Amazon looms over drugstores as analysts see market entry

epa06243864 (FILE) - Workers at the Amazon e-trader's new logistics center in Sady, near Poznan, Poland, 24 October 2014 (reissued 04 October 2017). The Euroepan Commission on 04 October 2017 order e-commerce giant Amazon to repay 250 million euro in back taxes as it amazon was givent an unfair tax deal in Luxembourg.  EPA-EFE/Jakub Kaczmarczyk POLAND OUT

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Amazon.com Inc. is almost certain to enter the business of selling prescription drugs by 2019, said two analysts at Leerink Partners, posing a direct threat to the US’s biggest brick-and-mortar drugstore chains.
“It’s a matter of when, not if,” Leerink Partners analyst David Larsen said in a report to clients. “We expect an announcement within the next 1-2 years.”
Amazon has a long standing interest in prescription drugs, an industry with multiple middlemen, long supply chains and opaque pricing. In the 1990s, it invested in startup Drugstore.com and Amazon Chief Executive Officer Jeff Bezos sat on the board. Walgreens eventually purchased the site and shuttered it last year to focus on its own branded website Walgreens.com.
Leerink’s calls with industry experts suggest that Amazon “is in active discussions” with mid-size pharmacy benefit managers and possibly larger player such as Prime Therapeutics, Larsen’s colleague, Ana Gupte, wrote in a report.
Representatives for Amazon didn’t respond to a request for comment. CNBC reported that Amazon could make a decision about selling prescription drugs online before Thanksgiving. The news network didn’t name its sources.
If the online retail giant does enter the pharmacy market, it would pose “an immediate near-term threat” to retail pharmacy chains such as CVS Health Corp. and Walgreens Boots Alliance Inc., Gupte said. Walgreens shares closed down 4.9 percent to $73.20 in New York, and CVS shares also declined 4.9 percent to $76.92.
CVS declined to comment, and referred to remarks made by its chief executive officer, Larry Merlo, on an earnings conference called on August 8. The pharmacy business has “many barriers to entry,” Merlo said at the time. Walgreens declined to comment. Amazon could quickly grow in prescription drug sales and distribution, especially if it bought a mid-sized drug benefit manager and used it to create a more transparent pricing model, said Linda Cahn, a consultant at Pharmacy Benefit Consultants in Morristown, New Jersey.
Pharmacy benefit managers, or PBMs, administer drug benefits for employers and health plans, processing the prescriptions pharmacies dispense. Currently, final prices for many drugs are negotiated in secret deals between drugmakers and PBMs. “Amazon could bring transparency into a marketplace that is entirely lacking,” said Cahn. “They are disruptive instantly if they do it differently.” Cahn is a critic of PBMs’ business models. The three biggest drug benefit managers—CVS, Express Scripts and OptumRx, a unit of insurer UnitedHealth Group Inc.—process about 70 percent of the nation’s prescriptions, according to Pembroke Consulting.

Potential Partners
Express Scripts shares declined 2.6 percent to $62.36. The drug benefit manager declined to comment. In an earnings call this summer, Express Scripts CEO Timothy Wentworth said he would be interested in partnering with Amazon, should it decide to enter the pharmacy space. One possible partner for Amazon is MedImpact Healthcare Systems Inc., a privately held PBM, Larsen said. MedImpact didn’t respond to a request for comment. Prime Therapeutics, which manages drug benefits for nonprofit Blue Cross and Blue Shield plans in a number of states, is another.
“We are unable to confirm any conversations that may or may not have occurred,” said Karen Lyons, a spokeswoman for Prime Therapeutics. Last November, Amazon began a partnership with Seattle-based pharmacy Bartell Drugs to deliver over-the-counter drugs from its stores to shoppers through Amazon’s delivery service Prime Now.
Rumblings about Amazon’s entry into the drug market have been brewing for months.

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