Subcommittee members should oppose PBM merger

Recently, the House Judiciary Subcommittee on Intellectual Property, Competition and the Internet began hearings that will play a significant role in deciding the fate of Express Script's proposed acquisition of Medco Health Solutions.  The outcome is tremendously important - especially to lower-income and minority communities across the country.  These communities are already at a significant disadvantage when it comes to having access to equal and affordable healthcare.  An approved merger could make things a lot harder for a sector of Americans already struggling just to make ends meet.  I hope that the subcommittee members will carefully consider this, and all of the potentially negative effects of an approved merger, before making their decision.

Most Americans today are feeling the effects of our troubled economy in some way or another.  This is especially true for the underserved communities that were struggling just to keep up even when our economy was doing well.  Education, housing, healthcare and jobs are just a few of the areas where underserved Americans have historically lagged behind.  Our economic downturn has only exacerbated these disparities.

For instance, according to the Department of Labor, African American unemployment reached 16.7 percent last month - the highest level since 1984.   Similarly, communities that are traditionally less likely to own their own home are even more likely to have lost their homes as a result of the recession.  And finally, the number of Americans without health insurance grew to 49.9 million last year - this number includes a disproportionate number of lower-income and minority Americans.

 

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These statistics are not pretty, and we need to work together to get things moving in a more positive direction.  To start, we can avoid making things worse for those that have been hit the hardest by taking away access to local community pharmacies and increasing prescription prices.  Unfortunately, this is what could result from an approved merger between two of the largest pharmacy benefit management (PBM) companies.

Not all mergers are bad - and there are certainly cases where merging two industry leaders would be a good thing.  However, in this particular case with these two specific companies, the consequences greatly outweigh any potential good.

PBM companies, which serve as middlemen between pharmacies, insurance companies, and patients, already wield a one-sided advantage in setting prescription medicine contract and reimbursement terms for community-based pharmacies. Express Scripts, one of the larger PBM companies, has already taken an aggressive stance against one of the country's leading community chain pharmacies - a stance that will potentially harm one in three Americans who use this national pharmacy by denying patients access to their local trusted pharmacist and cutting off the availability and convenience of the largest network of 24-hour pharmacies.

If Express Scripts is allowed to merge with Medco, it is very possible that the merged PBM will not only continue this bullying behavior, but will use its size and dominance to cause even greater harm to patients, community-based pharmacies and healthcare outcomes.

The potential harm posed by this merger is nationwide.  Many in the African-American and poorer communities across this country will be adversely affected if this merger is allowed to continue.  Their medical and economic well being are on the line at a time when they at their greatest vulnerability.

In these tough economic times, we can't afford to push policies or plans that increase the already heavy burden on hard-working Americans. Unfortunately, that is exactly what the planned merger would do.  I hope that subcommittee members do not support this potentially harmful course of action and stand with those in need of basic medical care.
 
Eva M. Clayton is a former member of Congress who represented eastern North Carolina (1992-2003), Member of the Agriculture & Budget Committee, and Chair of the Congressional Black Caucus Foundation.

 

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