Concern with a proposed merger of drug plan administrators is growing on Capitol Hill, with three more lawmakers urging federal regulators to give "close scrutiny" to a deal they say could force millions of Americans to pay more for their medicines.
The new letter brings to at least eight the number of lawmakers of both parties who have expressed concern with the proposed merger between Express Scripts and Medco Health Solutions.
Reps. Henry Waxman (D-Calif.), Frank Pallone (D-N.J.) and Diana DeGette (D-Col.) - the top Democrats on the Energy and Commerce Committee and its health and oversight panels - wrote to Federal Trade Commission Chairman Jon Leibowitz on Friday to share their concern that the proposed merger could harm patients and taxpayers.
Proponents of the merger, however say both groups stand to gain as pharmacy benefit managers force pharmacies and other drug distributors to become more efficient.
"The market for prescription drugs, which involves often opaque interactions between insurance companies, pharmaceutical manufacturers, pharmacies, and PBMs, is complex and rapidly changing, and the impacts of this merger could be significant," the lawmakers wrote. "We are therefore asking that you carefully examine the impacts on healthcare cost and access as a result of the proposed Express Scripts-Medco merger."
Pharmacy Benefit Managers are third-party administrators of prescription drug programs who act to keep costs low by negotiating low drug prices and getting people on generics.
Critics of the proposed merger between two of the nation’s largest PBMs say it would create a behemoth that would control more than half of specialty pharmaceutical sales for cancer and other complex diseases and close to 60 percent of the mail-order market.
"The merged entity will be able to use their dominance to shift patients to favor their in-house mail operations," the National Community Pharmacists Association said in written testimony ahead of a hearing Friday on consolidation in the healthcare industry.
"This shift in 'mix' will force more customers to mail order and deprive consumers of access to their local pharmacies, which provide vital healthcare services," the association said.
Other lawmakers have also weighed in.
House Judiciary Committee member Tom Marino (R-Pa.) issued a statement this summer expressing his concerns.
"Hometown pharmacies are already at a substantial disadvantage when it comes to negotiating with the PBMs," he said. "This merger could worsen the problem and ultimately lead to increased costs and decreased quality of care."
Last month, Rep. John Conyers (D-Mich.), the top Democrat on the House Judiciary Committee, asked committee chairman Lamar Smith (R-Texas) to hold a hearing on the issue.
Reps. Don Young (R-Alaska), Jan Schakowsky (D-Ill.) and Joe Courtney (D-Conn.) have all separately written to Leibowitz.