The $29bn merger between pharmacy-benefit managers Express Scrips and Medco Health Pharmacy will "harm small business opportunities" and "stunt job growth" if it goes ahead, an advocacy group has said in a letter to US federal anti-trust regulators.

Addressing FTC Chairman Jon Leibowitz, Small Business Majority, which represents the US’s 28 million small businesses, argued that the merger could reduce competition, raising costs and potentially forcing small-business owners to drop healthcare coverage for employees.

Discover B2B Marketing That Performs

Combine business intelligence and editorial excellence to reach engaged professionals across 36 leading media platforms.

Find out more

The group is the first of a large group of employers to express opposition to the merger.

Medco and Express Scripts are two of the three largest companies that administer prescription drug plans for insurers and employers.

They voiced confidence last week over the merger, saying the deal would overcome regulatory concerns to close in the first half of next year

GlobalData Strategic Intelligence

US Tariffs are shifting - will you react or anticipate?

Don’t let policy changes catch you off guard. Stay proactive with real-time data and expert analysis.

By GlobalData

Pharmaceutical Technology Excellence Awards - Nominations Closed

Nominations are now closed for the Pharmaceutical Technology Excellence Awards. A big thanks to all the organisations that entered – your response has been outstanding, showcasing exceptional innovation, leadership, and impact.

Excellence in Action
Awarded the 2025 Pharmaceutical Technology Excellence Award for Business Expansion in Integrated Manufacturing, Upperton Pharma Solutions is rapidly expanding its UK GMP and sterile manufacturing footprint. Find out how Upperton’s integrated CDMO model helps pharma companies move from early development to clinical and niche commercial supply with fewer handovers and faster timelines.

Discover the Impact