American Pharmacy Cooperative, Inc. (APCI) has submitted comments to the U.S. Department of Justice and Federal Trade Commission Joint Agencies, urging stronger measures to prevent further integration between pharmacy benefit managers (PBMs) and insurers. While commending proposed improvements to merger guidelines, APCI stressed the need for investigation into PBM and insurer practices that limit access to medications, restrict patient choice, and drive up prescription costs.
The concerns raised by APCI echo those of the community pharmacy, which has criticized existing antitrust laws for failing to prevent horizontal and vertical integration between PBMs and insurers. APCI supported its arguments with reports released by federal agencies in the past eighteen months that affirm these concerns. The cooperative believes that the government should use Section 5 of the FTC Act to investigate PBM practices that engage in unfair methods of competition, thus effectively preventing mergers that enable PBMs/insurers to continue their detrimental practices.
APCI highlighted PBM rebate practices as an example of how Section 5 of the FTC Act could play a role in merger analysis. The cooperative pointed out that PBMs already exert significant control over medication availability through exclusionary formularies, step therapy requirements, prior authorizations, restricted coverage, and mandating brand-name drugs over generics. APCI expressed concern that these practices may even influence which drugs physicians and other prescribers recommend.
APCI believes that traditional methods of merger analysis and draft guidelines may not adequately identify the threat posed by PBMs and insurers integrating. However, Section 5 of the FTC Act provides the necessary tools to evaluate and address these threats to competition when they involve unfair methods of competition.
In conclusion, APCI called for Section 5 of the FTC Act to be a central consideration in all mergers involving PBMs and insurers. CEO Tim Hamrick emphasized the importance of using every available tool to investigate and prevent PBM acquisitions that perpetuate unfair competition and safeguard the interests of pharmacies and patients.
APCI is a cooperative representing over 1,600 independently owned community pharmacies across 31 states. Established in 1984 and headquartered in Bessemer, Ala., APCI is known for its advocacy for prescription drug pricing transparency and reform.
– American Pharmacy Cooperative, Inc. (APCI)
– U.S. Department of Justice
– Federal Trade Commission Joint Agencies