[Congressional Record (Bound Edition), Volume 158 (2012), Part 5]
[Extensions of Remarks]
[Pages 6072-6073]
[From the U.S. Government Publishing Office, www.gpo.gov]




  MEGA PHARMACY BENEFIT MANAGER (PBM)--MERGER OF EXPRESS SCRIPTS AND 
                                 MEDCO

                                 ______
                                 

                             HON. MIKE ROSS

                              of arkansas

                    in the house of representatives

                          Monday, May 7, 2012

  Mr. ROSS of Arkansas. Mr. Speaker, I feel compelled to make a 
statement because I'm

[[Page 6073]]

concerned with the newly created mega pharmacy benefit manager (PBM). 
The Federal Trade Commission recently concluded its investigation into 
the merger of Express Scripts and Medco, two of the three largest PBMs. 
PBMs are primarily responsible for implementing and administering 
benefit plans that are care-effective and lower prescription drug 
spending. Now, approximately 135 million Americans will be forced to 
rely on this new mega PBM to manage their prescription drug benefits. 
This merger also creates the nation's largest mail-order pharmacy, 
accounting for close to 60 percent of all mail-order prescriptions 
processed in the U.S.
  PBMs claim to reduce prescription drug costs; in fact, they are 
contributing to the increase in healthcare spending. They create 
artificial barriers that limit patient choice and competition through 
referring patients to their own mail-order operations. PBMs also switch 
patients to more expensive medications allowing these companies to 
collect rebates from drug makers. Employers and health plans end up 
paying more for these expensive drugs.
  Since 2000, the number of large PBMs has declined and the 
concentration among the ``Big Three'' PBMs has increased. The merger of 
Express Scripts and Medco reduces the options for large plans from 
three to two. This new mega PBM will control over 40 percent of the 
national prescription drug volume.
  Mr. Speaker, given the possible concentration of market share by the 
mega PBM, I urge my fellow colleagues to demand transparency and 
accountability in this industry.

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