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Mega Pharmacy Benefit Manager (PBM)--Merger of Express Scripts and Medco

Floor Speech

Location: Washington, DC

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