April 23, 2009 
Given the market trends and the over-capacity of mail, could we ever see one facility that served everyone? It would be an interesting play. I think the evolution would be to allow all the existing mail facilities into the network (i.e., Express Scripts mail could serve Medco members and vice-versa). That would force consolidation and really put everyone in a competition around cost-to-fill and customer service.
Economically, it seems very logical to come down to a few high-volume facilities that filled all the automated scripts.
I guess the other play would be that mail just became a central fill for retail and every Rx was picked up locally but the majority were filled centrally and shipped for pick-up.
Neither are likely in the near future, but interesting models to debate.
Enabling Healthy Decisions 
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