AMA president: CVS-Aetna merger court ruling 'fails patients'

The American Medical Association (AMA) distributed the following statement by AMA President Patrice Harris, M.D., M.A., on September 5…

Despite an unprecedented review that dragged many details of this merger into the light, today’s decision ultimately fails patients, will likely raise prices, lower quality, reduce choice, and stifle innovation. The American people and our health system will not be served well by allowing a merger that combines health insurance giant Aetna Inc. with CVS Health Corporation – the nation’s largest retail pharmacy chain, specialty pharmacy, pharmacy benefit management (PBM) and Medicare Part D Stand-Alone Prescription Drug Plan (PDP) insurer.

For patients and employers struggling with recurrent increases to health insurance premiums, out-of-pocket costs, and prescription drug prices, it's hard to find any upside to a merger that leaves them with fewer choices. Nothing in the deal guarantees reductions on insurance premiums or prescription drug costs. As for promised efficiency savings, that money will likely go straight to CVS’s bottom line. CVS made no commitment to pass much-hyped savings onto consumers through lower premiums or drug costs.

We know from history that when health insurance and pharmaceutical benefit management markets are ruled by only a few massive companies, patients pay a steep price. The court found our concerns ‘warranted serious consideration’ and were sufficient to hold an unprecedented judicial review that included a hearing with expert and other testimony. Regulators should now be on notice of the antitrust risks associated with the CVS/Aetna merger, and must vigilantly monitor the conduct of the merged firm to make sure that this colossal new entity does not hurt patients in the PBM services, health insurance, retail pharmacy, specialty pharmacy, and PDP markets, which are already highly concentrated.

Although this outcome is not what we fought for, the AMA is optimistic that this case and the thorough examination of its underlying facts are a sign of things to come. When the public interest is harmed by health care mergers, courts charged with scrutinizing DOJ merger settlements must not be a rubber stamp.