Pa. Pharmacy Council Opposes PBM Merger

CAMP HILL, Pa. — The Pennsylvania Pharmacy Council opposes the planned merger of two large pharmacy benefit management companies, Medco Health Solutions and Express Scripts (ESI), it announced Monday.

Health plans hire PBMs to reduce prescription costs by negotiating directly with pharmacies and drug manufacturers. A Medco/ESI merger would result in unprecedented power to set the terms by which an estimated 135 million patients obtain medications, and the drug costs and reimbursement fees for community pharmacies, according to PPC. The Federal Trade Commission is examining issues related to the merger.

PPC is concerned since PBMs are increasingly referring patients to their own mail-order pharmacy companies, and in some cases mandating it.

“Community pharmacists are accessible health providers that patients see regularly for medications and for personalized counseling,” said Randy St. John, PPC senior vice president, in a statement. “But the proposed Medco/ESI merger could bring an end to community-based pharmacies and the convenient services provided there.”

Discuss this Article 1

Anonymous (not verified)
on Jan 4, 2012

The decision to mandate the use of mail order is not made by the PBM but by the plan sponsor.

In efforts to save money for the plan and their members, plan sponsors often make it more appealing to the members to use mail order. Either through amount of coverage and sometime requiring mail order.

So the statement saying the the PBMs require members to use mail order is not factual.

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