12/21/2011 3:55 PM 

Sally Greenberg, executive director of the National Consumers League, did not come right out and call the proposed merger of Express Scripts and Medco a "hound dog."  She did, however, come very close to saying a merged Express Scripts and Medco mega-PBM "ain't no friend of mine."

In a letter-to-the-editor published on The Hill's Congress Blog with the headline "PBMs NOT the friend of consumers," Greenberg took issue with a prior opinion piece by Jonathan Orszag.  Greenberg said that Orszag "portrays pharmacy benefit managers as the best friend of consumers," but "seems to lose sight of the interests of the ultimate consumer here  - the patient."

The National Consumers League is one of the national consumer groups that has written to the Federal Trade Commission to urge rejection of the proposed merger of Express Scripts and Medco.

Greenberg wrote, "In claiming to provide great savings and benefits for consumers, Orszag neglects to mention that many PBMs, such as Express Scripts and Medco, often prevent consumers from using the pharmacy of their choice. Thousands of patients are forced to use mail-order service, cannot use the preferred local pharmacy, and are deprived of the ability to make the choice that works best for them or their families.

"American consumers deserve to be in charge of their own healthcare decisions. But a merged Express Scripts-Medco could deny thousands more consumers the right to choose where they obtain their prescriptions."

Greenberg concluded, "Americans understand that when consumers have fewer choices, and when competition is reduced, prices go up. That’s where Orszag’s argument falls short. We fear that this is exactly what will happen if the Express Scripts-Medco merger is allowed to move forward."