By Dennis Archer, Chief Legal Advisor to Preserve Community Pharmacy Access NOW!
There’s always a lot of activity as we enter into a new year, people are returning to work, businesses are mapping out their business plans for the year, and Members of Congress are returning to Washington to begin a new legislative session. The Federal Trade Commission (FTC) will be making a decision on the mega-merger between Express Scripts Inc. and Medco Health Solutions, two of the nation’s leading pharmacy benefit managers (PBMs).
To many, the issue may seem like it won’t have much of an impact on the everyday American. For most of us, it’s the price and the convenience that matter most when filling prescriptions. We ask for example: How much will it cost?; and can I go to my local community pharmacy? These are the questions patients ask when considering their prescription coverage. However, this is the precise reason why one ought to care about this massive PBM merger—it will have a major impact on both of these important issues, and much more.
Currently, more than 60 percent of Americans are covered by one of three major PBMs, Express Scripts, Medco, and CVS/Caremark. To combine two of these three companies would result in lost competition, and anyone with basic knowledge of economics will tell you that lack of competition will nearly always result in higher prices.
Additionally, this mega-PBM will wield much power over local community pharmacies, possibly reducing their reimbursements, forcing their customers to go elsewhere for prescriptions, or even mandating that customers must fulfill prescriptions via mail order service. The result? Pharmacy access for chronically ill patients who rely on their pharmacists as a part of their health care team will be lost, prices for those lucky enough to still have access to a community pharmacist may go up, and local economies feeling the effects of the loss of small businesses and independently owned pharmacies will suffer. Thus, this merger affects us all!
While the merger will heavily impact rural areas where access to quality pharmacy care is already an issue, the effects of this merger will be felt across the country. And while vulnerable populations such as seniors, low-income, or chronically ill patients will be affected most, this is not an issue bound by geographic, ethnic or demographic makeup. In fact, opposition is rising to this merger from a wide variety of Americans: small business owners, community pharmacists, patient groups, seniors groups, and legislators are speaking out about the damaging and costly impact of the merger.
Lawmakers concerned about the resulting lack of competition and its impact on community pharmacies and consumers have voiced their opposition to the merger. In a letter to the FTC, Representative G.K. Butterfield (NC-01) raised concerns. Soon after, the entire Congressional delegation of South Dakota expressed their opposition. An assemblywoman in New York also led a rally of her constituents in opposition to the merger. Additionally, the merger has been the subject of hearings in both the House Judiciary Subcommittee on Competition and the Senate Judiciary Subcommittee on Antitrust, Competition Policy and Consumer Rights.
We know that the FTC is listening to this diverse array of voices speaking out against this merger, and we hope that they’ll do the right thing when the time comes, and stop it in its tracks.
Dennis W. Archer was the mayor of Detroit from 1994 to 2001. Before that, he served on the Michigan Supreme Court from 1986 to 1990. After leaving public office he became the first African American president of the American Bar Association in 2002-2003. Currently, he is Chairman of the Detroit-based law firm Dickinson Wright.