Specialty pharmacy group urges regulators to oppose ESI-Medco acquisition

WASHINGTON — The ink has barely dried on the acquisition agreement between pharmacy benefit management giants Express Scripts and Medco Health Solutions, but several groups already are seeing smudges — most recently, a trade organization representing independent specialty pharmacy providers.

On Monday, the Independent Specialty Pharmacy Coalition urged the Federal Trade Commission to block Express Scripts' $29.1 billion acquisition of Medco, saying the two PBMs' large specialty pharmacy businesses would create a "clear conflict of interest with their drug authorization duties as a pharmacy benefit manager." The ISPC said they had not lowered drug costs as a result of controlling specialty pharmacies, but instead used their control of them to prevent customers from using the pharmacies of their choosing.

"Allowing any PBM to acquire a dominant position in the specialty drug market will be a giant step backward in our nation's efforts to improve health care and manage drug costs," ISPC executive director Russell Gay said. "This proposed deal poses tremendous risk to all consumers, especially those dependent on vital specialty drugs."

The ISPC's statement follows a joint statement on July 21 by the National Community Pharmacists Association and the National Association of Chain Drug Stores that the Medco-ESI deal would "exacerbate PBMs' detrimental effect on pharmacy patient care" and that it would create "a middle man that is too big to play fair and will have immense power to unfairly dominate the market."