Something occurred to me on the train this morning (yes, I spend my morning commute thinking about what to post here. If it helps, I spend my evening commute thinking about dinner. Wow. Now I’m hungry. Are you hungry? Then take a moment and want this movie on cinema’s greatest sandwiches. Don’t worry, I’ll still be here when you get back).

Anyway, in an effort to play Seth Godin and try and look for the edges of an idea or industry (what? you haven’t read Linchpin yet? Geez…) I thought, what part of the pharma market hasn’t changed much in a long time. The retail side. The biggest change in retail is that Walmart started pushing for better pill bottles (which are pretty cool, actually). Before that? Probably the decision to keep pharmacists on platforms. While the development side has churned out new products and product development models year after year, retail stays stagnant.

So what would have to happen for retail to shift? An entrenched market, a well-established network of retailers in some of the biggest and smallest companies, regulated pricing… Yeah, seems like the only that will change things is… chaos.

Chaos in the form of a massive retail player with cash in their pocket willing to smash down some walls and think things through from a blank piece of paper. Yeah, that’s going to be Amazon.

Why would Amazon enter the market? If you exclude “I just got sick and I need some antibiotics today” market, you’ve got everyone with a chronic condition, the elderly who usually need a slate of drugs for a long period of time in a well-regulated schedule, and preventative medicine. These are groups who don’t mind waiting two days for meds, and would probably be thrilled to have things delivered to their house.

Amazon apply their own “lowest possible margins!” model and lower the cost a bit, probably more than enough to cover the cost of shipping.

The real thrill will be the critical mass as Amazon becomes the third or fourth largest retailer and begins to negotiate formularies with either insurance companies or the manufacturers themselves.

One of the biggest issues people have with pharma is that it’s complicated. Even if you can navigate the insurance waters, there are thousands of prescribed drugs and the permutations of any two (let alone three or four) in terms of interactions are insane. What did Amazon do to distinguish itself a decade ago? Adding more data! Others who got this med also got this med (huh. My HCP didn’t give me that. I wonder why? I should ask her…). Reviews and effects (think of it! Millions of people talking about their meds! Outside of a regulatory sphere! Think of the research data that could be collected for free!).

Clearly, this is an industry that would benefit from a little shake up and I wonder how far along Amazon has thought this idea through.

As always, comments are on, and I am reachable @digital_pharma.