Medco & Express Scripts merge, aka clusterf**k in the making

Despite being the subject of antitrust lawsuits, Medco Health Solutions and Express Scripts will be merging, announced on April 2, 2012. 

For those of you outside the industry, Express Scripts, which processes Anthem, TRICARE, and ESI, and Medco, which processes most UnitedHealth plans, among many others, are the giants of the insurance processing sector. CVS Caremark is a distant third, followed by a few more small processors. 

And, in case you've been under a rock or don't get prescriptions, as of January 1, 2012, Walgreens is no longer contracted with Express Scripts, forcing those patients to go to other pharmacies (and in my experience, most went despite strongly preferring to stay with my pharmacy). 


Now, in the US there exists something called an Antitrust Law. Antitrust laws, also known as anti-competition prohibition laws, are in place to keep any one company from creating a monopoly on an industry and unfair business practices. 


What this leads to is: Why did the FTC allow these two giants to merge? With approximately 70% of the industry contracts when combined, how would this mega-processor NOT be a monopoly?


Furthermore, what will this mean for Walgreens? The contract ended in 2011 due to unfair contracting by Express Scripts (unfair business practice- another violation of antitrust law). Does this mean that Walgreens will also lose Medco? Or will there be some sort of resolution? My hope is that the FTC comes to its senses and stops this merger, AND put some actual restrictions on acts prohibited by antitrust law, but hell. I'm young and naive, but I know enough to predict that this merger will pass (and money will pass hands, I'm sure), and Walgreens will be forced to take contracts at a loss in exchange for not losing access to 70% of the prescription market.


But hey, we can still do Medicaid. I think. 
Oh hell.