Completion of CVS Health-Aetna Merger Underscores Importance to Seniors of Scrutinizing Proposed CMS Drug Pricing Rule

DATE: November 29, 2018

Washington, DC – Commenting on the completion of CVS Health’s acquisition of Aetna — which establishes a massive entity combining health insurance, provider and pharmacy services — the Senior Care Pharmacy Coalition (SCPC) said seniors will be more vulnerable to prescription drug access problems than they were prior to the merger, and that it’s more important than ever a proposed Centers for Medicare and Medicaid Services (CMS) drug pricing rule receive significant scrutiny.

SCPC argues the CMS proposal ignores market concentration and consolidation and further empowers prescription drug plans (PDPs) and pharmacy benefit managers (PBMs).

“The completion of the CVS-Aetna merger should incentivize Congress to scrutinize how rapid, massive consolidation in the health care industry — especially in conjunction with the proposed CMS rule — will crush choice and competition at the expense of seniors in skilled nursing and assisted living facilities (SNFs/ALFs),” warned Alan G. Rosenbloom, President and CEO of SCPC, the only federal advocacy organization devoted exclusively to the interests of the nation’s LTC pharmacies and the patients they serve.

“We have long been alarmed by the fact that three healthcare conglomerates dominate related markets including PBMs, retail, mail-order, specialty and LTC pharmacy— and now two of these companies, including CVS Health, have added health insurance and Medicare Part D insurance as compoments of their cross-market oligopolies,” Rosenbloom continued. “This merger and acquisition activity, rapid vertical and horizontal integration and stubborn adherence to non-transparent business practices threatens the nation’s commitment to free and fair markets — and ultimately places LTC pharmacies at a competitive disadvantage,” he said.

LTC pharmacies, a distinct subset within the pharmacy community, serve a specialized population of seniors in skilled nursing centers, assisted living facilities and other residential care settings. The typical patient suffers from multiple chronic conditions, significant impairments in daily living activities, mild to moderate dementia, and takes 12-13 prescription medications daily – making drug prices and access to needed medications an essential variable in maintaining vulnerable seniors’ health and well-being.

The SCPC President and CEO noted more than 60% of hospital readmissions from nursing centers involve medication issues. Effective oversight and ready access to medications as part of a patient’s clinical care are important factors for reducing hospital readmissions and associated costs.

“Competition and choice are the two casualties of the now concluded CVS Health-Aetna merger, and the bottom line is the new CMS proposal if not changed will exacerbate the problem,” Rosenbloom concluded.

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The Senior Care Pharmacy Coalition (SCPC) is the only national organization exclusively representing the interests of LTC pharmacies. Its members operate in all 50 states and serve 750,000 patients daily in skilled nursing and assisted living facilities across the country. Visit seniorcarepharmacies.org to learn more.