies in town the process results in approximately 10-20% of the amount of trash.
See the images linked above as examples of what comes with each shipment - it's a plastic case full of little plastic pouches. There is 1 plastic pouch per dose of medication, and the plastic pouches are wound tightly inside. The volume of single-use plastic adds up rather quickly with PillPack.
EDIT:
Why all the downvotes? "Internet points" are unimportant, but it is curious and unsettling to see information about wasteful high-pollution corporate practices deep-sixed.
But I'm not sure if the plastic problem (a huge one, and I really love nature) will be solved by individual action.
In practice it would require laws, like the anti plastic bag law reduced demand by 70% in the Netherlands.
Or technology, like a better bio-degradable plastic alternative.
Hope it never happens but if they do with pharmaceuticals what they did with everything else they sell, it's only a matter of time before users are physically harmed.
Let's be optimistic though, I hope this helps them finally get their shit together and control the rampant counterfeiting going on right under their nose.
Do you really think that Amazon can get their stock medications from just anyone? Do you think there is no oversight on this kind of thing? The DEA doesn't fuck around. They take all of this stuff very seriously.
Commingling medications? Really? In a pharmacy, medications are NEVER allowed to be commingled. If your medication is coming from two different manufacturers, or even the same manufacturer but the pills just look different, the pharmacy must put them in two different bottles to give to you. Stock bottle are not allowed to be mixed together. Ever heard of a recall on medications? That is exactly why. When a recall happens, they need tedious records of where every pill went.
When a prescriptions for a schedule II drug is filled, the pharmacy technician has to count the number of pills being filled twice. Then the pharmacist has to count the number of pills, and then backcount the stock bottle to make sure everything is kosher and no pills are missing.
I understand not everyone knows everything about the pharmaceutical industry, my wife is a pharmacist is the reason I know as much as I do, but to think that there is that little oversight on pharmaceuticals is ludicrous.
http://www.slate.com/articles/health_and_science/medical_exa...
https://abcnews.go.com/amp/Health/amazon-prescription-drug-p...
Everyone knows pharmacies are highly regulated, however Amazon has somehow managed to flaunt regulations so far without much consequences.
Are there any exceptions allowed? I'm pretty sure I've had a major nationwide pharmacy give me a bottle with pills from two manufacturers in it. It had pills from the first in the bottom of the bottle, then a cotton wad on top of those, and the pills from the second manufacture on top of the cotton ball.
They opened the bottle when I went to pick it up, and pointed out what was going on inside and made sure I understood. They explained that they did not have enough pills in stock from the manufacturer they had used before for that prescription and refills, so filled out the order from a different manufacturer.
Perhaps it does not count as commingling because they divided the bottle into separate champers with a wad of cotton?
The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available.
I think it's just generally weird that a shipping and commerce company is taking interest in pharma to begin with. I think it SHOULD make users uncomfortable that a single company is potentially exposed to all these different vertices of user information. They know what you buy, soon they'll know what groceries people buy, what they read, what medicine they take which could in turn reveal metadata like sexual habits or genetic patterns.
It's weird.
Good grace. What a load of unnecessary bureaucracy.
The supply chain integrity problems were allowed by Amazon because it benefited their bottom line. If they wanted it perfect, they could have made it perfect.
Remember when the eclipse was happening and they actually did a pretty good job of removing all glasses which weren't safe? They know where integrity counts, and I think when it comes to pharmaceuticals they'll know how to play this game clean. As another user commented: Amazon didn't get this humongous by making silly mistakes like this.
They also recalled a number of good units, which only sowed confusion and anger among buyers.
https://www.usatoday.com/story/money/nation-now/2017/08/14/a...
And it turns out some of the counterfeit glasses did get out to to buyers who thought they were purchasing legitimate units.
https://www.reuters.com/article/us-amazon-com-lawsuit-eclips...
Exploding hoverboard case shows how hard it is to beat Amazon in court
https://www.cnbc.com/2018/06/02/amazon-not-liable-for-explod...
https://news.ycombinator.com/item?id=17216972
> [T]here were so many cases of fires and explosions that Amazon had halted sales. [...] Fox's case was filled with testimony and evidence illustrating that Amazon execs were concerned about the hoverboards sold on its site. [...] [A]n Amazon vice president said the company had decided to halt sales of hoverboards and send a 'non-alarmist' email to existing customers [...] Fox received the email the next day. It referenced 'recent news reports of safety issues' and offered 'safety tips' for using the product as well as an option to return the device for a refund. There was no use of the word 'fire' or 'explosion.' Fox testified that if Amazon had said that 'they knew what they knew, I certainly would have gotten it out of my house.'
Only after people let them know they were not safe and not within a reasonable timeframe for people to order replacements.
PillPack already has an established distribution network and prescription delivery licensing in 50 states. I don't know for certain, but I would assume that fake prescription medicine is a much bigger risk and would threaten the operation more than, say, fake batteries.
I reject specific manufacturers from my CVS and get trusted manufacturers all the time.
Hard to do these days though. Teva is killing off a bunch of generics, Puerto Rico still a mess, weird shortages of common meds, etc. Sometimes I spend an entire day going around the city trying to find the specific generic which I'm used to. And then only get partial fills, etc.
The potential liability they would be exposing themselves to if Amazon treated their drug supply chain the way they treat standard 'Fulfilled by Amazon' products would hopefully prevent something like that from ever happening.
It’s a big infrastructure lift so it’s still being implemented.
[1]https://www.fda.gov/Drugs/DrugSafety/DrugIntegrityandSupplyC...
Amazon isn't stupid: they know _exactly_ where they can play it fast and loose in order to maximize profit and where they must operate under strict regulation. This isn't the former.
You almost certainly have, though you may not be able to tell the difference if you don't actively look for it.
There would be no reason to integrate prescriptions in with their warehouses, so I don't think one is going to change the other.
Do they all ready have a supply chain close to the requirements needed in healthcare ? For what ?
I would love for Amazon to come in and transform this space. There are lot of improvements to be made but all the well established players know those improvements but unless the regulations catch up its hard to innovate.
One thing Amazon might be able to do is to take a hit to their bottom line by essentially selling drugs at a loss and wait it out till they drive everyone out of the market and increase prices. But no one cares when the price of a book/toy increases by x%. Everyone cares when the price of a drug increases by the same amount. (https://www.cnbc.com/2017/04/03/mylan-hit-with-racketeering-...)
I'm not sure anyone thinks Amazon will allow 3rd parties to sell prescription medications. Although if they want to let me cash in on my dead mother's extra chemo meds and pain pills, let me know where to sign up.
They're not, though.
As an example, my wife is allergic to a filler ingredient in one generic manufacturer's version of one of her medications.
This is news to me. Can you link an article about it?
In no way I say it was fine, I'm just saying that Amazon will have time and opportunities to fix whatever counterfeits popup before hammer will go down on them.
It may also be they won't allow 3rd party markets into healthcare, we just don't know yet all the details.
It also doesn't address this really annoying problem I have getting my daughter's ADD meds. These require a paper prescription that must be hand couriered to the local CVS. A giant PITA.
P.S. While we’re on the topic, if anyone’s interested in a libertarian perspective, check out Jessica Flanigan’s 2012 JME paper “Three arguments against prescription requirements”: https://jme.bmj.com/content/38/10/579
Most high-street pharmacies in the UK have offered pill-packs for years; you route all your prescriptions to them and their pharmacists arrange the medication into little time-inscribed compartments on a blisterpack.
For them there is benefit in monopolising the medicines of each customer ( more $$ from the NHS ) and for the customer it becomes simple to take medicine at the correct times and intervals. For relatives it's also simple to check that medicines have been taken as required.
PillPack seems to do that, but 'on the Internet'. shrug
>PillPack seems to do that, but 'on the Internet'. shrug
Leaving aside the fact that 'on the internet' is a huge and important distinction (you should check out this company Uber, it's like a taxi but 'on the internet'), you seem to be saying "there's this great service available to us here in the UK, I can't imagine why a company in the US would want to replicate it shrug."
Does the pillpack have a separate pack for each day with the date clearly labeled? If so I feel that would help a lot with adherence, which in my opinion is a serious problem
Additionally Pill pack address this on their website for temp. Controlled teams being shipped in a temp controlled way door to door (see Omaha steaks as an example of ‘it’ll be fine)
ExpressScripts is absolutely terrible. What once was a simple problem: Get a Rx from your doctor, go to any pharmacy and get it filled, has now become a painful process of:
- Call doctor's office, ask them to send the Rx to express scripts.
- Call express scripts, verify they have the Rx.
- Two days before you run out of medication, you get an automated call from Express scripts telling you to call them back.
- Call Express Scripts, wait on hold for 30 minutes.
- Someone finally tells you that there's a problem with the Rx, and you need to call your doctor and have him re-send the Rx specifiying dosages, etc. in a a very specific way. This is Friday afternoon, of course, and your Doctor's office is already closed.
- When you explain you're going to a miss a dose of a medication that is dangerous to stop suddenly, they absolutely do not care ("You'll have it in 5-7 days, once we receive all the info we need", click).
It isn't just me. I overhear a lot of angry phone calls between employees and express scripts in the cube farm at work now. Employees are wasting work-time dealing with something that used to be simple - getting their prescriptions filled. Hope the shareholders are happy.
No step in the retail pharmacy supply chain involves routinely putting it in a small black box sitting out in the sun until you get home from work in the evening.
Only problem I've seen is that they often (and I mean OFTEN) forget to apply medication savings cards, which adds up to quite a lot of money. I had to complain about this eight or nine times and ultimately escalated to one of their founders, a guy by the name of Eliot, to get this addressed. However, they may have fixed the problem as they haven't overcharged me so far in 2018.
Prices are set by insurance and shipping is already free so I can't see how Amazon would improve on that. I imagine their margins are razor-thin, but it's pretty clear this sort of service will be how everybody gets their medicine in the next couple of years so the volume makes sense for Amazon.
I’m not overly concerned about their dominance anymore. There are eventually going to be regulated.
No, because that would land them straight in jail.
The UK already has a company that does the government loves to outsource things to: https://www.theguardian.com/business/2013/jul/29/serco-bigge...
So I imagine you'd call about your local trash pickup or a kindergarten and you'd get put in the call center telephone queue.
I think ES does provide a service that people want regardless if it hurts Pharmacies and it doesn't hurt consumers if they want to pay for the service; but maybe it affects drug prices in other ways?
If the Cigna deal fails to go through they both owe some billions, coupled with Amazon in their space, ES looks doomed.
Link describing medication adherence potential health care savings. http://www.heart.org/HEARTORG/Conditions/More/ConsumerHealth...
Link describing medication adherence and Pill Pack. https://www.pillpack.com/healthcare-providers
I wonder what other industries out there can be arbitraged like this. I bet Amazon could shave well over $10b of market cap off of BKNG if they made the right strategic investment.
This means getting in there is going to be very profitable, and if amazon can get in there are use its existing scale they can get quite rich. There's now three benefit management companies that are in charge of altruistically deciding what medications you can afford. On the one hand, Amazon breaking up this pathological oligopoly would be good for consumers, but if it's really a market structure thing we run the risk of there still being on three companies, but with Amazon instead of CVS, ExpressScripts, or United Health.
If Amazon’s warehouses or Whole Foods are any indication of how they’ll approach the unavoidable human work involved at a pharmacy, I have serious doubts about the quality of service. And pill pack is already in a pretty sorry state.
How many pharmacists and pharm techs can be automated away by amazon that pillpack hasn’t already? And this is just a rhetorical question, neither of us are really qualified to address all the tasks to be done, nor current automation levels.
How did Walmart impact CVS and Walgreens? Both continued getting larger. Maybe Amazon will drain some or most of the remaining growth in the segment by taking a slice of market share. More likely it'll just end up being an expensive, terrible business that struggles, like most of Amazon's ventures (they fail far more often than they succeed).
On the other hand imagine what you could do with the data . Lets say you have clinical depression. Maybe it would recommend you a medical food such as Deplin or even the l-methylfoliate.
I had tried to use the mail-order drugs provided by insurance companies and they were a disaster. I couldn't find out what was coming when. Drugs would seemingly-randomly show up in my mailbox.
Edit, Adding source:
https://www.pillpack.com/questions/can-you-ship-prescription...
/cdn.vox-cdn.com/assets/3968063/PillPack_Shipment.png){kind=link}
This was so needed. Can they hasten the paper work doctors and insurance companies require?
Amazon.com "Instant gratification at the speed of UPS." /gBasically the system that pharmacies used to transfer prescriptions isn't secure
Plus they now have plenty of money to hire the best security firms to pen test their systems, plug holes, and run a serious monitoring operation.
Also read the advisory - the issue is not with them - it's with the legacy prescription transfer systems they hook into. That is something they cannot hire someone to pentest without getting all of their competitors to agree.
if people were paying out of pocket these kinds of markup could not survive
fun fact: thanks to lobbyists and congress, it is illegal under federal law for a pharmacist to voluntarily tell you it cheaper to pay cash than use your insurance co-pay, you have to know to ask