A major battle between two companies involving the sharing and acquisition of patient prescription data is erupting into a full-scale war, with one of those companies now turning information over to the FBI.
As a CNBC report noted on July 29, “Surescripts is upping its battle with Amazon-owned PillPack, accusing a third company of providing PillPack with patient prescription information ‘fraudulently,’ and turning the matter over to the FBI. It’s the latest in a series of moves that could make it harder for Amazon to enter the prescription drug market.”
As Christina Farr noted in her report, “Americans are spending an excessive amount on prescription drugs, the cost of which likely topped $330 billion in 2018. Amazon made its first steps into the space in 2018, when it acquired online pharmacy start-up called PillPack. A year later,” Farr noted, “Amazon is engaged in a tense battle with one of the largest incumbents in the space. Surescripts is owned by a coalition of potential PillPack competitors, including CVS and ExpressScripts, and manages about 80% of all U.S. prescriptions. It is such a dominant force that in April, the Federal Trade Commission sued the company, alleging ‘illegal monopolization of e-prescription markets.’”
As Farr noted, “The battle is the latest in a string of disputes between Amazon and the established pharmacy companies since the PillPack deal — a deal that sent shares of pharmacy owners and pharmacy benefit managers tumbling. Earlier this year, CVS filed a lawsuit against a former employee after he told the company he would be taking a job at PillPack. A judge blocked the employee from working for PillPack for 18 months.”
In a statement posted to the company’s website on July 29, Tom Skelton, Surescripts’ CEO, wrote that “After a preliminary investigation, we uncovered evidence that third-party vendor ReMy Health provided one or more of its customers unauthorized access to the health information network we maintain. In addition, it appears that ReMy Health or its customers provided fraudulent information to Surescripts when making requests for patient data from the Surescripts network. We are still investigating the full scope of these improper activities but today are taking immediate steps to protect the data our partners entrust to us and the privacy of the patients they serve. Specifically, we have suspended ReMy Health from our network, are terminating their contract, and are turning the matter over to the FBI for further investigation,” Skelton said.
Further, Skelton went on, “ReMy Health contracted with Surescripts to deliver providers access to a patient’s complete medication history, in addition to other services related to electronic prescribing and prescription benefits. Under the agreement, medication history information is to be used by providers when delivering care to support clinical decision-making before prescribing new medications or during the normal process of provider-discharge planning for patients leaving a hospital or health system. We found that ReMy Health had provided this medication history data to an entity that is not a provider in this type of care setting. This not only directly violates ReMy Health’s contract with Surescripts, it violates our partners’ trust in the appropriate use of the data they provide to the network and the privacy of the patients they serve. Moreover, we are very concerned that the data appears to have been obtained fraudulently for one or more of ReMy Health’s customers. Either ReMy Health or its customers concealed unauthorized access to the Surescripts network by fraudulently using third-party providers’ identifying information to access the system – even though those providers appear to be entirely unrelated to the patients whose information was requested.”
And, Skelton added, “Surescripts has spent nearly 20 years establishing trusted relationships and legal agreements with hundreds of data suppliers and EHR vendors across the country to securely exchange health information. These agreements ensure that the information we exchange is only used for patient care and not for the commercial benefit of any one data supplier. These agreements also help ensure that patient data is properly secured.”
“Surescripts' claims are unfounded, false and appear to be part of their overall market strategy,” ReMy Health’s president and CEO Aaron Crittenden shot back in an undated statement posted to his company’s website. “ReMy Health operates in full alignment with our contracts and privacy law. We support patients facing some of the most complex and costly health challenges – expediting patient access to medicines by equipping patients and their care providers with essential medical and plan coverage information. ReMy Health believes competition in the healthcare marketplace is best for patients and will continue to fight for what we know is right.”
Later in the day on July 29, Surescripts terminated its contract with ReMy Health. As Bloomberg News reported, “Surescripts, a company that enables electronic prescribing of drugs, terminated its contract with a vendor that it says improperly requested access to patients’ medication histories to give to Amazon.com Inc.’s PillPack subsidiary. Surescripts, which is partially owned by two of the largest pharmacy-benefit managers, said in a statement Monday it has alerted the FBI and stopped its vendor, ReMy Health, from accessing its network.”
John Tozzi, who wrote the Bloomberg article, obtained a statement from PillPack spokeswoman Jacquelyn Miller by email, that said, “Pharmacists need a comprehensive understanding of the medications each customer is taking,” and customers permit PillPack to access their history.
Commenting on all of this, Sy Mukherjee wrote in Fortune on July 29, in a commentary headlined “Surescripts Throws Down the Gauntlet in Amazon PillPack Spat,” “There's a veritable battle of the titans afoot in the pharmacy space. And it's pitting Surescripts, a health IT and information network, against a startup called ReMy Health and tech giant Amazon's online pharmacy service PillPack. Shares of legacy pharmacy chains such as CVS and Walgreens sunk when Amazon announced its pickup of PillPack last June, sending shockwaves across an industry that's been wary of the tech giant's forays into the health care space for a while now.”
Later in the commentary, Mukherjee wrote, “So, what's going on here? CNBC's Chrissy Farr had the first report on this growing brouhaha a few weeks ago. Put simply, Surescripts claims that ReMy Health had been providing disingenuous information in order to acquire prescription drug histories available on Surescripts' network and then giving it to one or more of its customers (aka, PillPack). This kind of data is critical, especially for a company like Amazon that's fairly new to the prescription delivery business. Now, Surescripts—which, critically, is backed by massive legacy firms such as CVS and the benefits giant Express Scripts, which aren't exactly fans of Amazon elbowing in to their territory—has cut off both ReMy Health and, by extension, PillPack. (PillPack had already threatened to sue Surescripts over being cut off from access to this patient information; Surescripts is now clearly hitting back.)”
And Mukherjee quoted a statement that PillPack’s Jacquelyn Miller had emailed him, which stated, "Our requests for patient information are made with the explicit consent of our customers and all information we provide is accurate. Any suggestion otherwise is false. Given that Surescripts is, to our knowledge, the sole clearinghouse for medication history in the United States, the core question is whether Surescripts will allow customers to share their medication history with pharmacies and if not, why not?"
As Mukherjee concluded, “The battle for digital pharmacy dominance is clearly heating up.”
