Lawmakers, Pharmacists Rally Against Express Scripts-Medco Merger Proposal

Published Online: Thursday, November 3, 2011
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National Community Pharmacists Association (NCPA) CEO, B. Douglas Hoey, RPh, MBA, participated in a press conference organized by the Preserve Community Pharmacy Access NOW! (PCPAN) coalition at the U.S. Capitol this morning, culminating an advocacy push that brought community pharmacists to Washington, D.C. from around the nation to urge the Federal Trade Commission (FTC) to reject the proposed mega-merger of pharmacy benefit managers (PBMs) Express Scripts and Medco Health Solutions.

PCPAN is a broad coalition of consumers, business and pharmacists chaired by former US Representative Eva M. Clayton (D, NC) in opposition to the merger. Also participating in the press conference were current U.S. Representatives Thomas Marino (R, PA) and Joe Courtney (D, CT). Hoey issued the following statement:

"The current PBM marketplace is flawed and we fear matters will only get worse if the Express Scripts-Medco mega-merger is approved. NCPA stands united in principled opposition with the Preserve Community Pharmacy Access Now! coalition, members of Congress like Thomas Marino and Joe Courtney, other consumer advocates, small businesses and a host of others.

"Quite simply, the windfall profits of major PBMs have soared and everyone else has been paying the price. To paraphrase independent pharmacist and NCPA member Joseph Lech during a recent Congressional hearing, we've previously heard PBM claims of reducing costs through mergers, but prescription prices keep going up, plan sponsors keep paying more, consumers are paying higher co-pays and pharmacies are being paid less, so where's the money going?

"The marriage of Express Scripts and Medco would give one corporation control of nearly 60% of the mail order pharmacy market and 52% of the specialty pharmacy market. It could mean more wasteful mail order spending and higher price spikes for specialty drugs. The already limited pharmacy management options for the largest health plans, including the federal government, will grow further captive to the major PBMs. Currently 42 out of the Fortune 50 largest US employers use the 'Big Three'—Express Scripts, Medco or CVS Caremark. It is safe to say that if the merger is green-lighted, the remaining two companies would face little, if any, resistance to raising costs, reducing choice and otherwise putting their own interests ahead of those of employers, patients and others.

"Another reason to oppose the merger is that PBMs have a history of getting their hand caught in the proverbial 'cookie jar.' PBMs have paid the states a total of $370 million for past actions, and now 28 state attorneys general are looking into the merger with a wary eye. The likelihood of further litigation will only increase in a post-merger environment.

"The unchecked, virtually unregulated growth and consolidation among PBMs also reinforces the case that Congress should pass companion bills S. 1058/HR 1971, The Pharmacy Competition and Consumer Choice Act of 2011, and HR 1946, The Preserving Our Hometown Independent Pharmacies Act. These bills would significantly boost the patient's choice of pharmacy while effectively curbing questionable PBM business practices that drive up health care costs."
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