ALEXANDRIA, Va. (Sept. 30, 2021) — The National Community Pharmacists Association has called on the Department of Justice to block UnitedHealth Group’s acquisition of data giant Change Healthcare after meeting recently with agency lawyers to warn that the merger would create an unfair competitive advantage for a company that is already dominant.
The DOJ is currently investigating whether the $8 billion deal between two dominant companies in the pharmacy sector would be in the public interest. UHG owns United Healthcare, a major health insurer, and Optum, a pharmacy benefit manager and mail-order pharmacy. Change Healthcare is a massive technology company through which lots of sensitive pharmacy data runs straight to the PBMs. The merger would create another corporate monster that would gobble up more market share, said NCPA CEO B. Douglas Hoey, pharmacist, MBA.
“This deal would give UHG a trove of intelligence on its smaller competitors, including thousands of independent pharmacies and their patients. We believe it would use that intelligence to steer patients away from local pharmacies and send them to their own mail-order business,” he said.
Change Healthcare runs a “switch,” which routes insurance claims from pharmacies to insurance companies and the PBMs that decide which pharmacies patients must use, how much they’ll pay at the counter, and how much pharmacies are reimbursed for the drugs they dispense. In many cases, independent pharmacists do not have an option to use a particular switch vendor because they are locked in through their pharmacy management system vendor. The data that flows through a switch is very valuable information. It includes dispensing fees, product cost fees, patient data, PBM details, and plan design. Armed with all that data on patients and competitors, UHG would have a massively unfair advantage in the marketplace, NCPA believes.
“That data will be used to undercut reimbursements and raise fees on independent pharmacies,” said Hoey. “It will be used to steer patients to UHG’s health plan and Optum’s mail-order pharmacy. This merger is a threat to fair competition, independent pharmacies, and patient choice.”
Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 21,000 pharmacies that employ approximately 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit www.ncpa.org.