THEIR VIEW: Jay's voice needed on pharmacy merger

By DENNIS ARCHER

WASHINGTON -- A proposed multi-billion-dollar pharmacy industry merger currently before the Federal Trade Commission may eliminate competition in the market, reduce consumers' choice and access to quality pharmacy care, and drive up the cost of health care.

If two pharmacy benefit management companies, Medco Health Solutions and Express Scripts Inc. are allowed to combine, it will create a market-dominant company with the ability to squeeze insurers, community pharmacies and drug manufacturers. The result will be reduced quality and more expensive pharmacy care for patients and families in West Virginia and every city across the country.

The Mountain State is home to a national leader on health policy who is a champion for quality health care access for all Americans. His voice is now needed on this issue. U.S. Senator Jay Rockefeller can play a powerful role in protecting patient care.

In addition to a nationwide coalition of consumers, small businesses and pharmacies, numerous state attorneys general have publicly opposed the merger. Last week, attorneys general in five of the country's most populous states (California, New York, Ohio, Texas and Pennsylvania) said they are considering filing a lawsuit to stop the merger if it is approved by the FTC. Their concern is that approving the merger as is, will not sufficiently guard against rising drug prices and decreased pharmacy services.

Let me explain why this merger is of such great concern and why it falls in line with Senator Rockefeller's long-held view that health care is a right, not a privilege.

PBMs are middlemen in the prescription drug industry. They manage drug benefits programs for employers, unions, health plans and others. Today, they control the drug benefits of more than 200 million patients nationwide, and they are largely unregulated, which allows them to assert a lop-sided advantage in determining the cost and availability of medications.

A combined Medco-Express Scripts company would have excessive control of the market, hold an unprecedented market share and could increase costs to consumers. These are already the largest and third-largest PBMs in the country, and together they would dwarf the next-nearest competitor. They would also control nearly one out of every three retail prescriptions, more than 50 percent of critical specialty drug prescriptions, and over 60 percent of the mail-order drug industry.

What the average American will see as a result of this merger is reduced choice. Many Americans will be forced into mail-order programs and denied the ability to visit their trusted community pharmacist. Communities will see their local, independent pharmacy shutter when it can no longer survive on the reduced rates paid by the mega-PBM. Employers will see the premiums they pay to provide health benefits to their workers increase - something that could very well lead to job losses or fewer Americans receiving health coverage through their employers.

The PBMs say that by combining resources and market power, they are able to find cost savings in the pharmacy care delivery system. Perhaps, but if that is the case, there is no evidence that consumers or employers will see those savings. Instead, they will increase the PBMs' profits, which have increased by double-digits in recent years.

A Medco-Express Scripts merger will put quality pharmacy care further out of reach for millions of Americans, while increasing health care costs. Senator Rockefeller has spent more than 40 years fighting against this kind of reduced health care access, and as this issue is being decided by the FTC, his voice would be a powerful one today.

Dennis Archer served as the mayor of Detroit, Michigan from 1994 to 2001. He served on the Michigan Supreme Court from 1986-1990. Archer is Chief Legal Advisor for the Preserve Community Pharmacy Access NOW! (PCPAN) coalition that opposes the Express Scripts/Medco merger.

Archer served as the mayor of Detroit from 1994 to 2001. He served on the Michigan Supreme Court from 1986 to 1990. Archer is Chief Legal Advisor for the Preserve Community Pharmacy Access NOW! coalition that opposes the Express Scripts/Medco merger.

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