Wrong Prescription for Lowering Costs

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As appeared in St. Louis Today

Merging two giant pharmacy-benefit managers is the wrong prescription for lowering drug costs ("Express Scripts-Medco merger is good for business, consumers," Aug. 24, 2011). The Federal Trade Commission should reject it.

It would create a dominant firm with more than 50 percent of the rapidly growing, ultra-expensive specialty drug market and nearly 60 percent of the mail-order industry.

Such consolidation probably would lead to anticompetitive and monopolistic behavior. It also probably would raise costs for patients, the government and employers. Already, these major PBMs have paid $370 million to settle charges of fraud and deceptive practices.

Express Scripts estimates $403 billion in medication-related "waste." Its No. 1 recommendation is moving patients to its mail-order facilities. Yet the company's figures estimate that would reduce "waste" by just 1.9 percent, while disrupting many patients and local economies.

The real savings—the 98 percent—is in utilizing pharmacists to ensure proper medication use and the appropriate use of low-cost, generic drugs. Ironically, in 2010 Express Scripts' mail order service dispensed generics 60.2 percent of the time compared to 72.7 percent at local pharmacies.

Douglas Hoey • Alexandria, Va.
Executive Vice President and CEO,
National Community Pharmacists Association

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