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Consumer Affairs

Seniors Group Opposes Pharmacy Merger

Worries that it will impact older consumers


PhotoPhotoThe 60 Plus Association, a conservative advocacy group, is asking the Federal Trade Commission (FTC) to block the proposed merger between Express Scripts, Inc. (ESI) and Medco Health Solutions, two pharmacy benefit managers (PBMs) that administer prescription benefits for many health plans, including some Medicare Part D plans.

In a letter to the FTC, the group outlined its concerns about the impact of an approved merger on seniors, in particular.

"Seniors tend to have more chronic conditions and take more medication than other age groups, and are especially sensitive to changes in the pharmaceutical-drug sector of the health market," the letter states. "When seniors lose access to community pharmacies because they are no longer part of a PBM network or go out of business, or when they are forced into a mail-order program, their health and safety is at risk.”

Concerns about impact

Seniors rely on local pharmacists for information, advice and counseling about their medications and possible side effects and drug interactions. Without this one-on-one counseling from a trusted pharmacist, some seniors will experience adverse drug reactions and health complications."

60 Plus said it is concerned that more seniors will be forced into the mail-order programs and lose access to local pharmacies, on whom they rely for information and advice. Some are already expressing frustration.

“I am a caregiver of my parents, who do not have or understand the Internet yet Medco wants them to go online to pay their bill so their much needed medication will not be held up any longer than necessary,” Gail, of Milwaukee, Wis., told ConsumerAffairs.com. It seems Medco will not send out any meds if their balance reaches $100? What? Excuse me? Never have they ever been behind in any kind of payment ever! Dad is fresh out of the hospital, after a three month stint from a bout of pancreatitis. That was when the doctors weren't sure he'd survive, yet, as stubborn as he is, he is still with us, but not through any help or concern of Medco.”

Too much control?

If the merger is approved, 60 Plus says the combined ESI/Medco will control prescription drug benefits for more than 100 million Americans, and more than 50 percent of several important components of the pharmacy market, including specialty pharmaceuticals and mail-order. The group calls that “monopolistic control,” and says it will eventually result in higher prices for all consumers.

"For seniors, the ESI/Medco merger will mean higher prescription prices, fewer choices in pharmacy care, and lower-quality health services than are currently available," said Jim Martin, 60 Plus Association Chairman. "This merger is anti-competitive, anti-consumer and anti-senior, and should not be allowed to proceed."

Noting that it is politically conservative and supports free enterprise, 60 Plus nonetheless says is also supports consumer choice and the well-being of seniors. The ESI/Medco merger, it says, would give two players in the PBM industry an unfair advantage in market share and setting prices. The result: higher prices, loss of pharmacy choices and lower-quality services for seniors.


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Mark Leventhal (Thu, 09 Feb 2012 00:06:02 +0000): What I think they are missing is the Medco has lost so many major clients they will not survive as a self standing company. If they do not merge with someone, they will eventually be forced into bankruptcy. They lost United Healthcare that was over 15% of their business. United Healthcare owns their own PMB so there is no way they are going to stay with Medco.
Cheryl Keller (Thu, 09 Feb 2012 02:09:26 +0000): Oh, wonderful. I just got away from that horrible Medco when my retirement plan when back to Caremark and now they want to merge. We do not need a monopoly of pharmacies. Medco has been dealing dishonest for some time now. As it is with Caremark (express scripts) now I can finally get a 90 supply locally at CVS and avoid the mail order, which I hate! You cannot even get a non child proof cap in the mail. With Medco they would do it but I had to be home to sign every time I got a prescription. Horrible.
Nancy Trincilla Conigliaro (Thu, 09 Feb 2012 15:24:45 +0000): I am very concerned about this merger. Up till now, Express Scripts has been great for my mom. The prices for generic drugs can't be beat by the local pharmacy, the customer service is good and she can pay by check through the mail. Her doctor orders for her online, during her office visits, and if there's any questions about interactions we are free to ask him at any time. If the merger means higher prices and lower quality service, then we are not for it.
MizPusspie Hootiepoot (Thu, 09 Feb 2012 15:37:35 +0000): Mark Leventhal.... I have UHC and have used Medco for my 90 scripts for about 12 yrs now. I hate Medco and their practices, but if I go to a pharmacy to get my meds, UHC will only pay for 21 days instead of a full 30... so I've always felt like I"m over a barrel in this. Can you explain more about your comment that Medco lost UHC? If that's a fact.... why am I still using these jerks?
Jack Carney (Thu, 09 Feb 2012 16:40:14 +0000): What does Obama have to say about this?
Krissy Clark (Fri, 10 Feb 2012 15:05:35 +0000): I HATE Medco! They handle our prescriptions through our work insurance (UHC plan through Chevron). This year, they started adding "penalties" to the cost of my "maintenance" prescriptions that I take every month (i.e. Singulair) because I choose to purchase through my local pharmacy rather than through mail order. The extra fee is approximately $65 per prescription if I don't agree to place my order through their mail system. Of course, they get money either way - they either profit by my purchasing from their crappy mail order system or they profit by having to cover less for my prescription costs due to their imposed "penalties." Never mind that I am no longer able to stay with a pharmacist that I trust. Last year, they called incessantly (several times per day) to try to get me to switch all of my prescriptions to their mail system. It didn't matter how many times I said I wasn't interested, they would not take no for an answer and kept harassing me until, finally, I bloced their calls. Shame on Chevron for okaying this bully! I guess they only care about profits and not their employees (and employees' families).
Laurie Rutledge Moore (Fri, 10 Feb 2012 17:34:43 +0000): How in the world do you get a new prescription filled that you need now? If you need and antibiotic because you have strep, how are you suppose to get it immediately??
Winona Hendrickson (Mon, 13 Feb 2012 02:24:40 +0000): I will not use MEDCO ever again. They suck.
Donna Kingsboro Hill (Mon, 13 Feb 2012 21:47:58 +0000): Express Script is the worst mail order company I have ever dealt with. Luckily my Part D medical insurance company allows us to get our Express Script prescriptions through our local pharmacy. Check your company's policy before you buy.
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