Pros and Cons of Amazon Pharmacy

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Just when you thought Amazon had enough money and had crushed enough small businesses, in comes Amazon Pharmacy! 

On Tuesday, November 17, 2002, the e-commerce giant debuted its own ‘drugstore’ and successfully tanked the stocks of several big, reputable names like CVS (where I used to work), Rite Aid and others.

This means that over time, all those nice retail pharmacies will take a hit in sales because consumers can now buy their drugs online using their Prime membership benefits. It will shake up the way people think about getting their medication filled, and refilled. But this whole “mail order pharmacy” type of business is nothing new, it’s already popular. People are getting more and more used to having their prescriptions  mailed to their home because this option has been available for more than 20 years now (some insurance companies forced it). And thanks to COVID, it enjoyed booming sales in 2020!  The only downside I can think of is the loss of your medications due to “porch pirates,” you know the looters who steal the boxes off peoples’ front porch. 

So it’s similar to mail order pharmacies, only the business model is getting a face lift because Amazon is going to be very efficient with it. They’re good at everything! Amazon is easy, convenient and cheap. You can sign up in 5 minutes or less, and they work with many insurance companies. Deductibles will have to be met of course so don’t get too excited.
Buying medications online with your laptop or phone is simple because you can do it from the convenience of your bed! You can probably yell it like this, “Alexa lower the temperature to 72 degrees and refill my Ambien.”

If you take a medication chronically, the refill feature will be as easy as 1-2-3. You will likely scan the barcode on your label, or type in a few numbers and within seconds your refill order will be placed.

Do you love the idea of that? Does it sound innovative and convenient? 

I’m sure it does. Let me shock you and tell you that this very same, exact service is available right now at all major chain drug stores. Yes, right now! With COVID, they were able to shape shift and do home deliveries for people as well. And depending where you live, they offer same-day delivery! So you can do it with your current pharmacy, you don’t have to go to Amazon for this incredible convenience.

Amazon is not warm and fuzzy, meaning there are no pharmacists to chat with about your interactions and side effects. Remember, your pharmacist is a drug information specialist and they have years of training to detect drug interactions. Will it be the same for Amazon when they fill your new prescription? Will they be checking your profile to make sure you don’t suffer an adverse reaction from the combination? It’s a good question and I certainly hope so.

If Amazon becomes the biggest pharmacy retailer in the United States, we can safely assume many retail pharmacists will face layoffs, reduced hours and diminished store sales in the front end of the stores.Techs and cashiers will be impacted. I’m not assuming that will happen, I’m sure of it. Amazon is very good at scooping up swaths of sales and crushing the little guy!

Did I just call Walgreens the “little guy?”
Well, compared to the behemoth Amazon, Walgreens and some of our other favorite pharmacies (and pharmacists) will fall into the quicksand. It doesn’t have to happen though, it’s up to you and the degree of loyalty you have to your local pharmacy. Remember, the “little guys” meaning the big retail chain pharmacies CAN and WILL gladly deliver to your home, and prices are not that much more than Amazon’s. Many offer same day delivery too.

Let’s talk about prices.  In one article I read, it said Amazon Prime members can save up to 80% on generic medications compared to brands. But did you know that that’s what you’d pay at any pharmacy in the nation, about 80 percent off brand. So nothing exciting there. With Amazon Pharmacy, you will save up to 40 percent on brand names when you pay cash (not through insurance). Most people do not even want the brand name drugs though, so in my estimate this is an attractive soundbite, but a moot point. But to be clear, if you prefer a brand name drug, those will be cheaper at Amazon Pharmacy compared to local pharmacies because Amazon has tremendous buying power. 

In short, drug prices may be lower for people who are uninsured, but for those with insurance, it will not matter. Insurance copays and deductibles will remain the same. As for generic prices, they are very inexpensive to begin with! Prices are comparable across all pharmacies, including Amazon’s. 

Here are some considerations regarding Amazon Pharmacy, and whether or not it is right for you. You may not want to switch over just yet, for some of the following reasons:
1. Trust.
You like your pharmacist and staff because you have cultivated that relationship for years. Supporting your local pharmacy helps ensure they are there for you when you need them. In other words, you may be attached to the care you’ve received, and have a trusting relationship that you don’t want to lose.

2. Security.
Private information is required to sign up with Amazon Pharmacy, and some people are leery of putting their social security number in (or even 4 digits of it), as well as their address, date of birth, phone number, drug list, etc. We know that many websites follow us using cookies and whatnot. Many Americans today are nervous about Big Tech, and what they might do with this private data. 

Imagine buying your medication for Cialis online with Amazon Pharmacy, and then getting pop ups all day long promoting ads about Viagra, while your kids are playing on your iPad. How  intrusive and embarrassing! Will that actually happen? I don’t know for sure, but I can say that annoying pop ups follow me around the Net for weeks after I even so much as visit a site and peruse items. Then my phone starts ringing with robocalls. It’s all very hard to get rid of. Some people want to buy certain medications, and they want it to be discreet.

3. Availability.
You have an urgent need. For example, you have food poisoning, a poison ivy reaction, a UTI infection, or you need your antibiotic right away. The discomfort of these conditions dictates urgent care and will prompt you to use a local pharmacy versus submitting a prescription to Amazon and waiting a day or two. If your physician has to phone in an emergency prescription drug, your local pharmacist can fill it within a couple of hours.

4. Age.
You are not 18 years old. Amazon requires you to be 18 or older to use their pharmacy. 

5. Residence.
You live in Hawaii, Illinois, Kentucky, Louisiana, or Minnesota. Those five states do not permit Amazon Pharmacy as of yet. You’re stuck with the little guys! 😉

6. Computer Access.
You are not tech savvy. Some people do not know how to use a computer or smart phone, and therefore will continue to call their local pharmacy for medications. FYI, local pharmacies will now deliver drugs to your home, just like Amazon does.

7.  Specialty Items.
You need a compounded medication such as a special ointment, pill or cream-based bio-identical hormone. These are just a few examples. There are thousands of medications that Compounding Pharmacies create for people every single day. Amazon Pharmacy isn’t doing any compounding like that and probably never will.

8. Schedule II Drugs
You need a Scheduled II drug such a painkiller, stimulant or sleeping pill. Amazon is not dealing with controlled substances that are Schedule II such as Adderall, Dexedrine, methylphenidate (Ritalin), oxycodone (OxyContin), methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), fentanyl and others. Schedule II drugs are classified as such due to their strong addictive potential and dangerous respiratory side effects. I don’t blame Amazon Pharmacy for steering clear of Schedule IIs. It’s a  big hassle to maintain paperwork, deal with DEA audits,  keep counting logs, and keep them locked up in a safe!  

Getting medications for legitimate mental problems, chronic, severe pain or insomnia is truly a challenge. Many people suffer because they cannot get their medications easily, or their physician has cut them off!  So I find it ironic that if you want a Schedule I drug such as heroin or cocaine, you can simply move to Oregon and get it. That’s because a new law just passed to decriminalize these drugs, such that you can get small amounts of it without too much hassle. Pot is widely available now in many states as well. But if you need pain medications from an auto accident, rheumatoid arthritis, a brain tumor or even chronic Lyme disease, forget about it! 

This interesting metamorphosis has been fascinating to watch over my 30 year career as a pharmacist. In essence, drug addicts or dealers can now present their ID card and be handed their drug of choice within minutes, at least in Oregon, but those of you with intractable pain and disability can’t find a doctor to help you anymore. 

A weird but true fact is that the laws permit one to get cocaine pretty easily in Oregon, but you might get in trouble if you have your family come over for Thanksgiving.  Other states will follow Oregon’s lead in terms of decriminalizing Schedule I narcotics, so if you’re interested, it will all be coming to a local dispensary near you one day. No pharmacist is needed. 

9. Convenience.
There could be problems with a giant like Amazon in terms of you losing or forgetting your medication. This is just me thinking out loud though. Imagine you took your family on vacation to the Florida Keys, and you forgot your blood pressure medication, or your anti-seizure pills.

You could walk into any retail pharmacy in the Keys (or call them) and they could transfer your medication immediately and fill it on the spot. Or another scenario is that the local pharmacy may advance you a 3-day supply until you get home… something could be done, it depends on the medication, and the pharmacist, and the specific state law, but you will almost assuredly be helped. And it will be fairly easy. Remember, local pharmacist wants your business, and appreciates you. 

Pharmacists and technicians want to help you in times of need, and they will immediately take care of a challenging situation such as forgotten or lost pills. Will Amazon? Do you have to wait for your 30 day supply to run out or would they fill an emergency supply for you? Do you have to call Amazon and stay on hold for 3 hours to plead your case with a human? If you’re with Amazon, and they filled your original prescription, you cannot just call your old pharmacy back home and ask for it because your prescription was inactivated once it is transferred to Amazon. If convenience is something you appreciate, especially in times of need, this is a consideration that only a local neighborhood pharmacy can help you with. As more information comes in, I will update this article.