Tag Archives: PBM

Will Amazon Pharmacy transform the pharmacy industry?

Amazon Pharmacy, the tech giant’s latest venture into healthcare, launched a mail-order pharmacy in November 2020. The venture provides mail prescription delivery for all patients, as well as the additional benefits of two-day prescription delivery and discounted medication prices for Amazon Prime members through the Prime Rx program. Patients can have providers send prescriptions directly to Amazon or Amazon can contact the provider on the patient’s behalf. Amazon Pharmacy complements Amazon PillPack, which sorts medications into small, individual packages based on the date and time of day they are to be taken. 

Effectively, Amazon is joining the existing pharmacy supply chain. Amazon Pharmacy works with pharmacy benefit managers to ensure its mail-order pharmacy service is included in pharmacy networks when prescriptions are filled with insurance. When insurance is not used, Amazon offers Prime members discounted pricing through its mail-order pharmacy or at participating retail locations. 

In this paper, Milliman professionals discuss whether Amazon Pharmacy will disrupt, conform, or lay the groundwork for future transformation in the pharmacy industry. 

How will HHS and CMS rules impact Medicare drug pricing?

A final rule by the U.S. Department of Health and Human Services (HHS) and an interim final rule by the Centers for Medicare and Medicaid Services (CMS) that focus on drug costs in Medicare Part B and Part D were recently published.  

While the rules were released as final and interim final, respectively, the road ahead is uncertain. It appears likely the rules will face legal challenges prior to or after the effective dates of their provisions. It is difficult to predict whether the policies finalized in these rules will reduce the total cost of drugs for the government and Medicare beneficiaries as intended. 

Milliman professionals explore the two rules and explain their implications for Medicare drug pricing in this article