PITTSBURGH (KDKA) — Express Scripts, the nation’s No. 1 pharmacy benefits management company, got the go-ahead from the Federal Trade Commission to merge with No. 2-ranked Medco Health Solutions.

Both companies are leaders in filling mail order prescription drugs.

In a statement, Express CEO George Paz hailed the decision.

“Our merger is exactly what the country needs now. It represents the next chapter of our mission to lower costs, drive out waste in healthcare, and improve patient health.”

While Express Scripts says this proposed merger could have the effect of lowering the price of mail order drugs, those on the ground at local pharmacies say it could actually have an adverse impact.

“There is a potential that the costs will actually go up both to the American public and the employers that are using those plans and those pharmacy benefit managers for prescription drug benefits,” Terri Kroh told KDKA Money Editor Jon Delano.

Kroh directs the Hill District pharmacy operated by Duquesne University, and she worries that mail order companies like Express will drive local pharmacies out of business.

“You wouldn’t order your pizza and have it delivered in the mail, so why would you order your prescriptions and have them delivered in the mail?”

Duquesne University pharmacy professor Rob Maher shares the concern.

“Pharmacists are constantly monitoring compliance, they’re constantly able to physically talk to their patients, working with their doctors,” he says, “and so now you’re taking that local pharmacy — whether it’s a chain or whether it’s independent — out of that patient’s area.”

And that explains why some pharmacies have sued in local federal court to block the merger.

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