Recently, Express Scripts looked to acquire Medco, which is still pending approval to my knowledge, but who knows. This is my issue with this. I have Medco, at least right now. It seems that every year I have a new mail order pharmacy, and every year I get nervous about how easy or hard it is going to be to get my supplies. Is there going to be an issue, do they have the strips that I use as a tier 1 or a tier 3. So, now I haven’t switched insurance companies or supplier, but if this acquisition goes through then I will be using Express Scripts. Typically mergers or acquisitions of large companies like this, not many things do change, but there will be some executive level decisions that could make some big differences. For example, Freestyle Lite strips may be considered tier 3 and cost 5 times the amount of a tier 1.
Mergers and acquisitions do not always go easy, I’ve seen some bad ones in the past,but let’s just hope that this one goes fine. I’ve never used Express Scripts before, so my question is to all of you, how have they been in the past? Any issues? Do they favor one specific brand over the other?
I look forward to all of your answers and feedbacks….that’s what the DOC is all about 🙂
Have a great week everybody
If it brings any comfort, the determination of whether a drug or medical product like test strips are tier 1 or tier 3 is actually determined by the insurance company, not the pharmacy benefits manager (PBM). Having said that, the PBM does have big influence over this, largely because they are the company who negotiates prices with the manufacturers and those costs are passed on to the insurance company, so if Express Scripts has a big deal with say Johnson & Johnson’s Lifescan/OneTouch business unit, chances are they will pass those prices onto your insurance company, who usually passes the cost (or savings) on to the patient. However, right now, besides waiting for antitrust approval (which is not assured with the Obama Administration’s appointees running the Justice Department), there is also a lawsuit against Medco’s management for selling the company for less than shareholders believe the company is worth. Whether that goes anywhere remains to be seen, but its never a dull moment when it comes to the business of diabetes!
I use medco too, so keep me posted if you hear of any changes!