ACI Urges Legal Action to Block Mega-PBM Merger

Says ESI/Medco Merger Will Increase Health Care Costs and Reduce Competition

WASHINGTON, D.C.The American Consumer Institute Center for Citizen Research (ACI) today expressed disappointment in the Federal Trade Commission (FTC) decision not to block the merger between Express Scripts, Inc. (ESI) and Medco Health Solutions merger, and encouraged states’ attorneys general to file lawsuits to halt the merger.

“To say that the FTC’s decision not to block this merger – or even to attach conditions that would sufficiently protect patients and consumers – is disappointing, would be a gross understatement,” said Steve Pociask, president of ACI.  “An ESI/Medco merger will undoubtedly increase health care costs and reduce competition, and needs to be stopped.  I sincerely hope that state attorneys general and others will step up now and to do whatever is in their power to make sure that happens.”

Earlier this year, ACI sent a letter to the FTC expressing concerns the PBM industry already poses anticompetitive risks for consumers and that an ESI/Medco merger will only exacerbate the problems that already exist.  In the letter, ACI urged the Commission to oppose the $29 billion deal.

In the letter, ACI said PBMs broker agreements on multiple sides – and profit from each.  Because they always have better and more complete information on costs and prices than other involved parties, PBMs have a lop-sided advantage in dealings with the other parties which enables them to profit from managing the health plans sponsored by corporations, governments and unions as well as by funneling sales to preferred drug manufacturers in return for kickbacks.

“The FTC’s decision does not favor anyone but ESI and Medco,” Pociask continued.  “It is exceedingly important that this merger be stopped before patients and consumers feel the negative effects.” 

It has been reported that attorneys general from five of the largest states in the nation are considering filing suit in the event of FTC approval.  ACI encourages them in their legal efforts to block the merger and hopes others will join.

ACI is a nonprofit (501c3) educational and research institute.  For more information, visit