I’ve been a PillPack customer for years and love the service.
If you take multiple medicines, and/or have a complex medication schedule, it’s super convenient. It self audits whether you took your meds already and avoids spending a lot of time sorting pills into organizers.
It’s also really convenient for travel; just tear off the packets for the time you’ll be away.
Even the stingy insurances in two European countries I checked tend to pay for a service it if you're taking 3+ medicines, suggesting that it's cheaper in the long term for them, either by reducing cost from waste, cost from classic pharmacies, or by improving outcomes in ways that result in less treatment (or the company running it managed to convince the regulator to make it covered by mandatory insurance because it's beneficial for patients).
When I was taking several different medications, I started seeing why this service would be useful, even as a relatively organized, non-impaired person.
Mind sharing the countries? Because it's only now after moving to certain 1 country that I see the "pill counting" and "translating scripts into layman terms" as parts of a pharmacist's job.
To me it was an absolutely American thing from the movies: I've always had the posology written by doctors already in layman terms, and nobody counts pills, you just get the number of boxes needed for the period of treatment (e.g. now for a treatment for which I need 38.5 pills I got exactly 38.5, in all other EU countries I've lived in I'd get 1x40/2x20/4x10 boxes).
Pillpack has been around for a long time, Amazon acquired them and launched Amazon Pharmacy, which delivers medications in traditional bottles - but kept the old Pillpack format around - which is a cellophane pack that is like a single use plastic sachet.
My guess is that the liability increase for mispacking the pills outweighs any incremental mail-order pill sales CVS generated with the program. With Amazon starting their program up, the ability to entice new customers is probably worth the risk to them.
Oh, there's no licensing fee to Amazon -- PillPack is just using off the shelf medication pouch packaging systems, albeit at larger scale than most pharmacies.
In the UK don't pharamcies do this sort of thing for you.
My mother's pills wer organised by day and time of day 15 years ago.
ALso comments about how it saves wasted pills don't make sense for me. The doctor prescribes x pills for the course of treatment. So the pharmasist gives you x pills.
Yes for ibuprofen and other drugs you take as needed then you will have some left over as typically you have a headache and take one dose.
> In the UK don't pharamcies do this sort of thing for you.
Yep, they do
> Also comments about how it saves wasted pills don't make sense for me
People don't follow instructions sometimes, and doctors overprescribe for the instructions they give you. My doctor wrote me a prescription for something a long time ago and warned me about the risk of addiction. They said I should stick to a dose, but prescribed me a larger amount because I could take more _if I needed it_ for a day or two. The pharmacist filled the prescription for about 3x what I should have been given without blinking an eye.
It sounds like the doctor trusted you but I don't think you sound happy about it.
There are costs involved in appointments and filling prescriptions and you being trusted with an excess gives the system some flexibility that might avoid an extra appointment or visit to pharmacy.
UK pharmacists are able to to do blister packs but this is a hugely labour intensive endeavour. Specific quantities of each medication need to be dispensed, placed in the correct pocket, checked and double checked. Compared to dispensing a factory sealed box of $X units. As a manual process it does not scale to providing this service for more than a small percentage of patients where the benefit is greatest (memory impairment, etc).
Also in my experience pharmacists dislike having to do this laborious process.
You'll be amazed how many pharmacies in the UK are unable to take 4 boxes from a shelf and put them in a bag without screwing up.
I have a friend who has had to change pharmacies multiple times due to unreliability and incompetence.
> Local pharmacies just apply a markup to get their profit.
You'd think so, but not on medication. Most of them at least.
Looking into it recently since the business fascinates me, independent pharmacies operate more like gas stations selling gas as a loss leader, making it up on convenience items.
Many drugs don't even get reimbursed at break even by PBMs these days.
Within a decade not a single independent will exist.
Local pharmacies absolutely want to work with you on stuff like this, many have for decades already. Like many industries, they are being squeezed out as some Ivy MBA decides they want every ounce and then some of that consumer surplus. This is done on purpose to push patients to the vertically integrated options like CVS Caremark.
They cannot compete in an environment where consumers will walk over a $3 difference, and they get squeezed by PBMs on the other side.
Anyone fulfilling via Amazon is playing with fire in my opinion. It's gonna work until you eventually get hit by the shortages that are only likely to increase. The ability to talk to a human is going to become extremely important, and likely only available to the very wealthy at this point.
Amazon is less taking advantage of scale, and more that of regulatory capture in my mind. The big innovation is being big enough the other monopoly players can't just totally dictate terms.
The mom and pop pharmacies by me keep inconvenient hours. The national chains like CVS are atrocious (long lines, terrible customer service). Switching to getting my pills delivered from Amazon took literally minutes and I haven’t had a single issue. I’m never going back to CVS!
Elderly people have a hard time dosing multiple to many medications, and some meds with narrow therapeutic-OD ranges need extra attention to avoid deadly mistakes.
Really annoying when these websites/services do not state clearly that they are operating only in US. Am I just suppose to guess it by the fact that phone number validation is US one?
Sweden's state-owned pharmacy has more or less the exact same service, so I don't think you can make such a broad claim: https://www.apoteket.se/doskund/
I find that day-based medication organizers don't work when I have a non-24-hour sleep schedule. I ended up writing down dates and times of doses on a paper notebook, because pill planner apps aren't built for non-24 schedules either, the one I found on F-Droid didn't record times which are useful for optimally spacing medication, and I kept forgetting to either take or record medications in my locked phone.
I assume they mean because a service like this is tied to specific time of day rather than an activity.
e.g. you might take some pills right after you wake up and some pills right before you go to bed.
If you wake up every day at 7am and go to sleep at 11pm then that's easy, but if your schedule is constantly fluctuating (go to bed at 8am and waking up at 3pm) I can imagine how it might become confusing.
My company changed FSA card providers and PillPack wouldn't let me use my FSA card moving forward because they kept trying to put a $1 preauth on it which my FSA card vendor kept rejecting. Pillpack's response was "lol, too bad" and I ended up having to go back to traditional pharmacy services.
From there I ended up moving onwards to try using medication dispensers to help me keep track of my medications -- finding Hero Health, using that happily for a couple years, until they decided to raise the service price from $30 to $50 a month for just the dispenser alone.
Now I use a multi-partition vitamin cup with custom-printed labels (giant quantity indication, photo of each pill, markings/imprints, and name/dosage) and just manually dispense each pill and twist.
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If you take multiple medicines, and/or have a complex medication schedule, it’s super convenient. It self audits whether you took your meds already and avoids spending a lot of time sorting pills into organizers.
It’s also really convenient for travel; just tear off the packets for the time you’ll be away.
[ed] fixed autocorrect error
When I was taking several different medications, I started seeing why this service would be useful, even as a relatively organized, non-impaired person.
To me it was an absolutely American thing from the movies: I've always had the posology written by doctors already in layman terms, and nobody counts pills, you just get the number of boxes needed for the period of treatment (e.g. now for a treatment for which I need 38.5 pills I got exactly 38.5, in all other EU countries I've lived in I'd get 1x40/2x20/4x10 boxes).
https://www.globalsupport.harvard.edu/travel/advice/tips-tra....
So 20mg Med A, 10mg Med B Morning 9/26/2023
The time depends on your prescription. So you can ask your doc to write it how you need.
Wonder if it's still under patent and Amazon jacked up the licensing fee?
Several other pharmacies offer similar products: https://medbox.com/ https://www.simplemeds.com/ https://accupacrx.com/ etc
https://rxsafe.com/solutions/pouch-packaging/
There is nothing innovative about this.
My mother's pills wer organised by day and time of day 15 years ago.
ALso comments about how it saves wasted pills don't make sense for me. The doctor prescribes x pills for the course of treatment. So the pharmasist gives you x pills.
Yes for ibuprofen and other drugs you take as needed then you will have some left over as typically you have a headache and take one dose.
Yep, they do
> Also comments about how it saves wasted pills don't make sense for me
People don't follow instructions sometimes, and doctors overprescribe for the instructions they give you. My doctor wrote me a prescription for something a long time ago and warned me about the risk of addiction. They said I should stick to a dose, but prescribed me a larger amount because I could take more _if I needed it_ for a day or two. The pharmacist filled the prescription for about 3x what I should have been given without blinking an eye.
There are costs involved in appointments and filling prescriptions and you being trusted with an excess gives the system some flexibility that might avoid an extra appointment or visit to pharmacy.
Did it turn out ok?
Also in my experience pharmacists dislike having to do this laborious process.
I really want to work with local pharmacies on something like this and not faceless, nameless, outsourced Amazon.
Am I alone?
Yes.
> I really want to work with local pharmacies on something like this
Local pharmacies don't want to work with you and really don't want an initiative like amazon's one to exist.
Amazon usually take advantage of large scale economy to get profits off optimized costs. Local pharmacies just apply a markup to get their profit.
You'd think so, but not on medication. Most of them at least.
Looking into it recently since the business fascinates me, independent pharmacies operate more like gas stations selling gas as a loss leader, making it up on convenience items.
Many drugs don't even get reimbursed at break even by PBMs these days.
Within a decade not a single independent will exist.
Local pharmacies absolutely want to work with you on stuff like this, many have for decades already. Like many industries, they are being squeezed out as some Ivy MBA decides they want every ounce and then some of that consumer surplus. This is done on purpose to push patients to the vertically integrated options like CVS Caremark.
They cannot compete in an environment where consumers will walk over a $3 difference, and they get squeezed by PBMs on the other side.
Anyone fulfilling via Amazon is playing with fire in my opinion. It's gonna work until you eventually get hit by the shortages that are only likely to increase. The ability to talk to a human is going to become extremely important, and likely only available to the very wealthy at this point.
Amazon is less taking advantage of scale, and more that of regulatory capture in my mind. The big innovation is being big enough the other monopoly players can't just totally dictate terms.
No you‘re not. Haven‘t touched or spent money with Amazon for several years.
People act like this societal direction is inevitable.
e.g. you might take some pills right after you wake up and some pills right before you go to bed.
If you wake up every day at 7am and go to sleep at 11pm then that's easy, but if your schedule is constantly fluctuating (go to bed at 8am and waking up at 3pm) I can imagine how it might become confusing.
My company changed FSA card providers and PillPack wouldn't let me use my FSA card moving forward because they kept trying to put a $1 preauth on it which my FSA card vendor kept rejecting. Pillpack's response was "lol, too bad" and I ended up having to go back to traditional pharmacy services.
From there I ended up moving onwards to try using medication dispensers to help me keep track of my medications -- finding Hero Health, using that happily for a couple years, until they decided to raise the service price from $30 to $50 a month for just the dispenser alone.
Now I use a multi-partition vitamin cup with custom-printed labels (giant quantity indication, photo of each pill, markings/imprints, and name/dosage) and just manually dispense each pill and twist.