Congressional Concerns Over Express Scripts-Medco Merger Continue to Grow

In the wake of a key Senate subcommittee hearing this month, and on the heels of the collapse of the blockbuster AT&T and T-Mobile merger, four more US lawmakers have joined the growing ranks of consumer groups, members of Congress, and employers questioning the proposed mega-merger of pharmacy benefit managers (PBMs) Express Scripts and Medco Health Solutions, according to the National Community Pharmacists Association (NCPA).

In a joint letter to Federal Trade Commission (FTC) Chairman Jon Leibowitz, the entire South Dakota Congressional delegation—Senators Tim Johnson and John Thune, and Representative Kristi Noem—urged that “preserving access to care and consumer choice should not be overlooked.” They pointed to the potential dominance that the company, if combined, could have, particularly in the specialty and mail order pharmacy markets, and noted that in South Dakota, “community pharmacists provide vital services to patients and support our local economies.”

In a separate letter to Chairman Leibowitz, Representative G.K. Butterfield (D, NC) noted, “I am concerned that this market dominance could force community pharmacies in my district, and across the country, out of business. In addition, because the consolidated PBM will have the largest piece of a market that is already highly concentrated, there is a possibility that prescription prices would increase. Ultimately this market consolidation and price increase will be disproportionally felt by elderly, poor and rural populations.”

“We greatly appreciate these members of Congress, and all members, who have taken a stand for patients by voicing their doubts about this merger,” said NCPA CEO B. Douglas Hoey, RPh, MBA. “Concern about this merger is bipartisan, bicameral and widespread. If approved, we fear it would reduce patient choice and access to pharmacy services and ultimately result in higher prescription drug costs.

“While CEOs for these companies may talk a good game in their Congressional testimony, many of their claims simply do not hold up to scrutiny,” Hoey added. “Their actions speak louder than words and raise serious questions about their commitment to containing costs for plan sponsors and beneficiaries.”

With these letters, now 33 members of Congress have directly voiced concerns about the merger.

In addition, while the FTC continues to scrutinize the merger, at least 28 state attorneys general have formed a working group to conduct their own review.