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NEW YORK — A less-than-flattering assessment of pharmacists from Express Scripts Inc. chief executive officer George Paz has fanned the flames over his company’s proposed merger with Medco Health Solutions Inc.
Paz, who is the company’s chairman and president as well as CEO, remarked during Express Scripts’ fourth quarter conference call, “Nexium is Nexium, Lipitor is Lipitor, drugs are drugs, and it shouldn’t matter that much who’s counting to 30.”
Paz also said patients generally are able to change from one retail pharmacy provider to another with little or no disruption.
Steve Anderson, president and CEO of the National Association of Chain Drug Stores, noted that Paz and Medco CEO David Snow told Congress in recent hearings that they like pharmacists. “Their comments about pharmacists in other settings may not rise to contempt of Congress, but they certainly meet the standard for contempt of patient care,” said Anderson.
He added that Paz’s comment “rivals the insensitivity toward patients and pharmacists” shown by Snow with his “now infamous ‘robots versus pharmacists’ comment.” (Snow said in October that Medco’s robots are “23 times more accurate” than human pharmacists.)
NACDS emphasizes pharmacy’s role as the “face of neighborhood health care,” calling attention to the “unparalleled value” of pharmacists as demonstrated through services including medication counseling, vaccinations, health screenings and education, and disease state management.
The association cites successes such as North Carolina’s ChecKmeds NC program — an example of how face-to-face medication therapy management (MTM) services for Medicare patients have helped to deliver a return on investment of $13.55 for every $1 invested.
Also, in the annual Gallup poll that measures public opinion of honesty and integrity across professions, pharmacists have ranked in the top three for nine consecutive years, and in every year but one since 1981. A July 2009 PricewaterhouseCoopers report found that respondents reported the least amount of difficulty in accessing care from pharmacists when compared with other health care professionals.
Also taking umbrage at Paz’s comment was Preserve Community Pharmacy Access Now! (PCPAN), a coalition formed last fall to oppose the Express Scripts-Medco merger. The group of consumers, businesses and community pharmacists claimed the remark illustrates a pattern of anti-pharmacist statements.
“ESI and Medco have spent the last several months trying to defend their merger against claims it would result in decreased access to local community pharmacies, but recent comments demonstrate that ESI and Medco completely devalue pharmacists and show that the claims are indeed valid,” PCPAN chair Eva Clayton, a former Democratic congresswoman from North Carolina, said in a statement.
“Comments like this should raise serious concerns about how a combined company with such an attitude would treat pharmacies that provide important services and employ people in our communities. This is yet another reminder that this merger must be stopped.”
PCPAN noted that in a Senate hearing last December Paz testified that he “can’t stop certain pharmacies from going out of business.”
Express Scripts and Medco have said that the $29.1 billion merger, announced in late July, is slated to close in the first half of 2012, pending regulatory approvals.
The deal is being reviewed by the Federal Trade Commission. The merger would combine the No. 2 (Express Scripts) and No. 3 (Medco) pharmacy benefit managers, creating the nation’s largest provider of prescription drug benefits, with about a third of the market between them.
“Nothing good can come from combining two health care giants that do not see the value in community pharmacists, and that have incentives to drive customers away from pharmacies and into their own mail-order programs,” Clayton stated. “The truth is an approved merger could have a devastating effect on health care and jobs in this country.”
PCPAN reported in February that over 100 employers nationwide sent a letter to the FTC to express their concerns about the proposed merger, particularly regarding the prospect of limited choice when shopping for pharmacy benefit plans.
“If the merger is approved, the company that emerges will manage the prescription plans for roughly 135 million Americans,” the letter stated. “PBMs are already a highly concentrated industry, and this merger will only magnify that problem. Because of this concentration, the merger will result in even fewer choices in an already limited market for employers who are seeking cost savings in their various health plans.”
