Pharmacy stocks, including pharmacy retailers and suppliers, have taken a pounding since the St. Louis Post-Dispatch reported last week that Amazon had received approval for pharmacy wholesale licenses from at least a dozen state pharmacy boards. Tanquilut said in a research note, however, that Jefferies’ research indicates the Amazon licenses aren’t for prescription drugs but for medical equipment.
“While that news strengthened investors’ fears about Amazon’s entry into drug retailing, our due diligence suggests that the licenses Amazon obtained are likely associated with their sale and distribution of medical equipment, rather than prescription drugs,” he wrote in his report, released Friday. “We believe that the wholesale distribution licenses brought to light yesterday afternoon by the St. Louis Post-Dispatch are associated with Amazon’s entry into the B2B medical sales and distribution business that began earlier this year.”
Taunquilut cited a business-to-business professional medical equipment web page posted by Amazon late last year as an indication that Amazon was issued the wholesale licenses between October 2016 and January 2017.
As for the possibility of an Amazon pharmacy market entry, Tanquilut said a big hurdle for the company in delving into the prescription drug space would be its lack of relationships with pharmacy benefits managers (PBMs) and payors. In addition, he noted, it’s unlikely that PBMs like CVS Caremark, Prime Therapeutics or Express Scripts would want to create “a formidable competitor” by partnering with Amazon, though Express Scripts has indicated it might be opening to exploring such a relationship.
“We believe Express Scripts willingness to work with Amazon pertains mostly to cash pay patients,” he stated. “So, absent a large PBM acquisition, we believe it will be difficult for Amazon to capture enough market share to gain the purchasing leverage necessary to economically justify an entry into the pharmacy space.”
Nevertheless, concerns about Amazon possibly expanding its distribution capabilities into prescription drugs aren’t likely to dissipate over the near term and will continue to impact pharmacy supply-chain stocks, according to Tanquilut. He cited this effect on Walgreens Boots Alliance’s fiscal 2017 fourth-quarter results another in research note Friday titled “Good Fundamentals Get Rained on in Jungle of Amazon Fears.”
“While we continue to have a positive view on WBA given its fundamental outlook, we recognize that investor concerns about Amazon’s potential entry into the pharmacy business has created an overhang that puts a near-term ceiling on WBA shares,” Tanquilut wrote. “We continue to believe that entering full-bore into the pharmacy space will be difficult for Amazon given the need for large PBM contracts for them to succeed.
“Realistically, we believe Amazon’s entry into Rx will be limited to OTC drugs and medical supplies, and maybe even cash pay Rx through an outsource arrangement with a third party,” he added.
Meanwhile, it’s too early to gauge the potential impact of Amazon’s medical equipment sales and distribution on current health product wholesalers, including McKesson, Cardinal Health and AmerisourceBergen, according to Tanquilut.
“While we believe that the distributors have strong and deep relationships with both large health systems and smaller physician practice groups, Amazon’s entry into medical device/supply distribution certainly poses risks that we believe are difficult to quantify at this point, given uncertainty about Amazon’s planned breadth of product offering and the willingness of physicians and hospitals to purchase products from multiple suppliers/systems,” he observed. “Additionally, tapping into the large health system market will likely prove more difficult, so meaningful disruptions in the near future to the distributors’ medical distribution businesses seems unlikely.”