The clock is ticking and it looks like the Express Scripts acquisition of Medco is almost ready to be approved. At WBC (www.wbcbaltimore) we been telling our readers for some time now not to believe the negative hype. This was a strong story that supports legislative efforts to reduce health care costs. Reducing pharmacy benefit costs is a big piece of the puzzle and the combined strengths of two solid pharmacy benefit titans is too good to pass up. Wall Street has warmed to the anticipated reality driving Medco stock to recent new 52-week highs. Not to mention the stampede to  Medco after their recent earnings call where Mr. Snow was giddy in announcing RECORD performance in all financial metrics!

Our Inside-the-beltway sources have told us that the deal is eminent, contingent on a couple of adjustments.  The main issue is a requirement that the newly formed “Expredco” will shed one of it’s Specialty pharmacy units.  You remember Specialty. Still the fastest growing component (20% trend) in a plan sponsor’s pharmacy drug spend.  Well, the powers that be have to throw the howling wolves (NACDS and NCPA)  a bone, so the sacrificial lamb will be Accredo, Medco’s superb Specialty management company.  Talk about throwing the baby out with the bathwater!  But that seems to be the price they must pay to get the deal done.  Recent press releases showed, for the first time, a softening of position by the community pharmacists, who said they could live with the new environment, as long as they get to participate in filling Specialty scripts.  We’ll see how it plays out.  As usual, stay tuned!

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