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    Why Every Pharmacist Should Care About the CVS/Aetna Deal

    Even if it doesn't happen, the deal says a lot about the future of pharmacy.

     

    Why the Deal?

    While the the deal is uncertain, it will have an impact. It is indicative of larger forces affecting pharmacies. Many believe the possible deal is a response to Amazon eyeing pharmacy. Others see it as a way to stem rising drug costs and increase a pharmacy’s buying power. These are pressing issues for all pharmacies, and CVS acquiring Aetna may be tan attempt to manage them.

    If Amazon enters the pharmacy marke, it will radically alter how consumers view pharmacies, said Cohen. The prospect of Amazon selling drugs is “scary for retail pharmacy.” He envisioned a future where consumers never enter a physical location to pick up their medications, instead ordering through an app. CVS is not making the deal because of some strategic plan, he added, but the move would be made because “CVS is afraid of Amazon.”

    Related article: Amazon Eyes PBMs

    If Amazon or others can beat price and convenience every time, where does that leave retail pharmacy? Smaller pharmacies will need to pivot to value-based care. If they cannot compete on prices, they can provide high star ratings, which health plans like, according to Cohen. 

    The key is to provide services that can reimbursed, which may not include dispensing. Cohen added that large chains like Walgreens, which tend to focus on volume rather than value-based services, will be left behind in the shakeup unless they can stay ahead.

    If the Deal Goes Through

    But if the CVS/Aetna deal goes through, it will help reshape the entire pharmacy landscape, Cohen said. It would impact mail, specialty, long-term care, home infusion, as well as retail pharmacies. Because CVS would be able to influence Aetna’s network composition, it would lead to a narrower network.

    Hayes was blunter: “This merger cannot be good for independent pharmacies,” she said. CVS could mandate that Aetna customers use prefer or use only CVS pharmacies and then charge what it likes for prescription drugs because the PBM sets the price, which will hurt consumers and plan sponsors. “We have returned to the robber baron years, only instead of coal and railroad tycoons, we are at the mercy of pharmaceutical manufacturers and PBMs.”

    But a CVS/Aetna merger is not a “game over” for retail pharmacy. If pharmacies can anticipate these changes, they position themselves to deal with them, said Cohen.

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