I actually was referred to a Canadian pharmacy by a local druggist because my medications when combined together were very expensive and I was about to quit taking all of them. My druggist where I do purchase locally told me that I should not quit taking them but go to Canada. If this option is removed I will not be taking things I'm supposed to take. Robert

Will FTC allow PBM monopoly?

posted Thu, 23 Feb 2012

The Federal Trade Commission (FTC) is now considering whether to allow Express Scripts and Medco Health Solutions (two pharmacy benefit managers) to merge. Community pharmacists, consumer rights groups and the attorney generals of 25 states oppose the merger, saying that it will negatively influence patient care and drive up prescription drug costs.

We’ve written before about our concerns with pharmacy benefit managers (PBMs). In theory, these companies assist in keeping prescription drug prices down because they act as intermediaries between big pharmaceutical companies and employers or insurance companies by negotiating bulk purchasing rates on prescription drugs. But the reality is not so straightforward. While it’s true that big PBMs save Americans money, it’s becoming clear that they could save us a lot more.

In the last decade, profits for the top three PBMs—Express Scripts, Medco and CVS Caremark—have grown at an exponential rate. If Express Scripts and Medco were to merge, they would form a conglomerate with estimated profits of $100 billion per year. This behemoth would fill one of every three U.S. prescriptions.

This mega-PBM would surely dominate the marketplace. Local pharmacies won’t be able to compete. Critics say PBMs have a history of forcing consumers into ordering their prescriptions by mail. Though mail order may be more efficient, it’s not the best choice for all consumers. Clearly there are people who gain health benefits from in-person consults with pharmacists.

The bottom line is that PBMs are for-profit businesses. And in any big corporation, the primary responsibility is to make money for shareholders. Express Scripts and Medco have done incredibly well with that task. If the FTC allows them to merge, the companies argue that they will have enhanced negotiating power—allowing them to get better prices on drugs. But can we trust them to pass those savings on to consumers?

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