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Express Scripts-Medco Deal Showcases New Post-Health Reform Reality

Express Scripts' merger agreement with Medco Health Solutions to form a mega-pharmacy benefits manager fits the new realities of the post-health care reform world. Together, the two PBMs managed more than 1.7 billion prescription claims for approximately 135 million individuals in 2010; thus, the tie-up, which was announced July 21, creates an entity that dominates the PBM space by a wide margin, with CVS Caremark the only other major competitor.

Express Scripts Holding Co.'s merger agreement with Medco Health Solutions Inc. to form a mega-pharmacy benefits manager fits the new realities of the post-health care reform world. [See Deal] Together, the two PBMs managed more than 1.7 billion prescription claims for approximately 135 million individuals in 2010; thus, the tie-up, which was announced July 21, creates an entity that dominates the PBM space by a wide margin, with CVS Health Corp. the only other major competitor.

In announcing the deal, the CEOs of the two firms said many players in the health care industry will be...

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