Coalition opposes Express Scripts-Medco deal

A year-old group representing the interests of pharmacies that deal in high-cost specialty drugs is urging the Federal Trade Commission to reject a proposed $29 billion merger between Express Scripts and Medco Health Solutions.

The Independent Specialty Pharmacy Coalition said that both companies run large specialty-pharmacy businesses, which could create conflicts of interest and higher costs with the companies' pharmacy benefit management services.

A written statement from the coalition said years of experience has already shown that pharmacy benefit management companies use their market clout to drive consumers away from independently owned specialty pharmacies. “Allowing a PBM to dominate the management of specialty care in the U.S. is the wrong prescription to control drug costs,” coalition Executive Director Russell Gay said in the written statement.

Specialty drugs are costly therapies developed for chronic conditions such as hemophilia, multiple sclerosis, HIV/AIDS and cancer. The specialty drug pharmacy coalition is currently housed in the Washington law offices of David Balto, a former policy director at the FTC who has been critical of the PBM business.

Last week, officials with the Pharmacy Benefit Management Institute and the National Community Pharmacists Association also came out against the merger, saying a combined Express Scripts and Medco would be able to “unfairly dominate the market.”

Express Scripts spokesman Brian Henry said PBMs help to manage healthcare costs, both in terms of pharmacy and medical benefits.

"The natural role of PBMs is to promote more competition throughout the pharmaceutical supply chain, including specialty pharmacies," Henry's statement said. "Since PBMs possess a deeper understanding of pharmacy pricing trends than most individual patients do, we help patients choose the most effective and most cost-efficient specialty pharmacies. In doing so, we are promoting competition and driving down overall healthcare costs."