05 Dec Post 1 The merger between Cigna and Anthem was blocked by

Post 1

The merger between Cigna and Anthem was blocked by a federal judge in order to maintain competition between health insurance companies and ensure that cost to consumers were not fully controlled by three main payers. Anthem and Cigna are two major health insurance payers, their merger would have limited competition and increased costs. Competition among insurance companies help reduce the cost of premiums, increase quality of care, and the ability to offer better benefits (Campbell, 2017).  

The merger between Cigna and Express Scripts differ from the Cigna-Anthem merger in that the acquisition with Express Scripts gives Cigna the ability have a PBM partner that can offer self-insured employer groups price transparency and help incorporate value-based pricing. In addition, Cigna will be able to demand better purchasing, pricing, and rebates (Sagonowsky, 2018).  

The proposed Walmart-Humana merger benefited patients by further stimulating the competition in drug pricing. Walmart currently has a co-branded Medicare drug plan with Humana that steers patients to Walmart stores. The partnership offers a prescription drug plan that can save up to 20 percent in drug costs for customer (Mathias, 2018).  

The Cigna-Anthem Merger differed from the Cigna-Express Scripts and Walmart-Humana merger in that the Cigna-Anthem merger was going to lead to increased cost and limit competition in the marketplace, ultimately having a negative impact on consumers, payers, and patients. The Cigna and Walmart mergers had a more positive impact on competition in the marketplace, improving pricing transparency, and reducing healthcare costs. 

POST 2

In the climate of mergers, the DOJ has the responsibility to maintain competition within the healthcare industry and prevent monopolies or companies who command a significant percentage of the market share that can control prices and reduce fair competition. The proposed Cigna-Anthem merger would have been a horizontal merger of two companies who combined would provide insurance for half of the large companies with at least 5,000 employees (Cooper, 2017). This differs from the merger between Cigna and Express Scripts since this is a vertical merger between an insurance provider and pharmacy benefits manager. Despite the difference in integration, the top three PBMs command 80% of the market share for prescription claims with CVS/Caremark commanding 33%, followed by Cigna/Express Scripts at 26% (The Top Pharmacy Benefit Managers of 2021, 2022). Both the horizontal and vertical mergers presented above adversely impact competition through consolidation which provides these companies a commanding percent of the market share. The Cigna/Express Scripts merger was able to demonstrate how they would achieve cost savings through this merger, where the Judge did not believe that the Cigna-Anthem would effectively reduce costs. Additionally, Cigna would not be able to increase costs within their own competitive marketplace as a result of a vertical merger. 

The proposed Walmart/Humana merger is again a vertical merger seeking to acquire an insurer to accompany the healthcare services they already provide: in-store walk-in clinics and laboratories through a partnership with Quest Diagno