More Questions for Express Scripts-Medco Merger; 57th Member of Congress Weighs in

By Kevin Schweers

A remarkable 57 Members of Congress to date have expressed their bipartisan concern regarding the proposed mega-merger of pharmacy benefit managers (PBMs) Express Scripts and Medco. The most recent being U.S. Senator John Boozman (R-Ark.) and Rep. Louise Slaughter (D-N.Y.), each of whom sent a letter to the Federal Trade Commission (FTC) this week on behalf of their respective constituents and local pharmacists.

In his letter, Sen. Boozman raised the possibility that the merger could “substantially decrease competition” especially in the PBM market. “Many of the alternative PBM competitors lack the economy of size and national breadth necessary to compete for many of the large health plan sponsors that compose a majority of the market.”

The Senator, who sits on the Senate Committee on Commerce, Science and Transportation, also registered his concern with respect to the merger’s potential harm on independent community pharmacies. “These entities play a critical role in our healthcare economy, particularly in rural America, and I am concerned with any market transformations that might jeopardize their capacity to operate.”

Rep. Slaughter wrote that the merger’s consolidation of the PBM market and mail order market share “raises the possibility of higher prices for prescription drugs and reduced choices for consumers. My primary concern is the impact that the merger could have on community pharmacies and patients who rely on them not only for their medicine, but also for counseling and other specialized services and products.”

“Community pharmacies are not only providers of crucial health services that our residents need, but also a vital part of our economy,” Slaughter added, noting that the district she represents is home to 34 independent community pharmacies, filling more than 2 million prescriptions annually and providing employment to 364 individuals.

In light of the merger’s impact on hundreds of millions of Americans with private insurance and taxpayer-funded programs like Medicare, Medicaid and TRICARE, she urged the FTC to review the proposal carefully.

A full list of Congressional and other letters questioning the merger was recently updated by NCPA.

NCPA, leading consumer advocates and others continue to oppose this merger, which could lead to reduced competition among PBMs, fewer pharmacies for patients to choose from and higher prescription drug costs.

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