Consumer, Antitrust Watchdogs Tighten Screws in Case against PBM Mega-Merger
1/10/2012 2:30 PM
High profile national organizations have written again to the Federal Trade Commission (FTC) to debunk arguments that - while dubious - have been utilized to allay fears about the potential ramifications of the proposed Express Scripts and Medco merger. The organizations that wrote the letter to help prevent the proposed merger from slithering through the antitrust review process include National Consumers League; Consumer Federation of America; American Antitrust Institute; Community Catalyst; U.S. PIRG; and the National Legislative Association on Prescription Drug Prices (NLARx).
The groups wrote, "There appears to be a common misperception that health plans are able to effectively
represent the consumer interest and alter the anti-consumer conduct of PBMs. We do not believe
that is the case currently and is even less likely to be true if this anticompetitive merger is
approved. Health plans often have distinctly different interests than their subscribers, and thus
have not been adequate protectors of consumer concerns. When consumers are victimized by
anticompetitive, fraudulent, or deceptive conduct by PBMs, they cannot easily change health
plans in response. Nor are health plans particularly sensitive to these complaints and the PBM
and plan may simply blame each other leaving the consumer with little or no recourse.
"Moreover, health plans may be insensitive to higher costs to consumers, in either higher
out of pocket costs or lower quality of service. Many health plans that encounter unreasonably
high expenses in their interactions with PBMs simply pay them, and then pass on these costs to
consumers in the form of higher premiums. As the PBM market continues to consolidate, health
plans will only become less able to protect consumers. This merger will create a dominant PBM
with the market power and leverage to effectively force plans into restricted networks that will
ultimately harm consumers."
The organizations noted that the National Coordinating Committee for Multiemployer Plans, an AFL-CIO umbrella group covering over 26 million Americans, has come out in opposition to the merger.
Click here to read about a prior communication to the FTC from leading consumer groups, and click here to read about a prior communication to the FTC from the American Antitrust Institute.