The $29.1 billion cash and stock offer by Express Scripts for Medco Health Solutions is not just one of the largest deals of the year. It is also a huge antitrust roll of the dice. The combination would create a behemoth in the pharmacy benefits management industry. So much so, it looks like a provocation to trustbusters. Express Scripts, led by George Paz, says the combination will yield $1 billion in annual cost savings. That is believable: though the two companies have similar levels of earnings before interest, taxes, depreciation and amortization, Express Scripts has about half as many employees.The big savings explain the 5% bounce in Express Scripts' share price on Thursday, which in turn increased the value of its offer to around $73.64 per Medco share. But the regulatory uncertainty explains why Medco shares, though up a deal-fueled 14%, settled at a relatively large 13% discount to the value of the bid. It won't be easy to convince the Federal Trade Commission that the deal will not decrease competition. The combined group would have about 35% of the market.
In a social media landscape shaped by hashtags, algorithms, and viral posts, nurse leaders must decide: Will they let the narrative spiral, or can they adapt and join the conversation?
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