No Choice for Pharmacy Prescription Drugs if Merger Approved

Herndon Virginia workers comp lawyer Doug Landau shares consumer group concern over the proposed Medco and Express Scripts merger, as the new giant pharmacy benefits manager could restrict the access to new drugs and give even more control to Virginia workers compensation insurance companies over injured workers and their families

If a proposed merger between Medco Health Solutions, Inc. and Express Scripts takes place, consumer groups fear that patients’ choices would be restricted and costs of medicine would be increased. The proposed merger of two of the three largest pharmacy-benefit managers (“PBMs”) is the subject of a U.S. House antitrust subcommittee hearing. The hearing will examine the merger’s likely effect on PBM competition and health-care costs. Five consumer-advocacy groups sent a joint letter to the U.S. Federal Trade Commission. The consumer groups are: Consumers Union—the publisher of Consumer Reports—as well as Consumer Federation of America, National Consumers League, U.S. Public Interest Research Groups and the National Legislative Association on Prescription Drug Prices.

The groups want the government to examine the merger’s likely effect on PBM competition and health-care costs according to the Wall Street Journal. A combined Express Scripts-Medco would “substantially” reduce competition, giving the merged company an “incredible dominance” of the fast-growing specialty pharmacy market, according to the letter. A merger could also lead to consumers being pushed into highly restrictive pharmacy networks and limit access to new, innovative drugs, according to the letter. Express Scripts launched a $29 billion bid in July to buy its rival Medco, combining the first- and third-largest PBMs by revenue. CVS Caremark Corp. is the second-largest PBM.

PBMs administer prescription-drug coverage for employers and insurers, promising to fetch lower prices with drug makers and pharmacies by buying in large quantities. At the Herndon law firm, ABRAMS LANDAU, we are concerned when insurance companies, third party administrators (“TPAs”) and employers control the supply of necessary medications to injured workers and their families. Virginia Workers Compensation lawyers have seen insurers and employers cut off medicines to disabled workers despite “open comp awards.” The wait for needed drugs be a nightmare, as Northern Virginia Compensation claims are being set 6 months from now in the Fairfax County workers comp office. Because of the delays and the control by insurance companies of access to medical care and medications, it is important to watch and hire the best experienced Virginia workers compensation lawyer for your on the job injury case.