More than 25 states and pharmacy groups are analyzing a proposed $22 billion merger between pharmacy benefit managers (PBMs) Express Scripts and Medco Health Solutions that they say could increase the companies' dominance and aggression in the prescription drug market.

Connecticut and Iowa are among the states concerned about the potentially anti-competitive effects of the merger, which was announced in July and would combine two of the country's three largest PBMs (the largest is CVS Caremark Corp.).

According to Reuters, the states' probe likely will further compel the Federal Trade Commission (FTC) to investigate Express Scripts' proposed acquisition of Medco.

Pharmacists have met with the FTC five times since the deal's announcement, voicing concerns that the merger will not only mean higher prices for consumers, but also fuel the PBMs' bullying tactics in persuading consumers to stop filling their prescriptions at local pharmacies and instead switch to mail-order prescriptions.

More than 25 states and pharmacy groups are analyzing a proposed $22 billion merger between pharmacy benefit managers (PBMs) Express Scripts and Medco Health Solutions that they say could increase the companies' dominance and aggression in the prescription drug market.

Connecticut and Iowa are among the states concerned about the potentially anti-competitive effects of the merger, which was announced in July and would combine two of the country's three largest PBMs (the largest is CVS Caremark Corp.).

According to Reuters, the states' probe likely will further compel the Federal Trade Commission (FTC) to investigate Express Scripts' proposed acquisition of Medco.

Pharmacists have met with the FTC five times since the deal's announcement, voicing concerns that the merger will not only mean higher prices for consumers, but also fuel the PBMs' bullying tactics in persuading consumers to stop filling their prescriptions at local pharmacies and instead switch to mail-order prescriptions.