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Physicians fear the settlement that greenlit the acquisition will harm patients by driving up drug costs and limiting where beneficiaries receive care.
Last month, CVS Health completed its $70 billion acquisition of Aetna. And while Larry Merlo, president and CEO of CVS Health said was excited to “transform the consumer health experience” through a new innovative healthcare model, other healthcare insiders expressed concern about the merger.
U.S. District Judge Richard J. Leon yesterday asked CVS and Aetna to keep operations distinct while he reviewed the public comments on the settlement.
CVS and Aetna’s have already announced integration plans.
While organizations such as the American Medical Association and the American Antitrust Institute spoke out against the merger when it was not yet finalized, some have continued to voice concerns, most recently in a letter to Peter Mucchetti, chief of the Healthcare and Consumer Products Section of the Antitrust Division of the U.S. Department of Justice.
The letter, written by the Association of American Physicians and Surgeons, warned that the proposed settlement that cleared the path for the acquisition “will result in less competition, fewer options, harm to patients’ pocketbooks and ultimately their health.”
The organization’s president, Marilyn Singleton, M.D., J.D., said the merger puts CVS in the position to steer patients covered by Aetna to receive care from CVS-run clinics instead of their physicians.
The deal would also drive affected patients to get their prescriptions from CVS — and CVS is already known for limiting patients’ choice of pharmacy, Singleton and her colleagues argued. DrugChannels.net said that the CVS Health’s Maintenance Choice Program is the most prominent limited network model for commercial plan sponsors and limits its beneficiaries to obtaining medications from either a CVS retail or CVS Caremark mail pharmacy.
This year, Consumer Reports revealed that CVS charges the highest prices for drugs. After comparing the prices of five standard prescriptions, the report found that drugs cost a combined $66 at an online pharmacy, $105 at Costco and $900 at CVS. At an independent physician’s office in a state that allows in-office dispensing, patients can get the same drugs for a total of $29, the report found.
“Allowing this merger to proceed will hand the combined CVS/Aetna even more clout to drive up costs without any corresponding benefit to patients,” the Association of American Physicians and Surgeons wrote in a September letter to then-Attorney General Jeff Sessions.
A federal case against CVS Caremark, is also ongoing, where Sarah Behnke, who was the chief Medicare actuary for Aetna — remains ongoing. The suit accused CVS Caremark of gouging Medicaid and Medicare customers with high prescription-drug costs, and violating federal laws while under contract with Aetna to administer Part D plans. Behnke has since been placed on administrative leave, but she claims CVS’s actions cost the federal government more than $1 billion in fraudulent charges.
But CVS Health still has big plans for 2019.
The company hopes to open new pilot stores and push lower-cost sites by reducing the use of emergency rooms and moving certain procedures out of expensive settings.
“By delivering the combined capabilities of our two leading organizations, we will transform the consumer health experience and build healthier communities through a new innovative healthcare model that is local, easier to use, less expensive and puts consumers at the center of their care,” Merlo said in a statement.
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