NACDS urges opposition to Express Scripts-Medco merger in comments to U.S. House panel
ALEXANDRIA, Va. — The National Association of Chain Drug Stores is calling on Congress to scrutinize the proposed merger of pharmacy benefit managers Express Scripts and Medco and, in a letter submitted Friday to the House of Representatives Ways and Means Subcommittee on Health, outlined the “problems” it believes would result from the mega-merger.
The House panel held a hearing Friday titled “Health Care Industry Consolidation.”
“This proposed merger, if allowed, would have grave consequences for consumers and the nation’s community pharmacies that serve them, as well as for health plans and employers that utilize PBM services, including Medicare Part D, specialty pharmacy services and mail-order pharmacy services. In fact, just last week, the FTC issued a ‘Second Request’ to Express Scripts and Medco to gather more data on the merger. Clearly, this proposed merger should be subject to a high level of scrutiny,” the comments stated.
NACDS stressed that the anticompetitive nature of this merger ultimately will hurt patients the most, limiting their choice in how and where they obtain their pharmacy services and prescription medications.
“The proposed merger of Express Scripts and Medco would result in unparalleled market concentration in an already extremely limited marketplace. Express Scripts and Medco are two of the ‘Big Three’ PBMs that control 50% to 60% of the national overall prescription drug volume. If approved, approximately one-third of all Americans (roughly 135 million people) would rely on the new ‘super PBM’ to manage their prescription benefits. Certain classes of customers, such as large, complex health plans, would be left with only two choices for PBM services: the merged entity and the one remaining large PBM,” the comments stated.
The letter also denounced claims that PBMs reduce costs in the healthcare system. “PBMs operate unregulated and in an opaque manner. They claim that they save money by negotiating rebates and discounts from drug manufacturers and negotiating lower reimbursement rates from pharmacies. However, there is no proof that they pass along any of this purported savings to health plans, employers and ultimately to consumers," NACDS stated in its comments.
"In recent years, cases brought by a coalition of over 30 state attorneys general have resulted in over $370 million in penalties for deceptive and fraudulent conduct," NACDS continued. "In essence, the PBM uses lack of transparency to negotiate higher rebates from drug manufacturers, higher drug prices for health plans/employers and lower payments to pharmacies, while keeping the gains for itself.”
The PBMs also claimed that they help drive down health costs by utilizing mail order for prescription medications. However, their increased market share will eliminate patient access to community pharmacy and force consumers and employers to instead use their mail-order system only, NACDS stated. In addition, NACDS highlighted research that showed that community pharmacy — not PBMs — have higher generic drug dispensing rates than retail community pharmacies.
“Although the merging firms may claim that shifting prescriptions to mail-order prescriptions from retail community pharmacies will drive down drug costs to consumers, their increased market power is likely to result in an artificially high reduction in prescriptions filled through community pharmacies, and increased costs for payers and beneficiaries. A ‘super PBM’ would be even more likely to increase drug costs by shifting more patients to mail order, which utilizes more expensive, brand-name drugs. This increased cost would be borne by health plans, including Medicare Part D, employers and ultimately consumers,” the letter stated.
“NACDS thanks the committee for consideration of our comments on healthcare industry consolidation. We are extremely skeptical that the American public can trust a ‘super PBM’ to look out for the best interests of patients and payers, including Medicare Part D, or to pass any purported ‘savings’ along to beneficiaries and other consumers. These concerns are compounded by the fact that the PBM industry as a whole is virtually unregulated,” NACDS concluded in its comments.
I think it is trustful healthcare industry. But stile now i suggest be careful. This industry and other industry is totally deference about care. Just like that, Television Media Buying is not so care.But healthcare industry is too much careful industry.
Usually, with most insurance today, the amount the insurer pays the docs is already agreed upon. If you have insurance B, then it doesn't matter which doctor you go to, insurance B will pay the same. Only thing you can shop around is the health insurance check Penny Health for health insurance ideas to save money.
Walgreens: master of multifaceted multichannel offerings
WHAT IT MEANS AND WHY IT’S IMPORTANT — There are plenty of retail banners out there that are successfully connecting and interacting with their best customers while they field a robust multichannel offering. But how many are fielding a multifaceted multichannel offering? Whatever retailers you’ve placed on that list, Walgreens has got to be the one banner at the tippy-top.
(THE NEWS: Walgreens mobilizes Facebook fan base to drive flu voucher program. For the full story, click here)
There are just so many angles, so many new ways of thinking how business gets done, that can be drawn from this story. For starters, what other venue outside of social media allows you to "share" with 1 million of your best customers in real time? And these aren’t passive customers — they all opted in for that connection by very publicly stating how much they "like" the brand.
That’s how social media becomes such a powerful enabler. Those retailers embracing a comprehensive social media outreach strategy are finding that they can communicate quickly with their most loyal customers in a relatively inexpensive way. Think about it — how expensive a proposition would it be to reach 1 million impressions through a 30-second spot during primetime network television? How expensive a proposition to reach 1 million impressions on radio? In print? And of those 1 million paid impressions, how many already have intimated that they really like shopping at the advertised location?
Then there’s the social stewardship this story represents. Walgreens isn’t propositioning a message of, "Hey, come spend some money in our stores!" No. Walgreens instead is saying, "Listen, stick with us and we can accomplish good things together!" All someone has to do is check in. That’s it. See what’s happening. And in that simple act that can take place on their laptops at work, on their iPads while they take the kids to the playground or on their smartphones during some down time, Walgreens’ customers can feel that they’ve helped someone else realize better health. Because, in a very real way, they just did.
Finally, think about the other underlying message Walgreens is getting out there through a sort of grassroots social media campaign. "You can get your flu shot at Walgreens. Anytime you want." It wasn’t too long ago that flu shots had to be scheduled at the retail pharmacy, and those shots could only be administered by nurses participating in a third-party flu clinic hosted at the home store. But today consumers can fit their health care into their own, personal schedule.
"Consumers today, they want a multichannel offering. They want to be able to shop where and how they want to." That’s a quote from Walgreens president and CEO Greg Wasson in his television interview with Jim Cramer, host of CNBC’s "Mad Money!" (for that story, click here). He was talking to Cramer about the sway a Walgreens.com or Drugstore.com holds with today’s consumer. But the same can be said about health care. Today’s consumers want their health care on their schedule. And Walgreens aims to do just that.
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The data demonstrates the growing role PAs play in the healthcare field, including clinics
WHAT IT MEANS AND WHY IT’S IMPORTANT — The release of the “2010 Census Report and Salary Report,” which indicated that the number of practicing physician assistants has tripled in the past 10 years is important to note, especially as the convenient care clinic model continues to expand.
(THE NEWS: Study: Physician assistant workforce reaches record high. For the full story, click here)
Retail-based clinics undoubtedly are on the growth path, not only with regard to the scope of services but also the number of clinics. As the model continues to expand — and does so more rapidly — it is likely that clinics may need to rely more on physician assistants to assist nurse practitioners in serving patients.
This is especially evident when you also consider the short of primary care providers and the influx of some 30 million uninsured gaining healthcare coverage under healthcare reform. The need for alternative sites of care, such as retail-based health clinics, is on the rise.
The number of practicing physician assistants reached 83,466 in 2010, a 100% increase over the last 10 years, according to the census.
Not all clinic operators employ physician assistants in all clinic locations, largely because of state regulations that vary state to state. However, those clinics that do employ both nurse practitioners and physician assistants undoubtedly have reaped the benefits.
Physician assistants, who are trained in a medical model versus a nursing model, are hailed by clinic operators as being terrific providers who work collaboratively with nurse practitioners. In addition, the two providers often learn a great deal from each other given their different educational background and philosophies, industry sources have told Drug Store News.
The bottom line is perhaps best summed up by Robert Wooten, president of the American Academy of Physician Assistants, who said: “The PA profession is growing rapidly, and it is key to expanding access to quality health care for millions of Americans.”
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