The recent denial of a motion from pharmacy groups to freeze a merger between two of the nation’s largest pharmacy benefit managers by a judge in Pittsburgh (“Express Scripts judge won’t derail Medco merger,” Business, April 25) only adds to the woes of consumer advocates worried about the rising cost of prescription drugs. As Express Scripts and Medco, two powerful managers of prescription drug programs, are cleared to merge, an industry that already operates under a shroud of secrecy will likely become even less transparent. The new mega-PBM’s increased market share will only increase its power to charge plan sponsors huge mark-ups for prescription drugs.
Often, large PBMs like Express Scripts and Medco charge exorbitant fees for medications and keep the profits. This practice is known as spread pricing, and it is why employer drugs costs continue to increase year after year. Meanwhile, pharmacists are contractually forbidden to tell the PBM’s clients how much they receive for the same drug. That lack of transparency gives the PBMs all the privacy they need to price-gouge consumers. The judge in Pittsburgh missed a chance to stop the merger and put an end to this greedy process.
— Dave Marley, president, Pharmacists United for Truth and Transparency, Washington