Express Scripts-Medco Decision Could Rely on Specialty Pharmacy Divisions

The FTC’s approval of the highly publicized merger may depend on the divestiture of some of Medco’s assets.

Will prices increase across specialty pharmacy offerings if a larger PBM is able to dominate the marketplace through greater buying power?

Rumors are swirling that the Express Scripts-Medco merger will probably get a Federal Trade Commission (FTC) ruling on March 30, 2012, and "close the transaction as early as the week of April 2, 2012, subject to satisfaction or waiver of the remaining closing conditions," according to a Bloomberg report.

Some say the conditions in question pertain to selling off some of Medco’s specialty pharmacies in order for the FTC to allow the merger to go through. Medco and Express Scripts own the nation’s number 2 and number 3 specialty pharmacies, respectively—and many are worried that if joined, these 2 companies could use their leverage when acquiring distribution contracts from drug manufacturers.

According to an article in The Wall Street Journal, the FTC could also prevent the merged entity from requiring that large employers and insurers use the combined company’s specialty pharmacies.

Spending in specialty is rising, and as previously reported, Express Scripts-Medco would control 52% of the specialty drug market if their merger is approved. The new company would be 3 times the size of its nearest competitor.

Supporters of the merger claim that the combined efforts of Medco and Express Scripts could actually put more pressure on the specialty drug manufacturers to lower their prices. Lowell Weiner, a Medco spokesman, told The Wall Street Journal that a partnership between the companies could “further reduce the cost of providing specialty-pharmacy care for our clients and their members.”

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