Local view: Senators should inspire others to oppose pharmacy merger

Talk about it

On behalf of our 2,000 members in Minnesota and 3,000 members in Wisconsin, we applaud U.S. Sens. Herb Kohl and Al Franken for their leadership and vision. Like us, Sen. Kohl, Chairman of the Subcommittee on Antitrust, Competition Policy and Consumer Rights, and Sen. Franken are very concerned about the ramifications of the proposed merger between Express Scripts Inc. and Medco Health Solutions. If the Federal Trade Commission approves this merger, two of our nation’s largest and most profitable pharmacy benefit managers will combine into an entity with enough market share and control to change the future of the pharmacy profession, threaten small and large pharmacy jobs, raise prescription drug costs and subvert patient access to quality prescription drug care.

This proposed merger has the potential to change and diminish the patient-pharmacist relationship forever.

Patients in urban, suburban and rural areas alike depend on their community pharmacist for trusted advice and counsel regarding their medications, side effects and drug interactions. Express Scripts already has a history of driving patients from their local pharmacy by mandating the use of its mail-order pharmacy. While mail-order pharmacies might be a viable option for some patients, mandating their use will undermine traditional patient-pharmacist relationships.

The FTC cannot ignore the anti-competitive nature of this proposal. If approved, the merger will create a “mega-pharmacy benefit manager” that controls over 40 percent of the national prescription drug volume. This situation would reduce competition while creating serious harm to pricing, which ultimately impacts patient costs.

Pharmacies, especially local community pharmacies, and their employees will suffer the consequences of this anti-competitive marketplace. The reduced reimbursement rates likely to be forced on these businesses by the mega-pharmacy benefit manager could lead to store closures and job losses.

On Dec. 6, Sen. Kohl’s subcommittee, on which both Sen. Franken and Senator Amy Klobuchar, D-Minn., sit, held a hearing on this subject, at which time the chief executives of Express Scripts and Medco each testified. When Express Scripts’ CEO was questioned about the merger, his response was that he “can’t stop certain pharmacies from going out of business.” On Feb. 2, Sen. Kohl wrote to FTC Chairman Jon Leibowitz expressing his grave concerns about how this mega-pharmacy benefit manager would affect consumers and local pharmacies. Last week Sen. Franken spoke directly with Leibowitz to deliver equally serious concerns. We applaud them both.

If there was any industry in which caring should always be part of the equation, that industry would be health care. While this leadership statement is devoid of any caring, it does reflect a value of profit over patients.

Thank you again, Sens. Kohl and Franken. We hope that your colleagues, Sens. Amy Klobuchar of Minnesota and Ron Johnson of Wisconsin and U.S. Reps. Chip Cravaack of Minnesota and Sean Duffy of Wisconsin, are inspired by your collective leadership and will join in expressing their opposition to the FTC regarding this anti-competitive proposal. If approved, it will only undermine patient access, increase costs and undercut the goals of health-care reform.

Julie Johnson is Executive Vice President of the Minnesota Pharmacists Association. Christopher Decker is Executive Director of the Pharmacy Society of Wisconsin.

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