Grassley Praised by National LTC Pharmacy Group for Seeking Justice Department Review of PDP/PBM Mergers

DATE: August 16, 2018

Washington, DC – The Senior Care Pharmacy Coalition (SCPC) today praised Senate Judiciary Committee Chairman Charles Grassley (R-IA) for asking the U.S. Justice Department to conduct a “robust analysis” of the proposed mergers between CVS Health and Aetna, and Cigna Corp. and Express Scripts.

Alan G. Rosenbloom, President and CEO of SCPC, says the two proposed mergers between major health insurers offering Medicare Part D prescription drug plans (PDPs) and pharmacy benefit managers (PBMs) “may simply serve to validate a growing arms race to concentrate within markets and conglomerate across related markets, driving health care costs higher, particularly prescription drugs, while undermining consumer choice and optimal outcomes.” Rosenbloom noted that these consumer concerns are especially problematic for the nation’s seniors since they typically need more health care services and prescription drugs than the general population. SCPC is the only federal advocacy organization devoted exclusively to the interests of the nation’s long-term care (LTC) pharmacies and the patients they serve.

“We thank Senator Grassley for asking the Justice Department to review these proposed mergers to better understand how consolidation among health insurers and middlemen like PBMs– and the rapid, unchecked pace of consolidation in related markets like specialty, mail order and LTC pharmacy — is affecting both consumer drug prices and the health care marketplace more broadly,” Rosenbloom continued, particularly given recent research findings that the combination of insurers and PBMs yields sub-optimal results both for consumers and ultimate payers like employers or Medicare.

“This is a timely, necessary review of the rapid vertical and horizontal integration now underway among major players in many markets that will focus on access to payment for prescription drugs. We encourage a deep dive not only into the two deals Senator Grassley has identified but also a look at the impact of unfettered conglomeration on consumers and competitors unaffiliated with the megaliths who are increasingly dominating America’s health care system. These trends undermine the nation’s commitment to free and fair markets, and ultimately places unaffiliated pharmacies – like most LTC pharmacies in the country – at an unfair and exploitative competitive disadvantage, benefitting neither consumers nor competition” Rosenbloom said.

The SCPC leader noted that just three PBMs already administer more than 90% of prescriptions dispensed to seniors in the nation’s LTC facilities and that two of the three – Caremark and ExpressScripts, are central to the two transactions Senator Grassley has targeted.

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 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 to learn more.

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