CVS/Aetna Merger Bad for Patients, States the Association of American Physicians and Surgeons (AAPS)
TUCSON, Ariz., Sept. 24, 2018 /PRNewswire/ -- In a letter to Attorney General Jeff Sessions, President-elect Marilyn Singleton, M.D., J.D., explains why the Association of American Physicians and Surgeons (AAPS) opposes the proposed merger of CVS and Aetna.
"Mergers can decrease competition and such mergers are not in the interest of our patients," she writes. This merger combines the third-largest health insurer and the largest national pharmacy chain, which has the dominant pharmacy benefits manager (PBM), CVS Caremark. "This merger is particularly troubling in light of the highly concentrated national market for PBM services and current lack of transparency in drug pricing and PBM contracts."
Experience has shown that mergers steer patients to insurance plans and site of care, and away from their trusted physicians, Dr. Singleton explains.
CVS and its PBM gain considerable profits from such steerage. Mergers make it nearly impossible for independent pharmacies and stand-alone PBMs to compete.
Patients win when there is a competitive market with independent pharmacies as well as online pharmacies. Diminishing competition means that patients will see higher insurance premiums, lower quality, and fewer novel insurance products that meet their specific needs, the AAPS letter notes.
As shown in the numerous articles cited by AAPS, CVS has already demonstrated a pattern of anticompetitive behavior. For example, the price of a generic prescription jumped from $45 to $241 after CVS took over a Target pharmacy. CVS Caremark drastically cut payment rates to independent pharmacies, sometimes below cost, while inflating payments to its own CVS pharmacies.
"Allowing this merger to proceed will hand the combined CVS/Aetna even more clout to drive up costs without any corresponding benefit to patients," the letter concludes. "It would enable, not hinder, continued anticompetitive tactics that squeeze competitors out of business and steer patients toward CVS/Aetna-controlled products, away from alternate sources of care."
The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in all specialties, founded in 1943.