Dear Jeff Bezos, Founder and CEO, Amazon, 

Dear TJ Parker, Vice President, Amazon Pharmacy,

Dear Amazon Employees, Customers and Investors, 

My name is Madi Johnson and I am writing to you all as a Washington State resident and Type 1 Diabetic. As someone who is insulin dependent, I am thoroughly disappointed in the recent announcement of Amazon Pharmacy . The pharmaceutical industry revenue was estimated at $312 Billion in 2019, so it is no surprise that Amazon would begin a pharmacy service. Although it is surprising and deeply concerning that Amazon would contribute to the insulin price crisis by inflating prescription costs and deceiving their customers with false insulin advertising. 

Currently, the United States is facing an insulin price crisis. This life saving medication only costs $3-$7 to manufacture but since 1990 the price of insulin has increased by over 1200% making this drug so expensive that 1 in 4 diabetics ration their insulin to live. There are many reasons why insulin is so expensive in the United States. Pharmacies play a small hand in the insulin price crisis and often have their hands tied by Big PhRMA. Amazon Pharmacy is not to blame for the insulin price crisis but, as it is acting now, this new entity will contribute to the crisis by falsely inflating insulin prices above the market value. Not to mention, Amazon Pharmacy is potentially violating the Federal Trade Commission Act by falsely advertising their medications which could mislead people with insulin dependent diabetes and result in fatal effects, see: 2.1. 

In the Amazon Pharmacy announcement, TJ Parker, Vice President, stated the following: “We work hard behind the scenes to handle complications seamlessly so anyone who needs a prescription can understand their options, place their order for the lowest available price, and have their medication delivered quickly.” As it stands, the insulin products are not easy to understand and are not the lowest available price. The diabetes community is demanding the following of Amazon Pharmacy:

Amazon Pharmacy to lower their list price of insulin to match the current market value.  

Novolog Vial of Insulin on Amazon Pharmacy cost $488.30 per vial while the average cost per vial ranges from $250-$380 per Novolog vial (both costs are without insurance). Even with the 40% Amazon subscription discount, a vial of Novolog insulin from Amazon Pharmacy would cost $292. 

Humolog Kwiki Pens on Amazon Pharmacy cost $179.01 per pen, or $895.05 for a box of five, which is how insulin pens are most commonly sold. Even with the 65% Amazon subscription discount, a supply of 5 pens would cost $313.27. This can compare with the average retail cost of $315 per 5 pack box but first requires an enormous spike in cost to make the discount seem effective (all costs are estimated without insurance). 

Amazon Pharmacy is putting trivial costs on these medications so their subscription discounts seem effective, when they barely bring the cost down to the average list price without insurance. In Canada, a Novolog Vial of insulin costs less than $50. These prices corner the Amazon Pharmacy market into the United States and is blatantly ignoring Amazon’s global customer base. 

Amazon Pharmacy to change the images on all their insulin products to accurately reflect the products being sold. 

Federal Trade Commission Act: “The Federal Trade Commission Act allows the FTC to act in the interest of all consumers to prevent deceptive and unfair acts or practices. In interpreting Section 5 of the Act, the Commission has determined that a representation, omission or practice is deceptive if it is likely to: (a) mislead consumers and (b) affect consumers' behavior or decisions about the product or service.” 

The Eli Lilly humalog insulin pens along with many others are being falsely advertised on the Amazon Pharmacy website. These images attached the products depict an entire box of insulin pens, commonly holding 5 pens, although the pens are sold individually. It does make this distinction on the point of ordering but the picture attached to the product is deceptive and could violate the Federal Trade Commission Act by misleading customers. 

The Eli Lilly humalog 3mL vial is being depicted with a 10 mL humalog vial. This is grossly concerning as the difference between 3mL and 10mL of insulin is life or death for an insulin dependent diabetic. 

In the response to this letter, the diabetes community expects Amazon Pharmacy to stay true to Amazon's Leadership Principles. 
“They seek diverse perspectives and work to disconfirm their beliefs.”
Now Amazon Pharmacy has the perspective of the diabetes community and we expect their beliefs and actions to change. 
“Leaders ensure that defects do not get sent down the line and that problems are fixed so they stay fixed.”
Now Amazon Pharmacy has seen their defects and we expect the gross misconduct of insulin pricing and marketing to be fixed. 
“Leaders are continually raising the bar and driving their teams to deliver high-quality products, services, and processes.”
The diabetes community demands Amazon Pharmacy to raise their bar in serving our vast community by changing their pricing and marketing to ensure they are delivering high-quality products. 

Amazon Pharmacy does not hold power to change the insulin price crisis in the United States. A crisis which is currently killing members of the diabetes community. However, Amazon Pharmacy has a responsibility to and should be held accountable for accurately depicting the medications they are selling and to lower their list price of insulin to more closely match market value, in order to not exploit our disability and to reduce the burdens faced by the chronically ill.