Mergers That Built Drug Middlemen Need Review, GOP Lawmakers Say

(Bloomberg) -- Republican lawmakers have asked the U.S. Federal Trade Commission to review whether past mergers by pharmacy-benefit managers have been good for consumers, on the brink of two pending major takeovers in the industry.

“Because some mergers may benefit patients while other mergers may harm patients, we believe it is important to closely monitor these trends,” wrote Representatives Greg Walden, Gregg Harper and Michael Burgess on Friday. Walden is the chairman of the House Committee on Energy and Commerce, which has legislative jurisdiction over many health-care matters.

PBMs typically contract with health plans or employers to provide prescription benefits to workers, and negotiate with drugmakers about what treatments are covered and what types of co-pays patients pay. Their business practices have recently attracted scrutiny from the Trump administration, which is considering new regulations as a way of dealing with drug costs.

Three major PBMs -- CVS Health Corp., Express Scripts Holding Co. and UnitedHealth Group Inc.’s OptumRx unit -- oversee about 70 percent of prescriptions dispensed each year in the U.S., the lawmakers said in their letter. There is conflicting information about whether a series of deals that helped consolidate that market have benefited consumers, or served to boost profits at the merging companies, the Republicans said.

The Justice Department is currently reviewing two proposed deals involving PBMs: CVS’s acquisition of Aetna Inc. and Cigna Corp.’s purchase of Express Scripts. The lawmakers didn’t mention those deals in their letter.

Express Scripts said it helps save clients money, and that it is “proud of the work we do for more than 3,000 payers to help make medicines more affordable and accessible for 83 million people.”

Representatives for CVS and UnitedHealth didn’t immediately return requests for comment.

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