NCPA, NACDS Issue Joint Statement to Oppose Express Scripts, Medco Deal: "Too Big To Play Fair"

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Emphasize near-monopoly's threat to patient care, pharmacy access

Alexandria, Va. - July 21, 2011

National Community Pharmacists Association (NCPA) Executive Vice President and CEO B. Douglas Hoey, RPh, MBA, and National Association of Chain Drug Stores (NACDS) President and CEO Steven C. Anderson, IOM, CAE, issued the following joint statement today regarding the proposed merger of Express Scripts, Inc. and Medco Health Solutions, Inc.:

"Today's announcement that Express Scripts will buy Medco creates a middle man that is too big to play fair, and will have immense power to unfairly dominate the market. This combination will monopolize control of the supply line for brand and generic prescription drugs, threaten access to pharmacy patient care, and is a bad deal for America, for healthcare plans, for pharmacies, and—most notably—for patients.

"For the ultimate good of patients, NCPA and NACDS are committed to advancing the unsurpassed value of community pharmacy as the face of neighborhood healthcare. Community pharmacy services help to improve patient health and lower overall healthcare costs. Unfortunately, practical and rhetorical actions by the PBM community have increasingly ignored, and treated with irrational hostility, the vital importance of the patient-pharmacist relationship. This proposed merger will exacerbate PBMs' detrimental effect on pharmacy patient care.

"NCPA and NACDS are consulting with the Federal Trade Commission, the state Attorneys General, and other enforcement officials to determine appropriate next steps."

The National Association of Chain Drug Stores (NACDS) represents traditional drug stores, supermarkets, and mass merchants with pharmacies—from regional chains with four stores to national companies. Chains operate 39,000 pharmacies, and employ more than 2.7 million employees, including 118,000 full-time pharmacists. They fill nearly 2.6 billion prescriptions annually, which is more than 72 percent of annual prescriptions in the United States. The total economic impact of all retail stores with pharmacies transcends their $830 billion in annual sales. Every $1 spent in these stores creates a ripple effect of $1.96 in other industries, for a total economic impact of $1.57 trillion, equal to 11 percent of GDP. NACDS represents 137 chains that operate these pharmacies in neighborhoods across America, and NACDS members also include more than 900 pharmacy and consumer packaged goods suppliers and service providers, and over 60 international members from 23 countries. For more information about NACDS, visit

The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies, pharmacy franchises, and chains. Together they represent a $93 billion health-care marketplace, have more than 315,000 employees including 62,400 pharmacists, and dispense over 41% of all retail prescriptions. To learn more go to or read NCPA's blog, The Dose, at

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