Proposed ESI/Medco merger hot topic at NCPA convention

Community pharmacists’ opposition to the proposed Express Scripts/Medco Health Solutions merger was heard loud and clear during the National Community Pharmacist Association’s (NCPA) Annual Convention and Trade Show held last week in Nashville, Tenn.

“We continue to be extremely concerned. There have been a number of communications on our part, including the [Congressional] hearing last month,” said B. Douglas Hoey, RPh, executive vice president and CEO of NCPA.

“If this merger is allowed to continue, it is going to be a significant tipping point. If pharmacies cannot negotiate with the PBMs, in all likelihood, certain pharmacies would not engage in their networks,” added Jennifer Mallon, NCPA general counsel.

NCPA has hired the law firm of Hogan Lovells to assist in opposing the merger and has held several conference calls with Federal Trade Commission (FTC) officials. “We are also working with a working group of state attorneys general on this issue. At least 20 states have concerns about the merger,” Mallon said.

Don Colcord, RPh, owner of The Apothecary Shoppe in Nucla, Colo., expressed his concerns about the merger and how declining reimbursements are harming community pharmacies. The Apothecary Shoppe uses Anthem Blue Cross and Blue Shield of Colorado, an Express Scripts company.

Colcord listed 1 example of how declining reimbursements are harming his business. “For Humira [for rheumatoid arthritis], I lose $43.40 every time I use the drug. Also, in many cases, the prescriptions for Medicare Part D are being reimbursed at a rate that doesn’t cover the cost of the bottle,” Colcord said. As a result of such difficulties, he said, there were 3 pharmacies in the Nucla area when Colcord opened his business and now The Apothecary Shoppe is the only one.