Amazon launched their pharmacy today:
Doubtful I’ll try it right away, my neighborhood pharmacist treats me well and I’d hate to abandon another local small business. Hopefully this will put some serious downward pressure on prices across the board.
Nice
Just at a glance with prime membership their cash price for tresiba is $103 for a box of pens (1500u)
And $114 for fiasp or novolog. Only $61 for humalog! $94 for levemir! $51 for amdelog That’s the best I’ve seen in the USA maybe anywhere. Turns out insulin doesn’t cost near as much as they’ve been telling us after all if we eliminate the PBM…
Now if enough people just start paying cash, which may become feasible with someone like amazon involved, maybe we can finally strangle the pbms out of the system
These prices are lower than a lot of people’s insurance copays I suspect… this has the potential to be a game changer for the USA prescription drug fake price mega-scam
Wow. This is phenomenal. For inside the US. We really need to pass the word.
It’s funny. I was a very strong supporter of Amazon the first few years. But over the past 10 years I never thought the moment would come when I would want to advertise them!
Can you imagine the potential if this really makes it clear how fake “list prices” really are and that it’s all a racket? And finally someone doing it who’s big enough to not just be crushed out of business by PBMs. The potential of this is huge across the rx drug spectrum
I agree and honestly wish it was someone else, but unfortunatly it may take someone with the size and market presence of Amazon as @sam said to not get crushed.
I poked around at Amazon pharmacy and saw this:
" The following categories of drugs and supplies are not available at this time through Amazon Pharmacy:
…
Yeah, thats understandable as how (I believe anyway, no voice of experience here) that most pump supplies don’t come through pharmacy but med equipment suppliers— Who are equally horrible in there own right. But my sense is that there is a trend toward more and more of what used to be considered DME (at least as far as diabetes goes) is trending toward pharmacy benefits… Eg a lot of pharmacy plans are covering cgm and omnipods now…
As far as test strips… 300 test strips are ~$40 for true metrix, which are solidly adequate on Amazon. I suspect a lot of people, (perhaps the majority?) pay more than that as copay with their insurance “benefits”
Yep I bought Contour Next strips on Amazon for a few years until they were no longer sold there.
I hope Amazon Pharmacy can start selling both test strips and CGM supplies.
I still see them there and buy them from Amazon sometimes. They are not always available, but they still have them occasionally.
Currently Walmart has better prices on them.
Yes I switched to WM on my last strip purchase. Now on G6 I bet my strip supply will last 6 or more months. Contour next strips are the one thing I could never convince my insurance to cover, so cash pay was the only option for a long while.
At this point I have blown past my Out of pocket max on insurance so anything I can run through insurance at my pharmacy I am going for it. In January when I start all over again on deductible and OOP copays I will give Amazon a shot for everything and see how they do.
I think one of their advantages is delivery of refills to Amazon lockers while traveling. That could come in handy if travel becomes a safe activity next year.
Here are my prices. I deliberately did NOT add insurance information because I know I’ve met my OOPMax so I pay $0 for anything at present:
FIASP (10ml): $295.20
Lantus (ONE pen): $143.55 (so that is $717.75/box)
This is with my 40% prime savings, so Amazon’s base price is:
FIASP (10ml vial): $492 (exactly)
Lantus (3ml pens, one BOX: 15ml): $1192.25
Anyone can do this: just go to Amazon, create an account, create a pharmacy account (no insurance information remember) and then search for the drugs on the Amazon account (do not transfer your prescription, or, I don’t know, do, but be prepared for a shock on Jan 1.)
Remember: most T1Ds on pumps and/or CGMs have already met their OOPMax, or their deductible if on some lame employee plan, so this is the ideal time for Amazon to launch. We suckers enter our insurance information and get costs which are really small compared to what we paid in January… Gee, I paid $300/month for each item in January and in July I paid $0 - work it out 
Damn… was I assuming the prices were for boxes instead of pens? Possibly—- I only access through the app and I can’t see any more than the headline for each item without a computer…
If so my enthusiasm was unfounded
Mine remains. El Bezos will continue to scam; that’s how he made his money. While I’ve been an Amazon customer for years I paused for 5 years after they proved unable to deliver to my branch of rural America; not enough money here. Nevertheless, while he is certainly out to make money he will do so by cutting the fat from the stomachs of the people currently making it. There is certainly money to be made:
(NOTE: humulin DOES NOT REQUIRE A PRESCRIPTION.) Of course I couldn’t find U100; no money to be made and money can only be made by claims against the insurance companies; I couldn’t find test strips in the pharmacy:
Ok… so I’m saying two things that are apparently contradictory; Amazon entering the marketplace is a joke and Amazon entering the marketplace is a good thing. Bezos embraces the marketplace; perhaps in the future we will describe a marketplace not as Keynsian but as Bezoid. So the US healthcare marketplace will, oops, stop, I did that before. Y’all work it out.
GoodRx reports that the non-insurance price with their coupon for a 10ml vial of Fiasp is $292.82 at Costco and Lucky (a grocery store), and that one Lantus “solostar” pen is $73 at pretty much every pharmacy (not sure if that’s the same kind you saw on Amazon). So either I made a mistake or Amazon’s prices aren’t that good.
“Humulin R … Cash price is $1,581.20”
I am hoping that’s not per vial. I mean, even if it’s allowed, how can anyone with any conscience charge that?
That is a lot of profit considering Walmart sells that vial for $25. Must be a mistake.
The price seems about right, a little inflated maybe. Were I to be prescribed it the cost on my insurance is $3881.07, the vial size is apparently 20ml and my insurance company has just switched to using MedImpact and allowing a 3 month supply (which they calculate as 3x20ml vials). It’s not clear what the quoted cost refers to; it might be one 20ml vial or it might be three. There are a lot of false or misleading statements made on the web about stuff like this, so here is a screenshot of the MedImpact page to prove what I just said:
It is, in fact a “Tier 1” drug, i.e. preferred. U100 Humulin-R is $388.07/10 ml vial, but it is “Tier 3” (non-preferred).
Anyway, it is almost impossible to work out the cost from the insurance company page because the numbers are presented without units; what I was actually paying this year was around $30/ml for U100 regardless of insulin type or delivery method (pen vs vial) and this is consistent with the numbers @ned found.
yeah, me too; what’s up with that? Now I have had to buy my OOP Contour strips from Ebay. I typically pay $200 for 600 strips.
Insofar as I can decode my insurance company’s web site correctly my price is $251 for each 10ml vial of Fiasp. When I refilled two vials at Walmart on November 6 the “cash price” was $653.37, so $326.69 per vial; my guess is that this is the starting point for negotiation with insurance companies.
Nevertheless the math seems incredibly simple; I use 50U/day because I use an Omnipod but I’ve actually injected (bolus+basal) 33.2U/day over the last 30 days. So I use 182.5ml/18 vials of Fiasp per year and I inject 121ml/12 vials.
The 2020 OOPMax set by the ACA is $8,150 but my insurance company, moda, sets a lower limit of $6000 for my (HSA eligible) plan. So if moda dedicates the whole $6000 to insulin the maximum price they can set before they start paying everything is $333 per vial for 18 vials. It would be under $500/vial for 12 vials if I injected (under because of the air shots - I need more than 12 vials to actually inject 12 vials of insulin into myself.)
If moda set the price too high the patient doesn’t pay any more, but moda pays a percentage of the over-pricing back to the pharmacy, the PBM and even a little to the manufacturer. So it is very much in moda’s interest to get the calculations exactly right for the diabetics on the plans which use the same pricing scheme and it is hardly difficult for them to do this since the people on the plan for 2021 will typically have been on a moda plan in 2020.
I think you can see that the price of about $25/ml of insulin is likely as not the number that solves this equation, nothing else; the price is not related to the cost of insulin, just the use, but it doesn’t come out of thin air either.
This math is the insurance companies math; the pharmacies can’t do anything about it. Bezos was probably a little surprised when Amazon first tried, and abandoned, doing a US pharmacy; I think he is used to being able to set the price!
