American Antitrust Institute to DOJ: Move to block CVS-Aetna deal

The nonpartisan American Antitrust Institute called on the federal government to move to block CVS Health's proposed $69 billion merger with Aetna.

In a 10-page letter sent to the Department of Justice's antitrust division, Diana Moss, PhD, president of AAI, outlined the organization's concerns about what combining one of the largest retail pharmacy chains with the third largest health insurer means for Americans.

"Together with the merger of Express Scripts-Cigna, CVS-Aetna would trigger a fundamental restructuring of the U.S. healthcare system," Dr. Moss writes. "Stronger incentives to exclude rival PBMs and health insurers and to engage in anticompetitive coordination would harm competition and consumers at all levels."

In February 2018, the DOJ requested additional information from CVS Health and Aetna for its review of the companies' proposed merger, according to a Feb. 1 Securities and Exchange Commission filing. About a month later, CVS Health and Aetna shareholders overwhelmingly approved the deal.

In her letter, Dr. Moss argues if CVS-Aetna and Cigna-Express Scripts pass regulatory scrutiny, three PBM-insurer forces (including OptumRx and UnitedHealthcare) will make market entry near to impossible for competitors, with only companies with a PBM and an insurer able to scale potential barriers.

"Any of the anticompetitive effects discussed in this letter would be detrimental to consumers through potentially higher prices, lower quality, less choice, and less innovation in markets for prescription drugs and health insurance," Dr. Moss argues. "In healthcare, these effects can make the difference between wellness or disease, and life or death."

"In light of all of this, the only effective remedy is for the government to move to block the proposed merger," the letter states.

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