A Special Message For The Profession From George Paz, President, Chairman, And Chief Executive Officer Of Express Scripts Incorporated.

Fellow patient advocates,

As you are probably aware, my company, currently the third largest prescription benefit manager in the country, recently made a bid to acquire MedcoHealth Solutions, the largest company in the field. While we are confident this deal will be in the best interests of each company, plan sponsors, and the people they cover, you may be concerned about what this means to you, our valued retail pharmacy partners. Let me put your mind at ease. You are about to be fucked over. Completely, absolutely and thoroughly fucked like a two dollar whore dropped into a roomfull of prisoners doing life without parole.

Wait. I shouldn't have used the phrase "two dollar whore."  That was wrong. I forgot we only pay you guys a dollar fifty per prescription. Still, I hope you get the idea. What you are in for will be in no way pleasant.

Some of you may be saying to yourselves, "For the love of God, after 30 years of shrinking reimbursements, pointless prior auths, endless waits on hold to contact a "help" desk, and slower and slower payments, short of actually bouncing checks, what more could they do to us?" Well, trust me, we'll find something. Unlocking the synergistic potential of our two companies is the very core of this deal, and while that certainly means things like eliminating duplicate functions and streamlining operations to take advantage of increased economies of scale, rest assured, we will also be working on new and innovative ways for you to take it up the ass with a barbed-wire covered penis of fire. For example, one idea we're batting around is actually charging you a "convenience fee" for the time and trouble it takes for us to send in an auditor to go through your records. After all, I'm sure you'll agree it is far more convenient to have them come to you than it would be for you to gather up all your files and bring them to our headquarters in St. Louis.

And if you don't? Too fucking bad, because we're soon going to control almost 40% of your third party business.

Before you completely panic though, let me assure you we have no intention of actually ending the entire business of retail pharmacy. We have learned over the years that while the process of filling a prescription is a simple one, essentially involving bringing a piece of paper to a store, and refilling a prescription is even easier, there is no small number of people who manage to fuck it up. Sadly, we are required by most plan sponsors to serve not only people with enough brain cells to be able to punch in a refill number, but those unaware of and completely incapable of handling the prescription filling process as well. The person who dumps all their pills into one vial and expects a refill on the one to cleanse their liver? That one's yours. The idiot who's been taking a blood pressure med for years and realizes at 10 o'clock on a Saturday night that they haven't had one for 3 days? Yup. You're on that one. The 86 year old lady who mailed her prescription to Oprah? Time for you to shine.

Not to mention you'll be covering for our fuckups as well. People whose enrollment information we lost, packages that get lost in the mail, prescriptions we just fill wrong. We'll leave you plenty of scraps to fight over, assuring a few of you will continue to be our valued colleagues as we assume leadership of the pharmacy benefits universe.

Just not valued very much. We're thinking 75 cents a prescription starting January 1st. If you beg for it hard enough.

Sincerely,
George Paz.

PS- I said beg for it, bitch.

Disclaimer- While this letter is completely fictional, the future it represents is very real.