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We just got the first look at how Amazon's $750 million acquisition of PillPack could upend the US healthcare system

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Jeff Bezos. JASON REDMOND/AFP/Getty Images
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When Amazon acquired the online pharmacy PillPack for $750 million one year ago, it sent shudders through the healthcare industry. 

A new lawsuit gives the first inside look at Amazon's plan to disrupt incumbents.

Read more: Online pharmacy PillPack was reportedly on track to make $299 million in revenue when Amazon acquired the company in a $750 million deal

In the suit, which was filed by CVS against a former executive who was recently hired by PillPack, CVS alleges Amazon is competing with its services and coming after CVS's clients.
A PillPack spokeswoman said in a statement that "It's important to keep in mind that what's being reported here is another company's speculation about our business strategy for a lawsuit to which neither Amazon nor PillPack is a party."

PillPack is competing with CVS for a lucrative business, lawsuit alleges

PillPack packages medications by dosage for customers and mails them to their homes. That offering directly competes with CVS pharmacies.

But CVS also runs a lucrative business negotiating drug prices for US health plans through its business unit Caremark. The company alleges Amazon's PillPack is trying to go past this entirely by contracting directly with health plans.

PillPack has been "aggressively" approaching CVS Caremark clients, the company wrote in the court filing. It cited "direct discussions" with the health-plan federation Blue Cross Blue Shield to deliver prescriptions to the homes of its more than 100 million members.

Read more: CVS and Amazon's showdown is intensifying

"The inescapable conclusion is that Amazon-PillPack and CVS Caremark directly compete with comparable offerings to fill prescriptions for patients," CVS said in court filings. "And, given its robust infrastructure, operational capacity, and distribution reach, Amazon-PillPack is uniquely positioned to negotiate directly with Payers and displace CVS Caremark's mail based services."

"In fact, CVS Caremark has already received feedback that clients are considering AmazonPillPack as an alternative to CVS Caremark's mail-based services," the pharmacy chain added.

The lawsuit is being brought against a former CVS executive, John Lavin, who had worked at Caremark for 27 years before giving notice to join PillPack in April. CVS is suing in hopes of enforcing a noncompete that would prevent Lavin from disclosing confidential information.

PillPack says on its website that it offers services for health insurers to help high-risk patient populations take their medications as prescribed, though it doesn't go into further detail.

The company has also worked with the health insurer Aetna since early 2017, before the Amazon acquisition. The partnership allows members of the government program Medicare to fill prescriptions through PillPack at no extra cost.

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Emma Court was formerly a senior healthcare reporter at Business Insider, reporting about the big business of new medicines. She covered the race among pharmaceutical and biotech companies to develop cutting-edge new products for serious inherited conditions, devastating diseases with no cure like Alzheimer's, better cancer treatments and more. She also reported closely about the manifold problems that crop up, including when it comes to drug prices keeping important products out of patients' hands.   Emma is also a Cornell University graduate and native New Yorker.