New Congressional Questions on Express Scripts-Medco Pharmacy Merger

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.

3 Responses to “New Congressional Questions on Express Scripts-Medco Pharmacy Merger”

  1. 1 Kathy Elliott December 15, 2011 at 12:35 am

    I have a question. Why doesn’t the FTC just take a look at the results of the merger of CVS and Caremark ???

    If I remember correctly, the FTC has had at least 2 investions which resulted in “settlements” paid By CVS Caremark, in 2009.

    In June 2010, the FTC launched an open investigation into allegations of both patient privacy violations and anti-competitive behavior following the merger of CVS and Caremark.

    Leibowitz told US Senators that the investigation, in both the Competition and Consumer Protection bureaus, is ongoing.


    Seems simple to me!

  2. 2 Helen Code Boise, ID January 11, 2012 at 9:05 pm

    We received a letter from Medco stating that we now will have to pay an additional $25.00 per prescription if we buy more than 2 months of long term prescriptions from our local pharmacist. Is this legal? What can we do?

  3. 3 kathy rothrock January 12, 2012 at 9:57 am


    Contact your state and US Legislators- and complain- LOUDLY !!! Local, independent pharmacists have been giving them an earful, but it seems as though we “do not matter”… However, when a “constituent” complains, they LISTEN!!!

    For your sake as well as ours, PLEASE DO SOMETHING! Letter to editor, anything. “Bad things happen when good men do nothing”


    kathy rothrock
    Rothrock Drug Company
    Blytheville, Arkansas

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