NEW YORK — The retail pharmacy and specialty pharmacy communities applauded the Federal Trade Commission’s move for further investigation of the proposed merger of pharmacy benefit managers Express Scripts Inc. and Medco Health Solutions Inc.
The National Association of Chain Drug Stores and the National Community Pharmacists Association have commended the FTC for issuing a "second request" with the two companies for information on the blockbuster deal, which would create the nation’s largest PBM, holding about a third of the market for prescription drug benefits.
"This is an important step in the careful consideration of a proposed merger that would have anticompetitive effects on patients, consumers, the market and the entire health care delivery system," NACDS president and chief executive officer Steve Anderson and NCPA executive vice president and CEO B. Douglas Hoey said in a joint statement.
"As we indicated to the FTC in our formal letter, NACDS and NCPA are concerned that the merger would result in a consolidated pharmacy benefit manager with excessive market power, ultimately to the detriment of consumers," Anderson and Hoey stated. "As community pharmacies whose primary concern is patient well-being, we are concerned about the threat posed by the planned merger to patient care and pharmacy access. We will support the continued and comprehensive investigation of this issue."
The FTC’s second request for information on the Express Scripts-Medco merger deal also was hailed by the Independent Specialty Pharmacy Coalition (ISPC), which said the union of the two PBMs could end up raising prices and threaten the level of care for millions of patients with chronics conditions that require extensive drug therapy management, such as hemophilia, infertility, multiple sclerosis, Crohn’s disease, hepatitis C, severe rheumatoid arthritis and cancer.
"The ISPC commends the commission on issuing a second request in the review of a merger that would combine two of the three largest pharmacy benefit managers and the two largest specialty pharmacy companies," commented Russell Gay, executive director at ISPC. "We are glad to see the FTC will be taking a detailed look at how further consolidation of the PBM and specialty markets may negate efforts to contain health care costs."
According to ISPC, the deal would give Express Scripts a 52% share of the specialty pharmacy market. Chief among the coalition’s concerns are that the merger would give Express Scripts the leverage to restrict specialty pharmacy network access and push manufacturers into exclusive distribution arrangements, resulting in higher prices for consumers and less patient choice.
"This merger would have a significant and harmful impact in the critical specialty market," Gay stated. "Specialty drugs are the most expensive drugs and serve the most vulnerable patients. The FTC will need to focus a lot of attention on the specialty market to truly understand the far-reaching implications of this deal."
Pointing to the high expense of of specialty drugs, ISPC reported that the average cost of a specialty medication is $1,867. The coalition, citing the Medco 2011 Drug Trend Report, also noted that about two-thirds of the drug trend over the next three years will be driven by new and current specialty medications. And by 2016, eight of the top 10 prescription drugs will be specialty medications.
