PHARMACY

Consumer groups go on record in support of retail pharmacy versus ESI-Medco merger

BY Michael Johnsen

PITTSBURGH — The U.S. District Court for the Western District of Pennsylvania on Wednesday accepted an amici curiae from the Consumer Federation of America, the National Consumers League, the National Legislative Association on Prescription Drug Prices and U.S. PIRG (a federation of 28 nonprofit, nonpartisan state Public Interest Research Groups) on behalf of retail pharmacy plaintiffs in their suit to dismantle the Express Scripts-Medco merger.

"Amici have long been concerned by the egregious, deceptive and anticompetitive conduct of [pharmacy benefit managers]," the groups noted. "Notwithstanding any cost benefits [pharmacy benefit managers] offer, they often harm consumers by engaging in deceptive practices, eliminating access to vital healthcare services and reducing consumer choice."

The amici made a three-pronged argument against the merger — notably that the resulting super-PBM would represent an increase in consumer costs and a decline in consumer choice. The third concern identified by the amici regarded the potential for an ESI-Medco combination to dominate the business of specialty pharmacy. "This incredible consolidation of the specialty market is of particular concern to consumers given the fact that specialty drugs are expected to be the single greatest cost-driver in pharmaceutical spending over the next decade," the groups wrote. "The cost of specialty drugs is rising rapidly, increasing by 19.6% in 2010 to reach as high as 27.5% by 2013. Meanwhile, by 2016, eight of the top 10 prescription drugs are expected to be specialty."

The brief was filed in support of the National Association of Chain Drug Stores, the National Community Pharmacists Association and nine individual retail pharmacy operators’ suit to reverse the ESI-Medco merger that was approved by the Federal Trade Commission at the beginning of April.

The judge presiding in that case, U.S. District judge Cathy Bissoon, entertained arguments from both the plaintiffs and defendants on April 10, but has yet to rule in the case.

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Bartell’s plans new store in North Bend, Wash.

BY Alaric DeArment

SEATTLE — Bartell Drugs will open its 59th store next year, the regional retail pharmacy chain said Thursday.

Bartell’s, based in Seattle, announced plans to open a store in North Bend, Wash., in mid-2013. The company said it would be the chain’s first "all-new store" to showcase its new store concept, which the company unveiled in September 2011.

The new store concept includes features such as an "Urban Market" section that highlights unique and locally produced products; a "Fresh Beauty" cosmetics section with natural and organic product lines; a "Wellness Courtyard" with vitamins, supplements and healthy beverages; and a "Sweets & Snacks" area with new displays and lighting. The company plans to convert six stores to the new format this year.

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‘Doughnut hole’ gap’s impact on adherence spells opportunity for community pharmacy

BY Antoinette Alexander

WHAT IT MEANS AND WHY IT’S IMPORTANT — The study’s findings that the Part D coverage gap — or “doughnut hole” — led to a significant gap in the adherence of cardiovascular medications may not come as a complete surprise; however, it undoubtedly underscores the important role that pharmacy can play in helping patients navigate plan strategies that promote the use of lower-cost medications.

(THE NEWS: Study unveils drop in adherence to cardiovascular meds during ‘doughnut hole’ gap. For the full story, click here.)

As the article states, Medicare Part D beneficiaries with cardiovascular conditions who had no financial assistance during the "doughnut hole" coverage gap were 57% more likely to discontinue their cardiovascular medications than those beneficiaries who had consistent drug coverage.

That is a significant drop, and it is especially alarming when you look at some of the stats. According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for both men and women. In 2008, more than 616,000 people died of heart disease; it caused almost 25% of deaths — almost 1-in-4 — in the United States. Furthermore, the agency stated that, in 2010, coronary heart disease alone was projected to cost the United States $108.9 billion. This total includes the cost of healthcare services, medications and lost productivity.

The study’s research team noted that cardiovascular drugs accounted for the largest proportion of spending (25%) and prescription volume (36%) in the Part D program.

While the study found no increase in short-term negative health issues during the coverage gap, the long-term health impact of nonadherence to cardiovascular drugs during the coverage gap is unclear, according to researchers. OK, the long-term health impact may not be clear — at this point — but it is hard to imagine that a lack of adherence would lead to a positive outcome. After all, it is well-known that annual excess healthcare costs, because of medication nonadherence, in the United States are estimated to be as much as $300 billion annually.

Clearly, helping patients with plan strategies that promote the use of lower-cost medications is critical and is yet one more way in which community pharmacy can help patients live healthier lives.

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