Surescripts cut PillPack's patient-data pipeline as Amazon entered US pharmacy

Surescripts manages electronic prescriptions for about 80% of US prescriptions; PillPack is Amazon's online pharmacy.

After Amazon bought online pharmacy PillPack in the summer of 2018, its potential competitors weren't making it easy. PillPack relied on a deal with ReMy Health to access patient medication history collected by Surescripts, the network managing about 80% of US prescriptions — which is owned by a group of potential PillPack competitors including CVS and Express Scripts.

In September 2019 Surescripts announced it was ceasing its relationship with ReMy Health. CEO Tom Skelton wrote that an investigation found fraud 'not limited to patient medication history information', extending to insurance and prescription price data 'ReMy Health provided to drug marketing websites'; the company said it turned the matter over to the FBI while finding no clear evidence of a patient privacy violation. ReMy CEO Aaron Crittenden called the allegations unfounded: 'We have never provided any data from the Surescripts network to pharmaceutical companies for marketing purposes.'

PillPack was left with no clear way to access medication history automatically, having to call patients or their doctors — a manual process prone to errors, since patients on multiple medications often forget their drugs and dosages. Spokesperson Jacquelyn Miller said the impact was real and hoped Surescripts wanted 'patients and their pharmacies to have the most accurate information available'.

Surescripts is owned by potential PillPack competitors including CVS and Express Scripts — the gatekeeper and the gated were on opposite sides of a market entry.

The cutoff arrived months after the FTC sued Surescripts for allegedly monopolizing e-prescription markets, sharpening the competitive frame.

PillPack's workaround — phoning patients and doctors — degraded the core promise of a pharmacy built on complete medication data.

Both sides claimed integrity: Surescripts cited fraud and FBI referral, ReMy denied everything and no privacy violation was found.

Control the pipes, not the product: when your competitors own the data network, every integrity dispute can double as a moat — and the incumbent's regulator is already circling.

As of September 11, 2019, PillPack had limited methods to obtain medication histories and was hoping to work directly with Surescripts, which it called the only commercial clearinghouse for comprehensive medication history in the US. The FTC's monopolization suit against Surescripts was pending.