Amazon Rx: a cure for supply chain kickbacks or just another poison pill?

Amazon is throwing its hat into the pharmacy business and Bob Campbell, MD of Physicians Against Drug Shortages weighs in on what this could mean:

The Amazon folks do not show their cards. When this began it was called the 1492 Project before it was reported by the press. I have asked them directly are you trying to undercut the GPO/PBM supply chain or do you just want to get in on the kickbacks? They didn’t say then and they don’t say now.

Some insights…they hired a ton of people from the GPO industry presumably to understand the supply chain dynamics.

Their initial focus was the hospital supply chain but they subsequently backed down from that publicly due to the “special relationships” of GPO and Hospital entities. Now their focus is the outpatient pharmaceuticals.

I have maintained that Amazon is the only non governmental entity with the scale and resources to create a parallel competitive marketplace as an alternative to the normal anticompetitive market. Still they will never dominate only survive and carve out a niche. The easier more lucrative approach would be to collect kickbacks. Amazon is different enough they may do the right thing. The Bezos model is your margin is our opportunity. The 43% Kickback rate in outpatient Pharma plus the usual participant margins makes for a fat gross margin to target.

Until Amazon says what they are really up to we can only speculate.

Do You Really Want A Unique Patient ID?

The House just passed a bill that eliminates the prohibition on the use of federal funding to assign all Americans a unique medical identifier. Former Congressman Ron Paul, M.D., got that prohibition enacted in 1998.

            The identifier is supposed to improve “efficiency”—of what? Government surveillance of all Americans? The agenda of government-favored special interests, who might want to silence persons with political views they don’t like? Persons who might see you as a threat to their success in business, academia, or other ventures?

            What might be in your record? A prescription for Valium or other drug prescribed during a distressing life crisis? This could be a psychiatric “red flag” causing denial of your gun rights. A diagnosis of a sexually transmitted disease? An admission that you had a temper tantrum or used an illegal drug at a party? Could this derail a job application or cause you to lose child custody or foreclose a political career?

            Can you be honest with your doctor if anything in the record might someday be used against you?

            “Make no mistake. The [patient identifier] would be the end of privacy and the foundation of a national health data system,” warns Twila Brase, president of the Citizens’ Council for Health Freedom and author of Big Brother in the Exam Room.

            The damaging information in the record might not even be yours. A hurried data-entry person might have clicked the wrong item on a drop-down menu or even cut-and-pasted something from another patient’s electronic health record.

            The prohibition on funding for the unique identifier needs to be restored, states the Association of American Physicians and Surgeons (AAPS).

Further information:

       

Insurance Networks are a Bug, Not a Feature: Practicing Physicians Ask Senate HELP Committee to Protect Patient and Physician Choice

The Senate HELP Committee, led by Chairman Lamar Alexander and Ranking Member Patty Murray, have asked for feedback on the draft of an ambitious “Lower Healthcare Costs Act of 2019.”

Tuesday, June 4, Practicing Physicians of America (PPA) will present, in Washington DC, a memo co-authored by PPA co-founder Marion Mass, MD and Vice President for Health Policy Craig M. Wax, DO.

The memo begins:

Writing on behalf of Practicing Physicians of America (PPA), we are grateful for and commend the HELP Committee’s efforts to introduce legislation aimed at reducing the varied costs of healthcare services and insurance by increasing the transparency of pricing across this sector of the economy.

It is our position that allowing market competition, with its attendant disciplines and efficiencies, can become the self-sustaining model for the delivery of medical services in the United States. Therefore, with the Lower Healthcare Costs Act of 2019 now under discussion, we offer comments and recommendations beginning on the next page.

Read the full memo at: https://ip4pi.files.wordpress.com/2019/06/ppasenatelhca060319.pdf

Or click on the image below: