Four more Members of Congress, Republicans and Democrats alike, recently voiced their concern over the proposed mega-merger of pharmacy benefit managers (PBMs) Express Scripts and Medco, bringing the total to 74 combined Senators and Representatives who have raised the issue.
Letters to the Federal Trade Commission (FTC) were sent by U.S. Reps. Rick Crawford (R-Ark.), Robert Dold (R-Ill.), Ron Kind (D-Wisc.) and Bobby Rush (D-Ill.).
“The proposed merger of these two corporations could result in an unparalleled market concentration in an already limited PBM market further exacerbating an increasing problem for pharmacists and further restricting consumer choice,” wrote Rep. Crawford. Citing the one-sided nature of PBM contracts and laws prohibiting independent pharmacies from collectively bargaining, he added that the merger has the potential of “widening the leverage gap which may lead to more independent pharmacies closing shop.”
Given the significant concentration that the merger represents, Rep. Dold wrote of his fear of it “potentially resulting in higher prices and less choice for consumers.” He later noted that, “Without competition, normal market forces that foster continued innovation and keep costs down are missing.”
“This merger is likely to have negative effects on a national scale on local pharmacies, local pharmacy jobs, and affordable and available access for patients to prescription drugs and other critical pharmacy services and offerings,” warned Rep. Rush.
“Market clout and consolidation at such outsized levels would threaten the viability of many smaller local pharmacies and the thousands of community pharmacists and pharmacy staff they employ,” he added. Concerned that “the most disadvantaged, needy and price-sensitive consumers” stand to lose the most, he noted that, “Without question, local pharmacies and pharmacists are often a community’s most accessible and affordable health care provider—this is especially the case in Illinois’ lower-income and minority communities.”
“Because of the significant potential impact of this merger on consumer choice and prescription drug prices, I request that you carefully consider how consumers would be impacted by this merger,” Rep. Kind advised the FTC. “In addition, I represent nineteen counties in rural Wisconsin where community pharmacies are a vital access point to health care. Therefore, while this merger raises important market competition issues that could increase prescription drug prices for consumers, I am equally concerned about patient access to local pharmacies in Wisconsin and throughout the country.”
NCPA commends these Representatives and all who have to date raised bipartisan questions and concerns about the merger.