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This is a very ill-informed opinion. The supply chain is very strictly regulated for pharmaceutical medications. Do you really think that Amazon can get their

by jeherr 8y ago

This is a very ill-informed opinion. The supply chain is very strictly regulated for pharmaceutical medications. Do you really think that Amazon can get their stock medications from just anyone? Do you think there is no oversight on this kind of thing? The DEA doesn't fuck around. They take all of this stuff very seriously. Commingling medications? Really? In a pharmacy, medications are NEVER allowed to be commingled. If your medication is coming from two different manufacturers, or even the same manufacturer but the pills just look different, the pharmacy must put them in two different bottles to give to you. Stock bottle are not allowed to be mixed together. Ever heard of a recall on medications? That is exactly why. When a recall happens, they need tedious records of where every pill went. When a prescriptions for a schedule II drug is filled, the pharmacy technician has to count the number of pills being filled twice. Then the pharmacist has to count the number of pills, and then backcount the stock bottle to make sure everything is kosher and no pills are missing. I understand not everyone knows everything about the pharmaceutical industry, my wife is a pharmacist is the reason I know as much as I do, but to think that there is that little oversight on pharmaceuticals is ludicrous.

vernie 8y ago
That kind of "innovation" is just what I've come to expect from Amazon.
- jhall1468 8y ago
  What part of heavily regulated is hard to understand? The Amazon Marketplace is regulated by Amazon. Pharmaceuticals are regulated by the FDA.
  - jeherr 8y ago
    Not just the FDA, but also the DEA and the states Board of Pharmacy.
mschuster91 8y ago
> When a prescriptions for a schedule II drug is filled, the pharmacy technician has to count the number of pills being filled twice. Then the pharmacist has to count the number of pills, and then backcount the stock bottle to make sure everything is kosher and no pills are missing. Good grace. What a load of unnecessary bureaucracy.
- beenBoutIT 8y ago
  In the modern world medicines come in pre-counted blister packs where there is zero room for error. Here in America we have to wait around an hour for some dolt to count and then double count the pills.
  - not_kurt_godel 8y ago
    It is pretty remarkable how inefficient getting pills from a pharmacist is. The actual dispensing could be easily handled by a glorified vending machine so all the pharmacist would have to do is punch some buttons on a computer instead of having to physically handle anything except dumping packages from the manufacturer in it upon delivery.
    - jeherr 8y ago
      Actually, some pharmacies do have counting robots now which count out their most commonly filled prescriptions, like norco. They’re not perfect though.
      - beenBoutIT 8y ago
        Who do you complain to when the robot shorts you? Unless most doctors are writing scripts for noncomposite amounts of pills this needs to be simpler. Boxes of 15 can turn into 60, 90, 120, etc.
      - shimon 8y ago
        Very common now. All the pharmacies in my primary health system's offices use these: https://innovat.com/pharmassist-robotx/ https://innovat.com/pharmassist-robotx/
anonymous5133 8y ago
Was also going to mention the same. Amazon will buy directly from the manufacturer.
qop 8y ago
Clearly the parent commenter didn't intend to imply that the industry is not regulated. I think it was more of a tongue-in-cheek jab at Amazon. I think it's just generally weird that a shipping and commerce company is taking interest in pharma to begin with. I think it SHOULD make users uncomfortable that a single company is potentially exposed to all these different vertices of user information. They know what you buy, soon they'll know what groceries people buy, what they read, what medicine they take which could in turn reveal metadata like sexual habits or genetic patterns. It's weird.
- digitalzombie 8y ago
  Is it weird? I feel like it's more like Amazon just trying to monopolize everything. There are articles out there talking about getting Amazon-ed. Where Amazon would go in your industry and dominate you out the market. (https://www.forbes.com/sites/jamescahn/2018/04/24/dont-let-your-industry-job-or-company-get-amazon-ed/#2487862422ee https://www.forbes.com/sites/jamescahn/2018/04/24/dont-let-y...) This is just a natural thing or the thing that Amazon does. Their modus operandi. > what medicine they take which could in turn reveal metadata like sexual habits They do recommendation system and I believe they sell sex toys so yeah... Alexia knows your kink already. It's not weird but I think the better question is is this okay for one company to have so much power in so many area. Or at least I believe that's what you are trying to convey.
  - qop 8y ago
    I guess I meant weird in the moral sense. It's certainly not unusual given their past behavior as a corp. Sort of depressing, really.
tiatia123 8y ago
What always seemed odd to me in such a wasteful society as the US: counting pills. Really? In many countries you get blisters. No counting. I suspect in some European countries it would actually be illegal to do this. The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available.
- NickNameNick 8y ago
  In New Zealand, I sometimes receive prescription medication in a generic box full of blister packs, where the last blister pack has been cut down to match the prescribed number of doses. Occasionally I'll get a couple of cut down sheets, presumably using up the leftovers from other people's prescriptions.
- toomanybeersies 8y ago
  > The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available. This is the exact reason why they count pills. You have a prescription for X pills, you get X pills. It's been a while since I've had a prescription filled, but I think that in New Zealand it's the same. Most prescription drugs like opiate painkillers or antibiotics are counted and bottled.
  - yudhiyudhi 8y ago
    Here in India, they'll either cut the blisters to your prescription or give already cut blisters from previous orders.
  - tiatia123 8y ago
    Yes, but is it worth the trouble? Also, you may be able to build robots to dispense pills. But have you seen a European automated pharmacy supplier? Everything is automated. They dispense all the blister packs into a small cart that gets delivered to the pharmacy. In the end it does not matter if you supply a pharmacy with 2-20 medicines or a consumer with 1-10.
astura 8y ago
Amazon has had drug problems in the past... http://www.slate.com/articles/health_and_science/medical_examiner/2014/05/amazon_illegal_drugs_muscle_relaxants_steroids_prescription_drugs_delivered.html http://www.slate.com/articles/health_and_science/medical_exa... https://abcnews.go.com/amp/Health/amazon-prescription-drug-problem/story?id=24095588 https://abcnews.go.com/amp/Health/amazon-prescription-drug-p... Everyone knows pharmacies are highly regulated, however Amazon has somehow managed to flaunt regulations so far without much consequences.
- jeherr 8y ago
  I’ll grant you it is worrying to see that happening, interesting articles I had no idea about. Though I would think now that Amazon is officially getting into the pharmaceutical game, this will bring them under much more scrutiny for this kind of thing in the future. I could be wrong, as the first article states, Amazon skated by without so much as a warning while bodybuilding.com had to pay fines for selling the same steroids, but I would expect the FDA is able to throw their weight around more with Amazon now by shutting down their official pharmaceutical operation if they continue to make perscription medications available like this on their retail site.
tzs 8y ago
> In a pharmacy, medications are NEVER allowed to be commingled. If your medication is coming from two different manufacturers, or even the same manufacturer but the pills just look different, the pharmacy must put them in two different bottles to give to you Are there any exceptions allowed? I'm pretty sure I've had a major nationwide pharmacy give me a bottle with pills from two manufacturers in it. It had pills from the first in the bottom of the bottle, then a cotton wad on top of those, and the pills from the second manufacture on top of the cotton ball. They opened the bottle when I went to pick it up, and pointed out what was going on inside and made sure I understood. They explained that they did not have enough pills in stock from the manufacturer they had used before for that prescription and refills, so filled out the order from a different manufacturer. Perhaps it does not count as commingling because they divided the bottle into separate champers with a wad of cotton?
- URSpider94 8y ago
  Pharmacy is regulated state by state. What they did may be ok in that state, or may be marginally ok. At the least, they didn’t just dump them into the same bottle together.
- pitaa 8y ago
  I don't know why you're getting downvoted. I've had the same thing happen multiple times, also at a certain "major nationwide pharmacy." Interestingly, the smaller/more local pharmacies have never done this.
dlhavema 8y ago
I can attest to this. I recently got 2 bottles of seemingly identical muscle relaxers, but they were just two diff manufacturers. And they made a point of calling it out so i knew why i got two half filled bottles..

by jeherr 8y ago

vernie 8y ago

That kind of "innovation" is just what I've come to expect from Amazon.

jhall1468 8y ago
What part of heavily regulated is hard to understand? The Amazon Marketplace is regulated by Amazon. Pharmaceuticals are regulated by the FDA.
- jeherr 8y ago
  Not just the FDA, but also the DEA and the states Board of Pharmacy.

mschuster91 8y ago

> When a prescriptions for a schedule II drug is filled, the pharmacy technician has to count the number of pills being filled twice. Then the pharmacist has to count the number of pills, and then backcount the stock bottle to make sure everything is kosher and no pills are missing. Good grace. What a load of unnecessary bureaucracy.

beenBoutIT 8y ago
In the modern world medicines come in pre-counted blister packs where there is zero room for error. Here in America we have to wait around an hour for some dolt to count and then double count the pills.
- not_kurt_godel 8y ago
  It is pretty remarkable how inefficient getting pills from a pharmacist is. The actual dispensing could be easily handled by a glorified vending machine so all the pharmacist would have to do is punch some buttons on a computer instead of having to physically handle anything except dumping packages from the manufacturer in it upon delivery.
  - jeherr 8y ago
    Actually, some pharmacies do have counting robots now which count out their most commonly filled prescriptions, like norco. They’re not perfect though.
    - beenBoutIT 8y ago
      Who do you complain to when the robot shorts you? Unless most doctors are writing scripts for noncomposite amounts of pills this needs to be simpler. Boxes of 15 can turn into 60, 90, 120, etc.
    - shimon 8y ago
      Very common now. All the pharmacies in my primary health system's offices use these: https://innovat.com/pharmassist-robotx/ https://innovat.com/pharmassist-robotx/

anonymous5133 8y ago

Was also going to mention the same. Amazon will buy directly from the manufacturer.

qop 8y ago

Clearly the parent commenter didn't intend to imply that the industry is not regulated. I think it was more of a tongue-in-cheek jab at Amazon. I think it's just generally weird that a shipping and commerce company is taking interest in pharma to begin with. I think it SHOULD make users uncomfortable that a single company is potentially exposed to all these different vertices of user information. They know what you buy, soon they'll know what groceries people buy, what they read, what medicine they take which could in turn reveal metadata like sexual habits or genetic patterns. It's weird.

digitalzombie 8y ago
Is it weird? I feel like it's more like Amazon just trying to monopolize everything. There are articles out there talking about getting Amazon-ed. Where Amazon would go in your industry and dominate you out the market. (https://www.forbes.com/sites/jamescahn/2018/04/24/dont-let-your-industry-job-or-company-get-amazon-ed/#2487862422ee https://www.forbes.com/sites/jamescahn/2018/04/24/dont-let-y...) This is just a natural thing or the thing that Amazon does. Their modus operandi. > what medicine they take which could in turn reveal metadata like sexual habits They do recommendation system and I believe they sell sex toys so yeah... Alexia knows your kink already. It's not weird but I think the better question is is this okay for one company to have so much power in so many area. Or at least I believe that's what you are trying to convey.
- qop 8y ago
  I guess I meant weird in the moral sense. It's certainly not unusual given their past behavior as a corp. Sort of depressing, really.

tiatia123 8y ago

What always seemed odd to me in such a wasteful society as the US: counting pills. Really? In many countries you get blisters. No counting. I suspect in some European countries it would actually be illegal to do this. The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available.

NickNameNick 8y ago
In New Zealand, I sometimes receive prescription medication in a generic box full of blister packs, where the last blister pack has been cut down to match the prescribed number of doses. Occasionally I'll get a couple of cut down sheets, presumably using up the leftovers from other people's prescriptions.
toomanybeersies 8y ago
> The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available. This is the exact reason why they count pills. You have a prescription for X pills, you get X pills. It's been a while since I've had a prescription filled, but I think that in New Zealand it's the same. Most prescription drugs like opiate painkillers or antibiotics are counted and bottled.
- yudhiyudhi 8y ago
  Here in India, they'll either cut the blisters to your prescription or give already cut blisters from previous orders.
- tiatia123 8y ago
  Yes, but is it worth the trouble? Also, you may be able to build robots to dispense pills. But have you seen a European automated pharmacy supplier? Everything is automated. They dispense all the blister packs into a small cart that gets delivered to the pharmacy. In the end it does not matter if you supply a pharmacy with 2-20 medicines or a consumer with 1-10.

astura 8y ago

Amazon has had drug problems in the past... http://www.slate.com/articles/health_and_science/medical_examiner/2014/05/amazon_illegal_drugs_muscle_relaxants_steroids_prescription_drugs_delivered.html http://www.slate.com/articles/health_and_science/medical_exa... https://abcnews.go.com/amp/Health/amazon-prescription-drug-problem/story?id=24095588 https://abcnews.go.com/amp/Health/amazon-prescription-drug-p... Everyone knows pharmacies are highly regulated, however Amazon has somehow managed to flaunt regulations so far without much consequences.

jeherr 8y ago
I’ll grant you it is worrying to see that happening, interesting articles I had no idea about. Though I would think now that Amazon is officially getting into the pharmaceutical game, this will bring them under much more scrutiny for this kind of thing in the future. I could be wrong, as the first article states, Amazon skated by without so much as a warning while bodybuilding.com had to pay fines for selling the same steroids, but I would expect the FDA is able to throw their weight around more with Amazon now by shutting down their official pharmaceutical operation if they continue to make perscription medications available like this on their retail site.

tzs 8y ago

> In a pharmacy, medications are NEVER allowed to be commingled. If your medication is coming from two different manufacturers, or even the same manufacturer but the pills just look different, the pharmacy must put them in two different bottles to give to you Are there any exceptions allowed? I'm pretty sure I've had a major nationwide pharmacy give me a bottle with pills from two manufacturers in it. It had pills from the first in the bottom of the bottle, then a cotton wad on top of those, and the pills from the second manufacture on top of the cotton ball. They opened the bottle when I went to pick it up, and pointed out what was going on inside and made sure I understood. They explained that they did not have enough pills in stock from the manufacturer they had used before for that prescription and refills, so filled out the order from a different manufacturer. Perhaps it does not count as commingling because they divided the bottle into separate champers with a wad of cotton?

URSpider94 8y ago
Pharmacy is regulated state by state. What they did may be ok in that state, or may be marginally ok. At the least, they didn’t just dump them into the same bottle together.
pitaa 8y ago
I don't know why you're getting downvoted. I've had the same thing happen multiple times, also at a certain "major nationwide pharmacy." Interestingly, the smaller/more local pharmacies have never done this.

dlhavema 8y ago

I can attest to this. I recently got 2 bottles of seemingly identical muscle relaxers, but they were just two diff manufacturers. And they made a point of calling it out so i knew why i got two half filled bottles..