The dispute between Amazon's PillPack and Surescripts, the largest medical data and e-prescription company in the United States, escalated last week as Surescripts cut off PillPack's data vendor from accessing its patient prescription information, arguing the company gained the information "fraudulently".

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Background

In June 2018, Amazon purchased PillPack, an online pharmacy that sorts and delivers prescriptions to customers nationwide and coordinates their refills and renewals.

Part of PillPack's business model relies on accessing an accurate list of a patient's medications so it can inform them about health and safety risks, as well as help them manage refills and eliminate any duplicative prescriptions.

PillPack has gotten that data through a contract with ReMy Health, a third-party entity that accessed the information from Surescripts. Surescripts is owned by a coalition of potential competitors to PillPack, including CVS Caremark, Express Scripts, and Medco Health Solutions.

PillPack has clashed with several of these companies, including CVS and Express Scripts. For instance, in 2016, before its acquisition by Amazon, PillPack had a high-profile contract dispute with Express Scripts that could have cut PillPack off from a third of its customers. The dispute was eventually resolved when PillPack CEO TJ Parker admitted to an "administrative error" in his contract with the company.   

Surescripts cuts ReMy Health off from its data

In July, ReMy Health informed PillPack it would soon be cut off from the Surescripts patient prescription data it had been providing them. Amazon in turn sent Surescripts a cease-and-desist letter, CNBC reports, suspecting Surescripts was behind ReMy's decision.

In response, Surescripts, in a statement on Monday July 29, announced it was cutting off ReMy Health from accessing its data and accused the company of violating its contract.

Surescripts alleged that ReMy Health had provided "fraudulent information" to Surescripts in order to get its prescription data. Specifically, Surescripts said that ReMy had claimed to be acquiring prescription information for "providers caring for patients in hospitals" when it was, in fact, providing that information to PillPack. It also accused PillPack of using National Provider Identifiers belonging to providers who had never seen its patients.

Surescripts added, "We are still investigating the full scope of these improper activities but today are taking immediate steps to protect the data our partners entrusted to us and the privacy of our patients they serve."

Tom Skelton, CEO of Surescripts, in a statement said, "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."

He said the company was turning the matter over to the FBI.

Reaction

ReMy Health said Surescripts' claims are "unfounded" and "part of their overall market strategy."

Aaron Crittenden, ReMy Health's CEO, said in a statement, "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."

PillPack in a statement noted that all requests for patient information are made with "explicit consent of our customers and all information we provide is accurate."

Jacquelyn Miller, a spokesperson for PillPack, said, "Pharmacists need a comprehensive understanding of the medications each customer is taking," and that customers allow PillPack to access their history. "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?" Miller said (Tozzi, Bloomberg, 7/29; Farr, CNBC, 7/29; Truong, MedCity News, 7/30; Farr, CNBC, 7/19, Farr, Fast Company, 4/26, Farr, CNBC, 5/10).