Federal Employees Health Benefits Program

Antitrust Hurdles Seen for Merger of Drug Benefit Managers

Two of the nation’s largest pharmacy benefit managers, Express Scripts and Medco Health Solutions , said on Thursday that they wanted to combine forces in a $29.1 billion merger that would account for about four of every 10 prescription claims in the country.

If federal regulators and the companies’ shareholders approve the deal, the merger would create a company with more than $100 billion in annual revenue. Analysts say the deal could fundamentally change the dynamics of the market for overseeing prescription drug use for health plans and employers, but they predicted that the merger would face the thorny issues of antitrust that have swirled around other ventures involving pharmacy benefit managers.

In announcing the proposed deal, the companies emphasized what they said would be significant savings in drug costs. “The cost and quality of health care is a great concern to all Americans,” said George Paz, chairman and chief executive of Express Scripts, in the company’s release . “This is the right deal at the right time for the right reasons.”

Under the proposed agreement, Express Scripts will own 59 percent of the new company, and Mr. Paz will retain both his titles.

While he played down the advantages the combined company would have because of its size, Mr. Paz said the two companies offered complementary approaches to managing patients’ drug benefits.

Express Scripts has specialized in understanding patients’ behavior and why they may not take their medicines, while Medco has emphasized clinical expertise to determine which medicines work best. “We’re going to take a lot of costs out of health care,” Mr. Paz said in a telephone interview.

But analysts, who expressed surprise at the deal, predicted strong opposition to the merger, which would leave the industry with just one other independent company, CVS Caremark , itself the product of a $27 billion merger four years ago. “I think it’s going to be a very tough fight through the Federal Trade Commission,” said Adam J. Fein, an industry consultant in Philadelphia.

While about 60 companies now compete, he estimates that the combined company might have had 40 percent of the market last year, compared to about 16 percent for CVS Caremark. He said both pharmacists and drug makers were likely to try to block the deal.

“I think this poses very serious antitrust concerns,” said David Balto, an antitrust lawyer who used to work for the F.T.C. and now represents community pharmacists. Consumer groups have already raised concerns with the commission over whether CVS Caremark, the result of a merger between a large drug store chain and a pharmacy benefit manager, is hurting competition, and regulators are likely to want to prevent the merger if they have similar worries that it will stifle competition, he said.

If I began tomorrow as a US Federal Govt. employee, what benefits ...

Retirement benefits based on amount of service and salary history.

Thrift Savings Plan (TSP):which is a Multiple investment options similar to a 401(k) plan.

Social Security:: Credit earned while working with the Government. Retirement benefits, disability protection, and survivor protection.

Medicare – Part A: Available to you at no cost at age 65. Federal Employees Health Benefits Program (FEHB):there are No waiting periods, required medical exam, or age/physical condition restrictions.

Federal Employees Group Life Insurance (FEGLI): Group term life insurance – Basic life insurance with three options (Standard, Additional, and Family).

Leave and Holidays: 13 days sick leave each year; 13, 20, or 26 days of vacation leave each year, depending on years of service; 10 days paid holiday each year.

Family Friendly Flexibilities: Flexible Work Schedules; Telecommuting; Family Friendly Leave Policies; Employee Assistance Program (EAP); Part-Time & Job Sharing Positions; Child & Elder Care Resources Adoption Information/Incentives; Child Support Services.

are some of the benefits !!!

Federal Employees Health Benefits Program, Competition and Other Factors Linked to Wide Variation in Health Care Prices

Federal employees health benefits program, early experience with a consumer-directed health plan: report to the Ranking Minority Member, Committee on Finance, U.S. Senate

Federal employees health benefits program, competition and other factors linked to wide variation in health care prices : report to the Honorable Paul Ryan, House of Representatives

Federal employees health benefits program, premium growth has recently slowed, and varies among participating plans : report to the Ranking Minority Member, Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia, Committee on Homeland Security and Governmental Affairs, U.S. Senate

Federal Employees Health Benefits Program, statement of Bernard L. Ungar, Director, Federal Human Resource Management Issues, General Government Division ; before the Subcommittee on Compensation and Employee Benefits, Committee on Post Office and Civil Service, Hosue of Representatives