This article was updated January 14, 2020.

Independent pharmacists are expressing concern over a growing practice involving Amazon’s Pillpack, describing what some believe is the company sending unsolicited phone calls to their patients as a way of requesting transfers of prescriptions. 

Dana Gordon, PharmD, who has owned and operated Central Avenue Pharmacy in Pacific Grove, CA, for more than 30 years, explained in an interview with Pharmacy Times that 3 patients living in 2 separate assisted/independent living facilities have received phone calls from the Amazon affiliate.

“One of the patients, according to the pharmacist that received the call, actually thought it was us calling them. So, they were confused and were calling to follow-up [with us], because we’re their pharmacy and we didn’t know,” said Gordon, whose Central Avenue Pharmacy is responsible for retail compounding in independent/assisted living skilled nursing facilities and which provides for 3 hospices on the central coast.

Claims surrounding this alleged practice began almost immediately after Amazon bought Pillpack, according to a report by CNBC.1 The $753 million acquisition occurred last year, with the online pharmacy promoting simplicity and seamlessness for patients taking multiple medications. Although the prescription transfer request is a standard process for the company,2 Pillpack’s competition, including independent pharmacies and larger corporations, such as CVS and Walgreens, are wary.

“We've had approximately 3 to 5 customers who experienced this about 8 to 12 months ago. Each customer said that they received a call from some company asking them about their medications,” explained Daniel Griffis, PharmD, pharmacy manager at Rainbow Drug Store in Brunswick, GA. “They each seemed to think it was a call from the insurance company going over their medications. None of the customers realized that they were transferring their medications to another pharmacy.”

Patients who take multiple medications comprise a large portion of a lucrative market because pharmacies are typically paid a fee or markup on each prescription, according to the New Hampshire Union Leader.2 An estimated 23.1% of the US population, more than 70 million people, takes 3 or more prescription drugs per month and 11.9% take 5 or more drugs each month, the report noted.

To move patients to its mail-delivery service, however, Pillpack needs for patients to switch from their existing pharmacy, which often means transferring prescriptions. PillPack spokeswoman Jacquelyn Miller told Pharmacy Times that the company only requests prescription transfers with the customer’s explicit and documented consent.

“With all pharmacies, if a customer wants to fill a prescription at a new pharmacy[,] they must provide specific information to the new pharmacy (eg their own demographic info, including birthdate; the name of the medication; the dosage of the medication; the prescribing doctor; and the pharmacy where they previously got the medication). The new pharmacy then calls or faxes the old pharmacy and requests a transfer of the prescription. This is what Pillpack does,” Miller said.

She added that Pillpack explicitly asks customers for their permission to transfer their medications prior to doing so, either on the phone or as part of the digital sign up flow.

Although Pillpack has expressed frustration at increasing pushback from companies such as CVS and Walgreens,2 independent pharmacies, such as Rainbow Pharmacy, expressed concerns regarding patient privacy.

“For each customer, we received a fax from PillPack requesting the transfer of the patient’s medication to them,” Griffis said. “When we contacted the patients, they all said that they didn't request the transfer and didn't want to change pharmacies. It seemed that these requests came in all at once and then suddenly stopped. Very strange.”

For larger companies, such as CVS and Walgreens, the battle with PillPack is not new. In the interview with CNBC, CVS said that it is not indiscriminately rejecting transfer offers but is calling patients when a request is submitted to make sure the customer has asked for it,1 similarly to the path that independent pharmacists have taken.

“When we contacted each patient about the transfer, the patients stated that they didn't want to change nor authorize the change, so we just ignored the transfer request,” Griffis said.

To PillPack, the situation serves as an added stress to patients who may want to switch pharmacies. Miller said in an interview with CNBC that the whole process is also driving down competition by creating systemic barriers that make it harder for a customer to switch pharmacies.1

Miller told Pharmacy Times that, although the company cannot respond to third-hand accounts and allegations, they would encourage patients who voiced these concerns to contact PillPack so that a representative can look into the matter and clear up any confusion.

However, independent pharmacists interviewed by Pharmacy Times said that a patient switching to a new service is less of a concern than maintaining their privacy.

“I imagine that [PillPack is] big enough that they can basically solicit everyone, but my concern was more of a privacy standpoint. How did they know where [the patients] were getting their medicine?” Gordon said in an interview with Pharmacy Times. “I could understand third parties like Express Scripts doing it, because [a patient may be] in their database and they see a prescription being filled, but the Amazon part was alarming. How did they know? Unless the information came from another source.”

National Community Pharmacy Association President, Brian Caswell, RPh, said that he had similar privacy concerns when he received unsolicited transfer requests at his pharmacy in Baxter Springs, KS.

“[I]n my professional opinion, it’s sad when a pharmacy has to go through tactics of not explaining to patients what they’re in for, just to gain prescriptions,” Caswell told Pharmacy Times. “I know PillPack has been out there for a while, they’ve been trying to grow their business. But it needs to be through a really legitimate means.”

According to the company website, Pillpack consolidates a patient’s medication list through a “personalized roll of pre-sorted medications, along with a convenient dispenser and any other medications that cannot be placed into packets, like liquids and inhalers.” The company then uses PharmacyOS, an in-house software platform, to coordinate refill renewals and it enables real-time notifications.3

“Customers should choose a pharmacy where they are happy and well supported in their needs, and we always encourage people to do so [—] whether that means PillPack or another pharmacy,” concluded Miller in her interview with Pharmacy Times.

References
  1. Amazon’s PillPack is battling with CVS and Walgreens over getting patient prescriptions. CNBC website. Published August 6, 2019. https://www.cnbc.com/2019/08/06/amazons-pillpack-expansion-faces-resistance-from-cvs-and-walgreens.html. Accessed December 11, 2019.
  2. Langreth, Robert. Amazons Battles for Corner Pharmacy Through PillPack. New Hampshire Union Leader. Published September 16, 2019. https://www.unionleader.com/news/business/amazon-battles-for-corner-pharmacy-through-pillpack/article_18e39364-2111-54af-b080-3b5764054b13.html. Accessed December 11, 2019.
  3. Press. PillPack website. https://www.pillpack.com/press. Accessed December 11, 2019.
  4. Rainbow Drug Store. http://www.rainbowrx.com/AboutUs.asp. Accessed December 11, 2019.