How is CVS not a monopoly??

[SCRph2014]

Just curious to see thoughts here. With every acquisition, I seriously wonder how the government can allow CVS to continue without being considred a monopoly? Is it really ethical to have one company own a large majority of the nation's pharmacy locations (and keep buying up more and more little guys along the way), but then also be Caremark/ESI and acquire Aetna? What loopholes is this satanic company using? The persuasion of $$$ ?

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[lane one]

Because of Walgreens.

 

[WVUPharm2007]

Because of Walgreens.

...and Walmart + Kroger.

 

[Litha]

Because of $$$$$$$

 

[wagrxm2000]

https://www.google.com/amp/s/m.wikihow.com/Play-Monopoly?amp=1

 

[lord999]

Because CVS is not stupid enough to get into horizontal integration DoJ monopoly territory. They are going for vertical monopoly territory where the regulatory complexity of unpacking two or more different industries is too hard. And until the start of the 10s, Walgreens and CVS were running neck-to-neck on store counts with their unprecedented growth. It also helps that they are from RI, and their Senators and Congressional representation know who pays into their PACs, so DoJ gets intimidated against going after them especially. Walgreens actually had more political trouble on expansion labor relations because of its historic conservative and decisively Republican ties in IL. Walgreens took a major cross-marketing effort with Al Capone (NYC's Duane Reade had a similar situation with Murder Inc.) and an endowment of UIC to buy off Chicago's Democratic establishment.

 

[alpha12]

also helps that they are from RI, and their Senators and Congressional representation know who pays into their PACs, so DoJ gets intimidated against going after them especially. Walgreens actually had more political trouble on expansion labor relations because of its historic conservative and decisively Republican ties in IL. Walgreens took a major cross-marketing effort with Al Capone (NYC's Duane Reade had a similar situation with Murder Inc.) and an endowment of UIC to buy off Chicago's Democratic establishment.

WTF

 

[ChalupaBatman86]

Because CVS is not stupid enough to get into horizontal integration DoJ monopoly territory. They are going for vertical monopoly territory where the regulatory complexity of unpacking two or more different industries is too hard. And until the start of the 10s, Walgreens and CVS were running neck-to-neck on store counts with their unprecedented growth. It also helps that they are from RI, and their Senators and Congressional representation know who pays into their PACs, so DoJ gets intimidated against going after them especially. Walgreens actually had more political trouble on expansion labor relations because of its historic conservative and decisively Republican ties in IL. Walgreens took a major cross-marketing effort with Al Capone (NYC's Duane Reade had a similar situation with Murder Inc.) and an endowment of UIC to buy off Chicago's Democratic establishment.

From what I have personally seen...not warm and fuzzy with Jack Reed. Doesn’t mean there isn’t a symbiotic relationship though. Not sure about the junior senator.


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[lord999]

From what I have personally seen...not warm and fuzzy with Jack Reed. Doesn’t mean there isn’t a symbiotic relationship though. Not sure about the junior senator.


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I have no idea on either case on non-Beltway relationships. What I do know is that both Reed and Chafee (Whitehouse came afterward) put extreme pressure on DoJ every time a CVS project came through, and that's cozy enough. The case I know most of all was when the DoD TriCare management contract left Medco and went to Caremark, CVS made it a priority acquisition target over antitrust warnings from DoJ. The entire RI delegation did their political jobs and kept DoJ off CVS's back. CVS scored Caremark for that contract (although the jury is out whether or not CVS made money or just kept market share, that's Woonsocket accounting for you).

I do agree that while they may not privately like each other, it's political suicide in RI to be anti-business due to Providence's decline. Unless there is something incredibly unusual, no politician in their right mind is going to screw up getting things done for NS Newport (sub base), CVS, Hasbro, or Royal Bank of Scotland - CFG.

 

[ChalupaBatman86]

I have no idea on either case on non-Beltway relationships. What I do know is that both Reed and Chafee (Whitehouse came afterward) put extreme pressure on DoJ every time a CVS project came through, and that's cozy enough. The case I know most of all was when the DoD TriCare management contract left Medco and went to Caremark, CVS made it a priority acquisition target over antitrust warnings from DoJ. The entire RI delegation did their political jobs and kept DoJ off CVS's back. CVS scored Caremark for that contract (although the jury is out whether or not CVS made money or just kept market share, that's Woonsocket accounting for you).

I do agree that while they may not privately like each other, it's political suicide in RI to be anti-business due to Providence's decline. Unless there is something incredibly unusual, no politician in their right mind is going to screw up getting things done for NS Newport (sub base), CVS, Hasbro, or Royal Bank of Scotland - CFG.

Reed knows that CVS is the second biggest employer in the state and he advocates for the interests of his constituents who work there. Especially the veterans. He is also a Democrat and very pro-union so...

I have met him and like him very much. He is more interested in interacting with the rank and file workers than the execs though.


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[Pharmaciststeve]

Just curious to see thoughts here. With every acquisition, I seriously wonder how the government can allow CVS to continue without being considred a monopoly? Is it really ethical to have one company own a large majority of the nation's pharmacy locations (and keep buying up more and more little guys along the way), but then also be Caremark/ESI and acquire Aetna? What loopholes is this satanic company using? The persuasion of $$$ ?

Insurance companies have been exempt from Sherman Antitrust in 1945 by the McCarran Ferguson Act... so CVS has Aetna, Caremark, Silver Scripts.. all perfectly legal for them to create a monopoly with the blessing of Congress

 

[VictorOfHungerGames]

Because we, as a profession, is too pu$$y to do anything about it...

 

[MilknCheerios]

Not to offend any pro-CVS pharmacists out here, but it's pretty ridiculous how one company can be pharmacy, LTC pharmacy, insurance, and PBM all rolled into one. Something is off when competitor A can decide what to reimburse competitor B for each prescription dispensed. My hope is that the company breaks up or its staff just does themselves a favor and just walk out.

 

[mentos]

Not to offend any pro-CVS pharmacists out here, but it's pretty ridiculous how one company can be pharmacy, LTC pharmacy, insurance, and PBM all rolled into one. Something is off when competitor A can decide what to reimburse competitor B for each prescription dispensed. My hope is that the company breaks up or its staff just does themselves a favor and just walk out.

Most people are living paycheck to paycheck, no way would they risk losing their job.

 

[VictorOfHungerGames]

Not to offend any pro-CVS pharmacists out here, but it's pretty ridiculous how one company can be pharmacy, LTC pharmacy, insurance, and PBM all rolled into one. Something is off when competitor A can decide what to reimburse competitor B for each prescription dispensed. My hope is that the company breaks up or its staff just does themselves a favor and just walk out.

We let this happen. No other profession would allow something like this to go on. Its like a huge law firm buying out prosecutors privately.

its not too late. We need to act now and correct this.

There is a post about PBMs being looked into by the federal courts. This is just a start. I foresee justice being served and the system correcting itself soon.

 

[Pharmacy is a Scam]

Just curious to see thoughts here. With every acquisition, I seriously wonder how the government can allow CVS to continue without being considred a monopoly? Is it really ethical to have one company own a large majority of the nation's pharmacy locations (and keep buying up more and more little guys along the way), but then also be Caremark/ESI and acquire Aetna? What loopholes is this satanic company using? The persuasion of $$$ ?

Because this is America and a free market economy.

LabCorp and Quest Diagnostics have monopolies over the laboratory testing market.

Spectrum and AT&T have monopolies over the telecommunications market.

Q-Tips have a monopoly over the cotton swab market.

CVS is no different.

 

[VictorOfHungerGames]

Because this is America and a free market economy.

LabCorp and Quest Diagnostics have monopolies over the laboratory testing market.

Spectrum and AT&T have monopolies over the telecommunications market.

Q-Tips have a monopoly over the cotton swab market.

CVS is no different.

Not necessarily. LabCorps do not own doctor's offices nor are patients forced to use LabCorp or Quest.

Specturm, AT&T, Q-Tips, Apple, Samsung all have dominated the market with free will. No one is forced to buy... well except for telecommunications i supposed since you're forced to use a certain company depends on your location...

What is happening to pharmacy or healthcare in general is not free market monopoly. Everything CVS has done with Caremark and Aetna is complete conflict of interest and should not exist.

 

[PikminOC]

Not necessarily. LabCorps do not own doctor's offices nor are patients forced to use LabCorp or Quest.

Specturm, AT&T, Q-Tips, Apple, Samsung all have dominated the market with free will. No one is forced to buy... well except for telecommunications i supposed since you're forced to use a certain company depends on your location...

What is happening to pharmacy or healthcare in general is not free market monopoly. Everything CVS has done with Caremark and Aetna is complete conflict of interest and should not exist.

The courts took time with this and eventually ruled that it was ok.

 

[Pharmacy is a Scam]

Not necessarily. LabCorps do not own doctor's offices nor are patients forced to use LabCorp or Quest.

Specturm, AT&T, Q-Tips, Apple, Samsung all have dominated the market with free will. No one is forced to buy... well except for telecommunications i supposed since you're forced to use a certain company depends on your location...

What is happening to pharmacy or healthcare in general is not free market monopoly. Everything CVS has done with Caremark and Aetna is complete conflict of interest and should not exist.

No one is forced to use anything in America... but it is the convenience factor that makes all the difference. You technically aren't forced to use LabCorp to get your labs done but if the nearest non-LabCorp/Quest facility is 300 miles from where you live or your employer contracts with one of those two facilities to make you do your background drug screens then you might as well accept that you are "forced" to use those testing centers.

With telecommunications, do you think it's fair that a company like Spectrum/TWC who used to be an internet provider only is now one of the biggest players in the internet, phone, TV and streaming services industry? I get constantly bombarded with ads to package my TV and internet together for a "discounted rate," and if I purchase internet alone it is almost 100 bucks a month... How is that not a conflict of interest if one player controls it all?

 

[owlegrad]

Yeah, I don't think CVS owning a PBM is comparable to your employer making you get a drug test from a certain lab. There is still competition in that space for your employer to choose from.

I think it would be more like if Toyota owned the roads we drive on and could control your access to them based on which car you drive. Or perhaps if they owned gas stations and only Toyota drivers could fuel up.

Edit: Maybe it is even more like if Toyota owned the car insurance market and gave drivers of their cars a better rate?

 

[VictorOfHungerGames]

The courts took time with this and eventually ruled that it was ok.

Yup they did. A good example of how our justice system isn't so just...

 

[DrVader]

Just curious to see thoughts here. With every acquisition, I seriously wonder how the government can allow CVS to continue without being considred a monopoly? Is it really ethical to have one company own a large majority of the nation's pharmacy locations (and keep buying up more and more little guys along the way), but then also be Caremark/ESI and acquire Aetna? What loopholes is this satanic company using? The persuasion of $$$ ?

It isn't going to matter, Amazon will still eat them alive. Perhaps the government knows this, retail pharmacy is a fickle thing

 

[Pharmacy is a Scam]

Yeah, I don't think CVS owning a PBM is comparable to your employer making you get a drug test from a certain lab. There is still competition in that space for your employer to choose from.

I think it would be more like if Toyota owned the roads we drive on and could control your access to them based on which car you drive. Or perhaps if they owned gas stations and only Toyota drivers could fuel up.

Edit: Maybe it is even more like if Toyota owned the car insurance market and gave drivers of their cars a better rate?

If you wanted to make a fair comparison using your analogy then it is more like driving on Toyota-owned toll/private highways, but Toyota only owns the east-west highways and not the north-south highways. It is definitely possible to navigate the country using side roads and north-south highways only but more convenient if you took the straight route from time to time, you'll just have to pay the toll.

Even though CVS/Aetna is a three-headed monster, there are still other pharmacies, insurers and PBMs out there that patients can choose from. So CVS doesn't have a true monopoly on the market either. Also, Caremark is the PBM for many insurances besides CVS- wouldn't you think that they would give themselves the best deals compared to outsiders, and effectively lower costs? Zero sum game in my opinion. You're either paying more on CVS/Aetna insurance premiums and paying less out of pocket drug costs, or paying lower premiums and higher out of pocket drug costs.

 

[Bubba98]

The courts took time with this and eventually ruled that it was ok.

And they took nearly 2 YEARS to approve the Sirius and XM merger. Life is a game and we shouldn't get too dogmatic about it. Pharmacists are not going to stop insurance companies. They make the rules of the game.

 

[Old Timer]

Because CVS/Caremark/Aetna controls less than 35% of of their individual markets

 

[VictorOfHungerGames]

Because CVS/Caremark/Aetna controls less than 35% of of their individual markets

Thats 1/3 of the market... one company controlling 10% in a trillion dollar market would be insane but 35%?! How is that fair?

 

[MilknCheerios]

The courts took time with this and eventually ruled that it was ok.

The courts are just a collection of humans. Humans are stupid, biased, politically-motivated and ultimately fallible creatures. I'm not saying that all mergers are bad, but a majority of Americans would agree that our healthcare system isn't great and a beast like CVS didn't help.

 

[Old Timer]

Thats 1/3 of the market... one company controlling 10% in a trillion dollar market would be insane but 35%?! How is that fair?

If others control 65% of the market they are by definition NOT a monopoly. I refer you to an old book called a dictionary.

 

[PharFromNormal]

Humans are stupid, biased, politically-motivated and ultimately fallible creatures.

I think you meant all humans but you.