Not long after a Senate Judiciary Subcommittee’s hearing on the proposed Express Scripts-Medco mega-merger of pharmacy benefit managers, two Michigan Republicans became the 28th and 29th Members of Congress to raise questions about the merger.
U.S. Reps. Bill Huizenga (R-Mich.) and Candice Miller (R-Mich.) have written to Federal Trade Commission (FTC) Chairman Jon Leibowitz to express their concerns and to request the FTC closely examine the proposed union.
According to the lawmakers’ letter, “it is of great concern that a consolidated PBM of such great size will simply dominate the market and will use this tremendous market power to squeeze the health care system for greater profits at the expense of the consumer.”
Their letter expresses support for the efforts of independent community pharmacists and adds, “Any potential for diminished choice and access to local pharmacies as a result of this merger is quite alarming.”
In addition, Pulitzer Prize-winning Washington Post columnist Steven Pearlstein has raised concerns about the merger. In a column, also featured on The Hill’s Healthwatch, he called “dubious” the claim that Express Scripts-Medco “will be able to use its clout to negotiate significantly better prices from drug companies for high-priced drugs under patent. With revenues of $44 billion and $66 billion, both companies are big enough to enjoy whatever negotiating advantages come with delivering a large number of customers.”
Mr. Pearlstein questions whether anyone other than the two PBMs involved will benefit from the merger. He is also skeptical that PBM price competition in the large health plan market would remain at today’s level if the “Big Three” (Express Scripts, Medco and CVS Caremark) become a Big Two.