Congressional Questions Mount on Express Scripts-Medco Mega-Merger

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Alexandria, Va. - October 24, 2011

Today the National Community Pharmacists Association (NCPA) pointed to a growing chorus in the U.S. Congress expressing concern with the proposed mega-merger of two of the three largest pharmacy benefit managers (PBMs)—Express Scripts and Medco Health Solutions.

In the latest development, 14 bipartisan members of the House of Representatives—Robert Aderholt (R-Ala.), Spencer Bachus (R-Ala.), Joe Bonner (R-Ala.), Mo Brooks (R-Ala.), Judy Chu (D-Calif.), Maurice Hinchey (D-N.Y.), Ruben Hinojosa (D-Texas), Tom Marino (R-Pa.), Cathy McMorris Rogers (R-Wash.), Mike Rogers (R-Ala.), Martha Roby (R-Ala.), Terri Sewell (D-Ala.), Peter Welch (D-Vt.), and Don Young (R-Alaska)—sent a joint letter to the Federal Trade Commission (FTC) explaining their misgivings about the merger. Rep. McMorris Rogers, the co-chair of the Congressional Community Pharmacy Caucus, spearheaded the letter.

In the Senate, the Chairman of the Health, Education, Labor & Pensions Committee, Sen. Tom Harkin (D-Iowa), voiced similar unease in a letter to the FTC. "I am concerned that combining two of the country's three largest PBMs might lead to reduced competition, less consumer choice, decreased access to pharmaceutical services, and ultimately higher prescription drug prices for health plan sponsors and consumers," he wrote.

Separately, congressional staff confirmed the intent of Sen. Herb Kohl (D-Wis.), chairman of the Senate subcommittee on antitrust, competition policy and consumer rights, to hold a hearing to examine the merger in November. This follows a Sept. 20 hearing of a House Judiciary subcommittee led by Rep. Bob Goodlatte (R-Va.).

"The U.S. Congress is clearly taking a much-needed and forceful role in favor of rigorous oversight of the proposed Express Scripts-Medco merger, clouding the once-certain forecasts of the deal's approval," said NCPA CEO B. Douglas Hoey, RPh, MBA. "Legislative time is at a premium, so these two hearings represent a major statement of congressional concern over this merger. These developments also demonstrate NCPA's tireless and coordinated efforts in opposition to the merger."

"The bottom line is this merger would reduce patient choice and access to pharmacy services and ultimately result in higher prescription drug costs, as history has shown," Hoey added. "Putting more than 50 percent of the U.S. specialty drug market and close to 60 percent of the mail order market in the hands of just one, growing company would be a recipe for disaster for patients, employers, government agencies and other health plan sponsors. We thank all the members of Congress who vocalized their uneasiness with the merger's impact on the marketplace after hearing the concerns of consumers and pharmacists, which NCPA has and will continue to deliver to Capitol Hill and elsewhere."

Separate letters have also been sent by Sen. Kent Conrad (D-N.D.) and Reps. Joe Courtney (D-Conn.), John Conyers (D-Mich.) and Jan Schakowsky (D-Ill). In addition, while the FTC continues to scrutinize the merger, at least 29 state attorneys general have formed a working group to conduct their own investigation.

The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent a $93 billion health care marketplace, dispense over 37% of all retail prescriptions, and employ more than 315,000 people, including 62,400 pharmacists. Independent community pharmacists are readily accessible medication experts who can help lower health care spending. They are committed to maximizing the appropriate use of lower-cost generic drugs and reducing the estimated $290 billion that is wasted annually by improper medication use. To learn more go to or read NCPA's blog, The Dose, at

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