Federal judge to block cvs from buying aetna health

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Market concentration has risen in more than three-quarters of industries since the late s. Concentration has led to higher profits and higher returns for shareholders at the expense of consumers. Antitrust authorities have become more supine: between and , regulators brought an average of 16 cases a year in order to prevent big firms from becoming even bigger; between and , that number fell below three. Health care is one of the industries that has been marked by bouts of consolidation.

Trustbusters have recently showed more teeth. In February a federal judge blocked a proposed tie-up between Aetna and Humana, two health insurers. They may soon face another big test. At first glance, it is hard to see why trustbusters would wave through this deal if they have balked at others.

But look closer and the picture becomes more complex. The CVS-Aetna deal would be a different animal. This tie-up would reach across three distinct layers of the health-care industry: the retail pharmacies for which CVS is famous; the pharmacy-benefit managers PBM , intermediaries which negotiate drug prices on behalf of medical plans and whose number again includes CVS; and the insurers, like Aetna.

Supporters of the deal argue that aligning the interests of insurers and pharmacies would reduce costs and improve life for consumers. An insurer that could send patients to walk-in clinics of the sort CVS owns would be better placed to monitor and improve results.

Antitrust types are usually less worried by the vertical integration of powerful firms than they are by horizontal mergers between them. The more market power a firm has, the greater its ability to set prices above the level that would prevail in a competitive market.

If two such firms exist along a supply chain, prices are inflated at each stage. As a result, vertical integration can achieve lower prices for consumers. In the case of CVS-Aetna, the incentive for the pharmacy-benefit manager to fatten its profits would disappear. The question then is would that benefit accrue to the consumer? That depends on whether firms are dominant in their respective markets.

The benefits to consumers of a vertical merger disappear if one of the parties has a monopoly. Uncontested markets would have a similar impact on the CVS-Aetna deal: a combined entity would be free to restrict insured customers to CVS medications and clinics, for example, if it had no rivals to fear.

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