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  1. #1
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    [EN] Amazon looking to make a move into selling drugs online

    Munsif Vengattil
    October 6, 2017

    Shares of drug retailers Walgreens Boots Alliance Inc, CVS Health Corp and Rite Aid Corp tumbled on Friday after reports that Amazon.com Inc was looking to make a move into selling drugs online.

    Amazon is reported to be in discussions with mid-market pharmacy benefit managers and has been hiring talent to assess the drug retailing market for its entry, brokerage firm Leerink analyst Ana Gupte wrote in a note to clients.

    “We are convinced that AMZN will almost certainly enter the drug distribution value chain within 2 years, evolving into a more disruptive offering over time,” Gupte said.

    Amazon’s entry into pharmaceuticals has been long rumored in the media.

    On Friday, CNBC reported that the e-commerce giant would decide before Thanksgiving whether to move into selling prescription drugs online, citing a company email and a source familiar with the matter.

    Amazon does not comment on rumors or speculation, a company spokeswoman said.

    Shares of drug retailers Walgreens closed down 6 percent, Rite Aid 5 percent and CVS Health 5 percent.

    http://www.reuters.com/article/amazo...-idUSL4N1MH3AJ

  2. #2
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    Amazon Pharmacy Could Make Walgreens, CVS Sick

    Leerink analyst Ana Gupte is convinced that Amazon.com will enter the prescription drug distribution chain within two years, a move that poses the biggest threat to Walgreens Alliance Boots, CVS and retail giant Wal-Mart Stores.

    Johanna Bennett
    Oct. 6, 2017

    The debate over whether Amazon.com will get into the prescription drug distribution business is heating up again.

    Citing recent calls with MEDACorp PBM and retail pharmacy specialists, Leerink’s Ana Gupte says she is convinced that e-commerce giant will enter the “drug distribution value chain” within two years, stating that the company is “hiring relevant talent and are in active discussions with mid-market PBMs and possibly even with large players such as Prime Therapeutics.”

    ...Our calls suggest Amazon. While the exact aspiration and glide path to entry are as yet not clear, it is believed that Amazon will start by capturing share in both the cash paying and third party mail order and possibly Specialty Pharmacy segments, through a low intensity buy and partner strategy with mid-market PBMs. Eventually, AMZN is expected to evolve to a full service PBM and "Bricks & Clicks" Retail Rx player that will disrupt the drug value chain.


    Gupte goes into more detail:

    ... AMZN is a meaningful competitive threat to existing players in the drug value chain with its best-in-class mail order fulfillment platform and easy-to-use one stop shopping Retail Pharmacy experience. It can exercise the option to offer discount cards tied to consumer HSA/FSA accounts and linked to saved credit card information. Only 15% of pharmaceutical spend is tied to branded drug rebates, with the remaining 85% generic script fills benefiting from AMZN's purchasing power through its brand loyal consumer base and likely enhanced by a drug distribution consortium/alliance. AMZN is expected to quickly drive up the penetration of mail order from retail, given only one-third of scripts filled are driven by acute conditions, with the remaining two-thirds related to maintenance chronic disease management. AMZN is expected to be able to secure licenses in fairly short order with a hub and spoke central order fulfillment experience with regional centers and licenses only required in key centers encompassing the Mid-West, TX and the West

    The specialists see AMZN as being able to quickly bring in the ability to adjudicate third party pharmacy benefits claims through either purchase of a mid-market PBM or a series of non-exclusive JVs with PBMs. The entry is poised to be a meaningful competitive threat to standalone PBMs including ESRX, or CVS with Retail Pharmacy & PBM, ranging from margin erosion to full-on business model disruption. Eventually, AMZN is expected to evolve its presence to a more price transparent, one stop shopping online Pharmacy Retail platform, though AMZN could choose to buy ESRX and CVS as a much lower probability strategic path to entry. AMZN could also choose to disrupt the business model through purchase of a player such as Change Healthcare for its online claims adjudication and a player such as Avella for Specialty Pharmacy.


    The move is most threatening to Walgreens Boots Alliance, CVS and Wal-Mart Stores, each of which operates a major pharmacy chain in the U.S., says Gupte.

    Meanwhile, she sees both a threat and an opportunity ahead for the pharmacy benefit manager Express Scripts, while UnitedHealth and Humana are largely protected by their own internally run PBMs.

    What about Anthem, Aetna and Cigna? Gupte says the insurers are likely "to contemplate Amazon's entry in their upcoming PBM contract decisions, with ANTM expected to announce on Oct. 25 and likely to trigger a domino effect of strategic industry contract and purchase decisions."

    http://www.barrons.com/articles/amaz...ick-1507309531

  3. #3
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    Amazon's push into pharmacy is very much an "if" and not a "when," sources say

    The drug supply chain is particularly complex, with regulatory hurdles and entrenched competition.

    Christina Farr
    2017-10-06


    Amazon is in the final stages of figuring out its strategy to get into the multibillion-dollar prescription drug market.

    The company will decide before Thanksgiving whether to move into selling prescription drugs online, according to an email from Amazon viewed by CNBC and a source familiar with the situation. If it decides to make that move, it will start expanding its senior team with drug supply chain experts.

    Amazon typically spends years researching opportunities before it telegraphs its intentions. The opportunity to sell drugs online is alluring given its market size -- analysts have estimated the U.S. prescription drug market at $560 billion per year. Amazon is well aware of the complexities, say sources familiar with the company's thinking.

    Amazon declined to comment.

    In the past year, Amazon has ramped up its hiring and consulted with dozens of people about a potential move into the pharmacy market. The consumables team, which includes groceries, kicked off the research, with the division's vice president, Eric French, taking the lead.

    It brought on Mark Lyons from Premera Blue Cross to build an internal pharmacy benefits manager for its own employees, say multiple people familiar. According to one of the people, it's possible that the push into the broader drug supply chain hinges on its success with this effort.

    In May, the company kicked off its search for a general manager to lead its pharmacy push, externally dubbed "healthcare."

    Analyst firm Leerink has separately reported that Amazon will get into the pharmacy management space and expects an announcement within the next year or two.

    Goldman Sachs published a report on the topic in August of this year, speculating that Amazon will ultimately look to improve price transparency for consumers and reduce out-of-pocket costs.

    Amazon already has a business selling medical supplies online, such as gauze and thermometers. It also has a health team called 1492, which is focused on both hardware and software projects, like developing health applications for the Echo and Dash Wand. Its cloud service, Amazon Web Services, continues to dominate the health and life sciences market.

    Why wouldn't Amazon go into pharmaceuticals? [video] https://www.cnbc.com/2017/10/06/amaz...ming-soon.html

  4. #4
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    Amazon’s getting into the pharmacy business is a ‘matter of when, not if’

    Drugstore operators face the biggest threat for now, but pharmacy-benefit managers and drug distributors could eventually be at risk, too.

    The easiest initial target for Amazon would likely be generic medications, which are lower-cost than so-called specialty medications and make up a majority of prescriptions.


    Emma Court
    Oct 6, 2017

    Whether online retailer Amazon plans to enter the pharmacy-services space has been the subject of speculation for months, and Leerink analyst David Larsen is now going public with his position on the will-it-or-won’t-it question.

    “It’s a matter of when, not if,” Larsen said, adding that he expects an announcement in the next year or two. “While AMZN is likely still researching what its ultimate strategy should look like, with [approximately 75 million] Amazon Prime lives, seemingly unlimited resources, and highly advanced technology capabilities, we believe [Amazon] can create disruption to the existing market.”

    As such, Larsen said he’s more cautious about pharmacy-benefit managers and retail pharmacies, both major players in the pharmaceutical supply chain.

    Pharmacy retailers such as Walgreens Boots Alliance and RiteAid Corp. face the biggest threat for now, he said, while companies like CVS Health Corp. may be able to leverage pharmacy-benefit-manager services to reduce risk.

    CNBC reported later Friday that an Amazon entry is “very much an ‘if’ and not a ‘when,’” adding that the company will decide by Thanksgiving whether to move into the industry.

    Express Scripts Holding Co., the largest stand-alone pharmacy-benefit manager, may be willing to partner with Amazon since it “has been facing deteriorating mail volumes for years and [Amazon’s] technology in our view could be the strategy needed to improve performance,” Larsen said. So might Walgreens, he said, through some kind of retail partnership.

    Drug distributors like McKesson Corp., AmerisourceBergen Corp. and Cardinal Health Inc. are likely to have less exposure in the near term, according to Larsen.

    The easiest initial target for Amazon would likely be generic medications, which are lower-cost than so-called specialty medications and make up a majority of prescriptions, Larsen said.

    An estimated 5% to 10% of U.S. individuals pay cash for their prescriptions, he said, and Amazon could potentially offer a drug discount program to those customers.

    There also might be an avenue into specialty pharmacy through an acquisition, Larsen said, based on conversations with specialists from consulting services firm MEDACorp.

    Amazon’s acquisition of Whole Foods in June sparked investor concerns that the store’s physical presence would provide Amazon an opening into the pharmacy category.

    But Larsen’s analysis suggested that Amazon’s mail capacity and online services constitute a greater advantage, though he did note that the company could open pharmacies inside Whole Foods stores.

    “We’re surprised to learn that it would take just [one or two] years to build a [pharmacy-benefits manager],” Larsen said. “There is significant mail capacity and there are claims platforms available that [Amazon] could use.”

    Further, “we do not believe that Amazon has to win a massive amount of [market] share to keep pressure on the pharmacy supply chain,” Larsen said, “rather ongoing reimbursement competition and discussions on drug pricing may be enough to keep pressure on the group.”

    Not all of Wall Street is sold, though. Mizuho analyst Ann Hynes has long maintained she doesn’t see any sign that Amazon has plans to get into pharmacy services.

    The company doesn’t appear to have posted any pharmacy-related jobs, and it hasn’t mentioned the industry on any of its earnings calls over the last decade, according to Hynes.

    The Health Care Select Sector exchange-traded fund has risen 5.3% over the past three months, as compared with a 5.6% rise in the S&P 500.

    http://www.marketwatch.com/story/ama...-if-2017-10-06





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  5. #5
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    Donald J. Trump‏ @realDonaldTrump Aug 16

    Amazon is doing great damage to tax paying retailers. Towns, cities and states throughout the U.S. are being hurt - many jobs being lost!




  6. #6
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    Amazon talking to pharmacy benefit managers

    Bob Herman
    Sep 20, 2017

    Amazon may be talking with some middle-market pharmacy benefit managers "in an effort to get into various contract arrangements," according to analysts at investment bank Leerink Partners who spoke with pharmacy executives. Amazon may pursue a mail-order pharmacy that initially targets uninsured customers or people who have high deductibles and pay cash for most of their prescription drugs.

    Reality check: The country is still a long way from Amazon handling people's prescriptions, if that time even comes. But conversations with prescription drug middlemen make it appear "that this is the direction Amazon is moving in," Leerink said in a report. Pharmacy executives who spoke with Leerink said it would take at least 18 to 24 months for Amazon to get proper drug licenses in 50 states.

    https://www.axios.com/amazon-talking...487579501.html


    Amazon eyes mail-order drug business

    Brigid Sweeney
    September 20, 2017

    Apparently overtaking the grocery industry isn't enough. Three months after agreeing to buy Whole Foods for $13.4 billion, Amazon is in talks with pharmacy benefit managers, according to a note published by the investment bank Leerink Partners. The move indicates the retail behemoth may be preparing to enter the mail-order drug business.

    Pharmacy benefit managers, or PBMs, are the powerful middlemen who control the flow of prescriptions to retailers like Walgreens and CVS. PBMs negotiate prices with pharmacies and drugmakers on behalf of corporate clients and pay their prescription drug claims.

    Walgreens Boots Alliance has a tumultuous history with these third-party players. It actually created its own PBM, Walgreens Health Initiatives, in 1995, but the business never achieved the heft necessary to negotiate good deals for its customers. The Deerfield-based drug chain sold it for $525 million in 2011 to Catalyst Health Solutions, which is today part of UnitedHealth Group's OptumRx, a large PBM.

    More recently, former Walgreens CEO Greg Wasson gained notoriety by picking a fight with St. Louis-based Express Scripts, the biggest PBM of all. His seven-month battle over reimbursement rates in 2011 and 2012 forced millions of Walgreens customers to fill their prescriptions elsewhere. It remains unclear how many of those customers returned to Walgreens after the drug chain and Express Scripts forged a new deal, though analysts agree the fight cost Walgreens millions of dollars.

    At the same time, archrival CVS was growing its own PBM, Caremark, into one of the biggest in the country. After Walgreens completed its union with Alliance Boots at the end of 2014, new CEO Stefano Pessina tried to fix the disadvantage created by lacking an in-house benefits manager. He began cutting deals with other PBMs, including Optum, the military's Tricare program and Prime Therapeutics, another huge PBM that works with 14 Blue Cross & Blue Shield plans.

    Amazon's conversations with some middle-market PBMs indicate the company is headed in the direction of handling prescriptions, according to a note from Leerink analysts, who spoke to pharmacy executives. The report said it would take at least 18 to 24 months for Amazon to receive drug licenses in every state.

    http://www.chicagobusiness.com/artic...-drug-business

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