A practice that's being called "adverse tiering" may be driving away patients with pre-existing conditions.
A practice that's being called "adverse tiering" may be driving away patients with pre-existing conditions. - 

Jeremy Hobson: When you go to the pharmacy to pick up your prescriptions, chances are you interact with either Express Scripts or Medco. Those companies process prescription drug claims. And this week, they're expected to finalize a merger with each other.

That's got some pharmacy chains worried, as our senior business correspondent Bob Moon reports.

Bob Moon: Brace yourself for less choice. That's what an ad from the pharmacy groups says will happen:

Radio ad: They'll be able to tell me when, where and how to get my medicine. They'll be able to squeeze big profits out of patients. Medco-Express Scripts? Too big.

But Brian Henry, a spokesman for Express Scripts, says the goal is beefing up bargaining power.

Brian Henry: What pharmacy benefit managers like Express Scripts and Medco do -- and we think we'll be able to do more of in the future -- is accelerate our ability to help drive down costs, and help improve the quality.

One way to do that, he says, is giving consumers the cheaper option of buying their drugs by mail. But the pharmacy groups complain Express Scripts and Medco combined could funnel even more business to their own in-house mail-order firms, freezing out the local pharmacies. Henry insists that's not so.

Henry: Home delivery is an option that we offer to clients and patients to opt into.

Don Bell speaks for the National Association of Chain Drug Stores. He says the merger could doom many corner pharmacies.

Don Bell: Pharmacies will have to cut service, cut their hours, have forced layoffs of employees and even closing of pharmacies.

And with reduced competition, he argues, consumers could end up paying more.

I'm Bob Moon for Marketplace.

“I think the best compliment I can give is not to say how much your programs have taught me (a ton), but how much Marketplace has motivated me to go out and teach myself.” – Michael in Arlington, VA

As a nonprofit news organization, what matters to us is the same thing that matters to you: being a source for trustworthy, independent news that makes people smarter about business and the economy. So if Marketplace has helped you understand the economy better, make more informed financial decisions or just encouraged you to think differently, we’re asking you to give a little something back.

Become a Marketplace Investor today – in whatever amount is right for you – and keep public service journalism strong. We’re grateful for your support.