Amazon Ends Telehealth Services, but Forges Ahead with Healthcare Disruption

Amazon is learning that disrupting health care isn’t as easy as selling books and household goods. In a surprise move, the e-retail giant announced that it will close down its Amazon Care primary health services for employees at the end of the year, thus continuing a pattern of recent failures by tech giants like Google and Microsoft to gain a foothold in health care.

The Rise and Fall of Amazon Care

Launched in 2019, Amazon Care was a pilot program designed to provide care to Amazon employees and their families in the Seattle region, including virtual urgent care visits and telehealth consultations, as well as fee-based in-home nurse visits for testing and vaccinations. The telehealth service expanded to all 50 states and the in-person service became available in at least seven cities.

Amazon had great ambitions for the service and last year began rolling it out to other employers, signing Silicon Labs, TrueBlue, Whole Foods Market, Precor, and Hilton as clients. The plan was to expand the model to more than 20 additional cities in 2022, including major metropolitan areas like New York City, Chicago, Miami, and San Francisco. And with the July acquisition of primary care company One Medical for $3.9 billion, Amazon Care appeared positioned to make even greater inroads into the market.

But then it all changed on a dime. Company leaders concluded that the business model wasn’t working and on Aug. 24, Amazon Health Services senior vice president Neil Lindsay sent health service team employees a memo announcing that the service would be shut down on Dec. 31.

“This decision wasn’t made lightly,” Lindsay wrote. “Although our enrolled members have loved many aspects of Amazon Care, it is not a complete enough offering for the large enterprise customers we have been targeting, and wasn’t going to work long-term.”

Complete Memo from Neil Lindsay Announcing Shutdown of Amazon Care

Health Services team,   We are working on an important, missionary opportunity. Our vision is to make it easier for people to access the health care products and services they need to get and stay healthy. We know accomplishing this won’t be easy or fast, but we believe it matters.   One of the ways we’ve worked towards this vision for the past several years has been with our urgent and primary care service offering, Amazon Care. During that time, we’ve gathered and listened to extensive feedback from our enterprise customers and their employees, and evolved the service to continuously improve the experience for customers. However, despite these efforts, we’ve determined that Amazon Care isn’t the right long-term solution for our enterprise customers, and have decided that we will no longer offer Amazon Care after December 31, 2022.   This decision wasn’t made lightly and only became clear after many months of careful consideration. Although our enrolled members have loved many aspects of Amazon Care, it is not a complete enough offering for the large enterprise customers we have been targeting, and wasn’t going to work long-term.    Our work building Amazon Care has deepened our understanding of what’s needed long-term to deliver meaningful health care solutions for enterprise and individual customers. You’ve heard me say it before, but I believe the health care space is ripe for reinvention, and our efforts to help improve the health care experience can have an immensely positive impact on our quality of life and health outcomes. However, none of these reasons make this decision any easier for the teams that have helped to build Amazon Care, or for the customers our Care team serves.   Our priority right now is to support you, regardless of the path you take. Many Care employees will have an opportunity to join other parts of the Health Services organization or other teams at Amazon — which we’ll be discussing with many of you shortly — and we’ll also support employees looking for roles outside of the company.   To the Amazon Care and Care Medical teams, thank you for all of your hard work over these last several years. You should be very proud of what this team has been able to accomplish in a short period of time. I am also thankful to our members and business customers for entrusting us with their care; this is not a responsibility we take lightly. As we take our learnings from Amazon Care, we will continue to invent, learn from our customers and industry partners, and hold ourselves to the highest standards as we further help reimagine the future of health care.   Sincerely,   Neil

What’s Next for Amazon

Amazon seems determined to maintain its healthcare disruption strategy. Lindsay suggested that building Amazon Care has deepened the company’s understanding of "what's needed long-term to deliver meaningful health care solutions for enterprise and individual customers." The decision to shutter Amazon Care doesn’t affect any of the company’s other health care operations, including the Amazon Pharmacy service launched in November 2020 following the $753 million acquisition of prescription-by-mail company PillPack.

The acquisition of One Medical, a membership-based, tech-integrated, consumer-focused primary care platform with 188 offices in 29 markets, expands Amazon’s access to the lucrative employer market. In addition to having nearly 800,000 members, One Medical works with 8,000 companies. Meanwhile, Amazon is reported to be bidding for home health services provider Signify Health.

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Here’s a summary of some of the key strategic diagnostic deals announced in August 2022:

Strategic Alliances, Partnerships, & Collaborations

Partner 1	Partner(s) 2+	Deal Summary
Becton Dickinson	Laboratory Corporation of America	• Objective: Develop flow cytometry-based companion diagnostics • Dynamic: Create framework to develop, manufacture, market, and commercialize flow cytometry-based CDx tests intended to match patients with treatments for cancer and other diseases
Beckman Coulter Life Sciences	Flownamics	• Objective: Create automated, on-line solution for bioprocess culture monitoring and control • Dynamic: Combine Beckman Coulter’s Vi-CELL BLU Cell Viability Analyzer with Flownamics’ Seg-Flow S3 Automated On-Line Sampling System to create a precise, rapid cell analysis platform for real-time characterization of bioprocess cell cultures
Age Labs	BioAge Labs	• Objective: Leverage data from longitudinal health study to develop new diagnostics and drugs • Dynamic: Use Trøndelag Health Study's biobank of samples collected from more than 100,000 volunteers to discover and commercialize biomarkers for diagnostics and clinical trials
Innovative Health Diagnostics	AIMA Laboratories	• Objective: Develop microRNA-based at-home test for endometriosis • Dynamic: Test detects miRNA biomarkers that are differentially expressed in women with endometriosis compared to women without the disease
DxGen	Precision Diabetes	• Objective: Launch DxGen's point-of-care analyzer for diabetes-related assays in US • Dynamic: Epithod AutoDx analyzer's test includes assays for hemoglobin A1C, C-reactive protein, and urinary albumin assays, with additional diabetes assays in the pipeline
SpIntellx	ICura	• Objective: Offer new spatial analytics products for precision cancer treatment • Dynamic: Combine SpIntellx's software-as-a-service offerings for precision pathology with ICura's technical expertise in multiplex assay development and omics data analysis to develop products combining genomic, proteomic, transcriptomic, and clinical data to explore spatial heterogeneity in tumor microenvironment
Invivoscribe	Kronos Bio	• Objective: Develop companion diagnostic assay to determine who to treat with investigational cancer drug entospletinib • Dynamic: Kronos Bio to conduct clinical trial for drug as a treatment for acute myeloid leukemia (AML) patients with a mutation in the nucleophosmin gene (NPM1)
Medicover	FYR Diagnostics	• Objective: Offer diagnostic development and testing services to pharmaceutical companies in North America • Dynamic: Use FYR's CLIA lab to provide pharma partners support for clinical trial assay development and implementation and novel diagnostic technology development, and companion diagnostic testing services
Personalis	BC Cancer	• Objective: Study Personalis’ NeXT Personal molecular residual disease assay in patients with colorectal and pancreatic cancers • Dynamic: Recruit approximately 220 patients from across BC for study to determine certain parameters for the tumor-informed liquid biopsy assay such as the best time to draw blood for ctDNA sampling • Also assess whether MRD testing in these patients has potential to reduce healthcare spending compared to existing imaging tools
Verogen	Gene by Gene	• Objective: Improve forensic investigative genetic genealogy (FIGG) • Dynamic: Gene by Gene to support DNA uploads generated by Verogen's ForenSeq Kintelligence genetic genealogy kit, which is expected to double the number of available FIGG profiles • Each company to create algorithms and software to increase the probability of generating uploadable single nucleotide polymorphism profiles and lower bioinformatic costs, enabling standardization of FIGG workflow
Regeneron	Mount Sinai Health System + Icahn School of Medicine at Mount Sinai	• Objective: Launch new large-scale human genome sequencing research project • Dynamic: Mount Sinai Million Health Discoveries Program aims to enroll 1 million Mount Sinai patients over a 5-year period, offering researchers the dataset to assess the potential of genetics-based precision medicine and generate new insights for potential new therapy discoveries and development • Leverage Regeneron's gene sequencing capabilities and scientific research expertise through its Regeneron Genetics Center with Mount Sinai's large, diverse patient population and advanced electronic health records systems
Congenica	Avesthagen	• Objective: Provide genomic analysis and reporting services for Indian firm’s Avgen Diagnostics business unit • Dynamic: Avgen offers whole-genome and exome-based diagnostics services across India to support predictive and preventive healthcare
Congenica	GenomOncology	• Objective: Develop a new diagnostic software platform to support precision oncology • Dynamic: Develop technology on GenomOncology Precision Oncology Platform, then combine it with a new, automated data analysis application from Congenica to improve the usability and scalability of genomic data to produce clinical decision support for individualized cancer therapies • Firms to seek CE-IVD marking for platform in Europe
Paige	Sonora Quest Laboratory	• Objective: Enable Sonora Quest’s Arizona labs to provide "precision diagnostics" • Dynamic: Paige to provide Sonora Quest a custom installation of its suite of AI-powered digital pathology software, including the FullFocus viewer, Paige Prostate Detect, and Paige Breast systems
VolitionRx	University of Texas MD Anderson Cancer Center	• Objective: Research role of neutrophil extracellular traps (NETs) in cancer patients with sepsis • Dynamic: Perform clinical trial using Volition's Nu.Q NETs test for detection and evaluation of NETosis, a form of cell death characterized by the release of NETs that trap and kill bacteria and viral particles
Exact Sciences	West German Study Group	• Objective: Evaluate whether Exact's circulating tumor DNA liquid biopsy test can detect minimal residual disease in hormone receptor-positive, HER2-negative early-stage breast cancer patients • Dynamic: Gather data from 3,000 German patients enrolled in three ongoing studies sponsored by the WSG, in which they have received Exact's Oncotype DX breast cancer recurrence test • ADAPT Triad analysis to generate evidence on ability of tumor-informed ctDNA MRD test to inform treatment decisions and help monitor recurrence of HR-positive, HER2-negative early-stage breast cancer
Metabolon	Mayo Clinic	• Objective: Develop diagnostic tests using metabolomic biomarkers • Dynamic: Metabolon to analyze patient clinical samples across different cohorts from Mayo Clinic to search for disease biomarkers and design tests for use by Mayo Clinic Laboratories • Initial focus: metabolite biomarkers for inflammatory bowel disease and nonalcoholic fatty liver disease
Amprion	Mayo Clinic	• Objective: Evaluate Amprion’s SynTap Biomarker test in rapidly progressive dementia (RPD) patients • Dynamic: Perform test on a mixed cohort of about 200 cerebrospinal fluid samples from well-characterized, clinically diagnosed RPD patients and healthy controls • Work expected to aid in the characterization and clinical evaluation of RPD, as well as understand the underlying role of synucleinopathy in the condition
LGC Clinical Diagnostics	Stanford University Department of Obstetrics and Gynecology	• Objective: Maternal and fetal diagnostic testing research • Dynamic: Exclusive partnership with Stanford to provide LGC clinical guidance in recruiting and selecting patients whose pregnancy has been identified with a genetic abnormality • LGC uses the cases to manufacture reference materials for noninvasive prenatal testing (NIPT)
Caris Life Sciences	Xencor	• Objective: Research, develop, and commercialize XmAb bispecific antibodies directed against new targets for cancer treatment • Dynamic: Discovery and licensing agreement with Caris to use its Caris Discovery platform to identify new targets for bispecific antibody drug candidates • Xencor to get exclusive options to research, develop, and commercialize products directed to up to three targets • Caris to receive upfront payment and be eligible to receive up to approximately $120 million in license fees and discovery, development, regulatory, and sales-based milestones, in addition to royalty payments on net sales of each product Xencor commercializes • Caris to also get future rights for molecular profiling and companion diagnostics related to drug candidates developed under collaboration
EliTech Group	InfanDx	• Objective: Develop test for hypoxic-ischemic encephalopathy (HIE), a form of brain damage caused by lack of oxygen occurring in newborns • Dynamic: Develop and manufacture InfanDx's HypoxE HIE early detection test for use on EliTech's Selectra Pro near-patient clinical chemistry analyzers • InfanDx responsible for assay design, verification, validation and submitting the test for CE-IVD marking • Prototype lots and final product to be contract-manufactured by EliTech

Distribution, Sales, & Marketing Agreements

Product Owner	Distributor	Deal Summary
Amoy Diagnostics	Alercell	• Products: Amoy Diagnostics' ROS1 gene fusion detection kit • Territory: US

Licenses

Licensor	Licensee	Deal Summary
University of Birmingham	Innova Medical Group	Innova licenses Reverse Transcription-Free Exponential Amplification Reaction (RTF- EXPAR) nucleic acid amplification technology
The Wyss Institute (Harvard University)	Spear Bio	Wyss spinout gets worldwide exclusive license to commercialize successive proximity extension amplification reaction (SPEAR) protein detection technology to develop a reagent-based platform for protein detection in small-volume samples
The Wyss Institute (Harvard University)	3EO Health	Exclusive, worldwide license to market at-home PCR-grade assay system with initial plans to develop a COVID-19 test
University of Dundee	Bio-Techne	Exclusive license to BromoTag, a technology that uses genome editing to tag target proteins, labeling them for subsequent modifications such as cellular degradation

Government Contracts

Contractor	Govt. Agency	Contract Summary
Ginkgo Bioworks	US Centers for Disease Control and Prevention (CDC)	$16 million contract, with potential to be worth up to $61 million, to expand partnership with XpresSpa group to provide SARS-CoV-2 surveillance testing in US airports to include Washington Dulles International Airport and new offerings, such as aircraft lavatory wastewater monitoring