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Oct 15 2018

Amazon bought PillPack and CVS merged with AETNA – What’s Next in the Changing Pharmacy Landscape?

Pharmacy-related issues have been very much in the headlines, with analysts full of predictions about how the latest news will affect the industry, Wall Street, consumers, and pretty much everything-and-everyone in between.  A cursory look though, at recent pharmacy-and-pharmaceutical headlines, reveals a consistent trend in favor of patient-centered, technology-based changes.

Among the most recent news:

June 2018:  Internet behemoth Amazon.com announces plans to purchase PillPack online pharmacy for roughly $1 billion, a move described by as “the strongest indication yet of Amazon’s intent to push further into the health-care industry.”  According to PillPack’s website, the company is “a full-service pharmacy that sorts your medication by the dose and delivers to your door.”  PillPack provides refill management services and is licensed in every state except Hawaii.

      September 2018:  The Wall Street Journal “breaks” the news that federal investigators are examining whether certain services offered by U.S. drug manufacturers to physicians and patients are actually kickbacks, intended to increase sales of their products.  Several drug companies are reportedly under investigation for services including patient education, device training, assistance in completing reimbursement forms, and the possibility that donations to third-party charities were intended to help pay drug copays for Medicare patients.  Drug manufacturers targeted by the investigation, the Journal notes, claim their services are intended to help doctors and patients. 

According to coverage by The New York Post, while “the existence of the individual probes into each company had been known for months as they were revealed in regulatory filings,” the Wall Street Journal was able to piece together the big picture, and determine the purpose of the overall investigation.

September 2018:  The U.S. Justice Department approves the proposed merger between Cigna health insurer and Express Scripts pharmacy benefits manager, a transaction worth a reported $52 billion.  As reported by The New York Times, the deal “represents a recognition by established companies that they need to change their business model in response to customer demands that prices are better controlled." The Times further noted that since CIGNA and Express Scripts both serve as middlemen for employers and governments, the merger is “an attempt to convince their customers that they are working to reduce costs.”

October 2018:  Merger-mania continues as the Justice Department green lights the $69 billion merger between CVS Health and Aetna, on the condition that Aetna sell off its private Medicare Part D drug business.  As reported by Reuters, the two companies claim the merger will allow them to better-coordinate patient care and control costs.  Among other things, “Aetna customers could be steered to walk-in clinics in CVS stores for less expensive medical services,” and “CVS could offer more preventative care services and screenings in its clinics, such as enabling patients with diabetes to monitor blood sugar levels, avoiding higher cost visits to doctors or emergency rooms.

·     October 2018:  The U.S. Health and Human Services Administration announced a proposal to require drug manufacturers to disclose the list price of medicines in their television advertisements.  According to USAToday, the requirement would apply to brand-name drugs that are covered by Medicare and Medicaid, if a typical course of treatment costs more than $35 per month. 

“Patients deserve to know what a given drug could cost when they’re being told about the benefits and risks it may have,” HHS Secretary Alex Azar said in announcing the proposal.  “They deserve to know if the drug company has pushed their process to abusive levels, and they deserve to know this every time they see a drug advertised on TV.” 

The HHS announcement was met with concern from the drug industry’s main trade association, the Pharmaceutical Research and Manufacturers Association (PhRMA) which, USAToday noted, said it was willing to reveal drug prices on websites, but not in commercials.  “Listing prices in commercials, it said, could discourage patients from seeking needed medical care.”

Clearly it’s a time of transition within the pharmaceutical and pharmacy industries.  And now that Amazon has made a move into the patient-care business, all bets are off with regard to what the “next big thing” will be.  But if recent history is any guide, it’s a safe bet that patients will benefit from increased levels of service, convenience and transparency.