The future?

The future?

Now that it’s known that Amazon owns the web domain AmazonRX.com and has obtained pharmacy licenses in multiple states it’s obvious where this is going. With CVS buying Aetna it just becomes more obvious. So why then when it comes to diabetes and better patient outcomes, something that everyone says is important, do we feel like nothing will change. That there is no correlation between lower drug costs and patient outcomes.

Perhaps we feel this way because we live in the real world and not in some fantasy land. Listen from a business perspective we understand what Amazon is doing and why CVS felt it necessary to respond. Amazon can drive cost out of the system and obliterate not CVS’s business but Walgreens too. However, from a patient perspective this is much to do about nothing, at least from an outcomes perspective.

So, Alexa will not just bring me my Tide, but she’ll make sure I have plenty of insulin, glucose sensors and other meds. Yes, lovely Alexa will have these drugs and supplies delivered right to my door and will charge my credit card for my co-pay. And as we all know she’ll also try and become Momma Kliff reminding me to take my meds and not to eat the wrong things.

We should note that even Momma Kliff couldn’t get me to eat my veggies, but we digress.

Alexa, being the sweetheart that she is, is also aware that she is competing for my affection. That Siri along with others also want to take care of me. Seriously we are flattered by all this attention just for having diabetes. It’s such a nice feeling that even with Momma Kliff gone, Siri and Alexa are ready to step in. We just can’t tell everyone how lucky and fortunate we feel.

Now we must admit that we are not the normal diabetes patient as we are actively engaged with our diabetes management. Put simply unlike most patients we get it and are willing to do all the work. Hence the problem when it comes to getting better outcomes MOST patients aren’t like us, they aren’t even close. To these patients who live in the real-world outcomes are a foreign and meaningless concept. Sure, their doctor talks about A1c and all that stuff but these patients don’t touch and feel A1c.

Let’s be clear Amazon is doing nothing that will significantly improve patient outcomes. They will blow up the current way drugs and supplies are delivered to the patient. They will likely, unless drastic changes take place, put CVS and Walgreens out of business. They will make even more money but what they won’t do is significantly alter patient outcomes for most patients with diabetes. This isn’t happening no matter what Alexa says.

We could care less if Amazon joins other cash rich high-tech companies and goes 100% at risk. We could care less if they give away drugs or supplies. What they can’t do, what Alexa will never do is the give the patient the want too. Alexa can give them the how to, but there is no way unless major changes are made, she can provide the want to.

Isn’t it about time that we just stop pretending and acknowledge what everyone already knows that this has nothing to do with improving outcomes, that it’s about money. Who makes it, who saves it and who spends it. Isn’t it about time that until someone thinks way out of the box that nothing much will change other than which companies make money, and which lose money.

The reality is diabetes management isn’t that complex for most patients. The wheel has been invented and there is no reason to reinvent the wheel, but that’s exactly what everyone including Alexa is trying to do. Alexa, Siri and the other talking devices all give the how to. They all can collect data, analyze it and regurgitate it back to the patient, hopefully in a language the patient understands. But they cannot give patients the motivation, the incentive or drive to do the work, the job of managing their diabetes.

Listen we know that Alexa and Siri think they are smart, that they have all the answers. Both believe that with all their way cool whiz bang toys to play with there is no way a patient wouldn’t listen to them. Of course, they reason, these people will follow our advice and do what we recommend. Why wouldn’t they? After all they will “feel” better, they will see improved “outcomes”.

Well the fact is, yep those pesky facts again, the reason these patients won’t do it is there is nothing immediate or tangible in it for them. Sure, everyone around the patient is making a buck but heaven forbid the patient get something real and tangible, that only makes sense and we can’t have any of that.

So please let’s end the charade already and call a spade a spade, this has NOTHING to do with improving outcomes and everything to do with money- who makes it, who saves it and who spends it. As Momma Kliff used to say; “I may not have an advanced degree from a fancy college, but I wasn’t born yesterday either.”