Caremark Rx Inc. (CMX) - Express Scripts (ESRX)

Charts

Caremark Rx Inc. (CMX) - CVS Corp. (CVS)

Charts

Announced: November 1, 2006 (Press Release)
Expected Close: Q2 /Q3 2007
Termination Date: November 1, 2007 / May 1, 2008
Terms: Caremark shareholders will receive 1.67 shares
of CVS for each share of Caremark.


Total Value: $
Website(s): CMX & CVS
Industry: Healthcare

Recent Updates Deal Links Home




Filings, Reviews & Approvals

Pending

Completed

Shareholders

 

CMX

CVS

SH Date March 16, 2007 March 14, 2007
Record Date Jan 15, 2007 Jan 19, 2007
Proxy Mailed Jan 29, 2007 Jan 29, 2007

SEC

Hart Scott Rodino

  • December 20, 2006 - Expired
  • November 20, 2006 - Filed

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Updates

March 22, 2007 (9:10a) - Transaction Completed

The companies have announced the formal completion of this transaction.

Transaction length: 142 days.

March 16, 2007 (12:30p) - CMX Shareholder Approval

CMX shareholders have approved this transaction.

The companies intend to complete the transaction next week, after certifying the vote count.

March 16, 2007 (10:25a) - CMX Shareholder Meeting Status

Reports are beginning to surface indicating that CMX shareholders have voted to approve the merger with CVS.

At the time of this update, CMX shareholder approval has not been confirmed.

March 15, 2007 (11:35a) - CVS Shareholder Approval

CVS shareholders have approved the merger.

The next 24 hours will almost certainly be filled with rhetoric from both sides, effectively cancelling out the respective arguments for and against the CMX-CVS transaction.

While this promises to be one of the more fascinating shareholder decisions in recent memory, this publication continues to anticipate CMX shareholder approval tomorrow.

March 14, 2007 (2:15p) - Status Report (Proxy Firms)

Two secondary proxy service firms (Glass Lewis and PROXY Governance) have reiterated their recommendations against the CMX-CVS merger transaction. As a result, CMX, CVS, and ESRX have been compelled to continue their respective publicity campaigns in order to sway CMX shareholders for or against the CMX-CVS deal.

This publication continues to perceive the chances of CMX shareholder rejection as fairly small, with the uncertainty of the FTC review being the deciding factor.

Barring some type of highly unusual development between now and this Friday's CMX shareholder meeting, CMX shareholders continue to be expected to approve the current merger agreement.

March 13, 2007 (8:35a) - ISS Recommendation

Institutional Shareholder Services has reversed its previous recommendation, and now recommends CMX shareholders support the current merger agreement with CVS.

This development is not perceived as the proverbial 'nail in the coffin,' but it certainly signals that the hammer is coming down on ESRX. There is now a much smaller chance of CMS shareholder rejection this Friday, and therefore very little chance ESRX will be able to prevent this deal from closing.

It will be noted that CVS played this situation almost flawlessly and will be rewarded by finally consummating this merger. Chances of CMX shareholder approval are now perceived to be higher than 90%.

March 12, 2007 (11:35a) - Status Report

ESRX has announced that it will not increase its offer again for CMX before the CMX shareholder meeting on March 16. The tone of ESRX's press release indicates the company is essentially conceding the failure of its attempt to derail the CMX-CVS transaction, although the company continues to recommend CMX shareholder rejection of the current merger agreement.

As noted previously, lacking an increased offer from ESRX, the odds of CMX shareholder rejection are believe to be less than 20%.

There are currently no obstacles to completing the transaction on March 16, other than CMX shareholder consent.

March 8, 2007 (9:25a) - CVS Offer Increased

Late yesterday (3/8), CVS "enhanced the terms in the merger agreement by increasing the special dividend to $7.50 and by offering a:

"...cash tender offer for 150 million (or approximately 10%) of the outstanding CVS/Caremark shares at a price of $35 per share promptly following closing of the merger."

Obviously, this is not a shocking development given the current circumstances. However, this publication is hesitant to now proclaim this a done deal for two reasons. First, the quick increase leaves plenty of time before the CMX shareholder meeting for ESRX to once again boost its offer and allow CMX shareholders to consider rejecting the CVS merger in hopes of obtaining the higher premium. Granted, this is a highly risky option, but it is one that it must be assumed a large portion of CMX shareholders are contemplating.

Second, so far the response of proxy advisor services remains unchanged. CtW continues to oppose the CVS deal, claiming the offer remains inadequate. As of this entry, ISS has not issued its updated recommendation and will very likely offer a similar negative recommendation for the CVS offer. However, this is by no means assured.

CVS claims that the "enhancement" is the final offer it will make for CMX. This was an unnecessary statement and one which can not be taken seriously -- especially if CMX shareholders vote against the merger next week. CVS has simply come too far and gone through too much turmoil to walk away from CMX if it comes down to a matter of another small increase.

That being said, yesterday's increase does lower the chances of CMX shareholder rejection considerably -- assuming ESRX does not announce another counter offer within the next few days. If both offers remain unchanged going into the CMX shareholder meeting on March 16, chances of rejection are now perceived to be less than 20%.

March 8, 2007 (9:20a) - ESRX Offer Increased / HSR, DE Status

In response to the combination of an imminent second request from the FTC and another rejected injunction from the Delaware Chancer Court, ESRX has "improved" its offer for CMX. The new proposed terms are as follows:

"The Express Scripts offer is to acquire all outstanding shares of Caremark for $29.25 in cash and 0.426 shares of Express Scripts stock for each share of Caremark stock. The Company will now pay additional cash consideration of approximately 6 percent per annum on the $29.25 cash portion of Express Scripts' offer."

The ball is now squarely in CVS' court. In order to absolutely assure CMX shareholder approval next Friday (3/16), CVS will need to increase its offer -- even if it's only a slight increase. Lacking any adjustment to the current merger agreement the CMX shareholder vote outcome must be considered tenuous. This, of course, would be changed if the various institutional proxy advisors reverse their recommendations in favor of the CMX-CVS deal. There is currently no indication that this will happen in the next week.

If CVS intends to risk CVX shareholder rejection under the current terms, the company can certainly adjust the terms upwards after the fact and hope for CMX shareholder approval at some point in the spring. But this seems to be a terribly risky, if not negligent, course of action.

This has developed into one of the more fascinating scenarios in recent memory, and it is now somewhat difficult to confidently predict events for the next several days. It is the opinion of this publication that CVS will slightly increase the current terms if, and only if, substantial indications of CMX shareholder rejection emerge over the next week. This includes, but is not limited to, the proxy service reactions to yesterday's events.

If CVS chances obtaining CMX shareholder approval without an adjustment, the chances of this backfiring would seem to be relatively high: +/- 30%.

It continues to remain the expectation of this publication that the CMX-CVS deal will ultimately be completed well before ESRX is able to obtain HSR clearance.

March 7, 2007 (11:35a) - HSR Second Request (Unconfirmed)

Reports are surfacing that the FTC has issued, or will issue, a second request in the propose CMX-ESRX combination. There has been no confirmation of this development from the companies or the FTC as of this entry.

March 7, 2007 (9:00a) - DE Chancery Court Status (Appeal)

According to published reports, the CMX shareholder groups involved in the initial Delaware Chancery Court lawsuit will not join ESRX in its current attempt to enjoin the merger. Instead, the shareholders will instead request a further delay to the CMX shareholder meeting beyond March 16.

This publication continues to expect the Chancery Court to reject the current attempts to enjoin the merger and is not likely to delay the shareholder meeting a third time. The Court has already displayed reluctance to question CMX's (execs/management) business decision, and will probably view the disclosures provided last week in the same light. Perhaps in some other jurisdiction (California?) ESRX might have a chance to derail the transaction, but the Delaware Chancery Court simply does not inject itself into these situations without sufficient cause. That cause does not exist in this case.

As discussed from the entrance of ESRX into this situation, a second request under HSR is anticipated for the unsolicited ESRX offer. If this does indeed occur tomorrow, the pendulum will swiftly swing in favor of the CMX-CVS deal as even small shareholders will have little interest in waiting several more months for a still-uncertain outcome.

March 1, 2007 (3:35p) - ESRX Appeals DE Chancery Court Ruling

ESRX has appealed Judge Chandler's of last Friday (2/23), claiming CMX has failed to sufficiently provide disclosure to shareholders as ordered by the Delaware Chancery Court. ESRX has also again requested that the CMX-CVS transaction be enjoined on the basis of CMX misconduct.

This attempt by ESRX smacks of desperation and will very likely be viewed that way at the appeal hearing. The chance of additional disclosures being required, along with another CMX shareholder postponement are very small. The chances of the merger agreement being killed by the courts: virtually nil.

February 26, 2007 (8:15a) - CMX Disclosure / Shareholder Meeting Details

As anticipated, CMX has fulfilled its disclosure obligations as dictated by the Delaware Chancery Court and sent the information to shareholders. As a result of the disclosures, CMX has again re-scheduled its shareholder meeting date to March 16, 2007 -- the current expiration date for the ESRX offer.

With this task accomplished, this transaction now boils down the the HSR review in the potential CMX-ESRX combination. If the FTC does not issue a second request next week (3/8), CVS will essentially be forced to raise its offer for CMX to at least match the ESRX offer, in order to obtain CMX shareholder approval on March 16.

If a second request is issued on March 8, the complexion of CMX shareholder vote should shift significantly in favor of the CMX-CVS deal, although by no means will a positive outcome (for CVS) be guaranteed by a second request. As stated several times, CVS needs to make at least one more gesture towards CMX shareholders to secure approval of the merger transaction, even if the FTC does issue a second request in the CMX-ESRX review.

This publication continues to expect a second request for ESRX next week, despite ESRX's claims that it is working to clear the HSR review without further delays. There is simply too much evidence to suggest an extended FTC review, including the DOJ established difficulty in understanding the PBM industry (see December 19th entry), the fact that an ESRX-CMX combination will create the top PBM entity by quite a large margin, and the involvement of several state Attornies General who have openly expressed their concerns for the potential merger to federal regulators. In short, HSR clearance of CMX-ESRX would be a small miracle.

This publication also continues to foresee a successful completion of the CMX-CVS deal. This should occur on March 16 asssuming CVS, again, takes the necessary steps to secure CMX shareholder approval.

February 23, 2007 (5:10p) - DE Chancery Court Ruling

Delaware Chancery Court Judge William B. Chandler III has denied ESRX's and certain CMX shareholder's request to invalidate the $675 termination fee in the CMX-CVS merger agreement. Furthermore, Judge Chandler has rejected the plaintiff's injunction based on alleged CMX director misconduct.

Judge Chandler offered the following explanation for his decision:

"Although plaintiffs allege facts concerning the process by which the deal was negotiated that trouble the court, very few of their arguments suggest that I am in a better position than Caremark's shareholders to make the ultimate decision."

Chandler further ruled that the CMX shareholder meeting again be postponed for at least 20 days from disclosures regarding appraisal rights associated with the special dividend and certain fees paid to banks involved with merger transaction.

CMX is expected to provide the required disclosers very quickly -- probably before the end of next week -- allowing the special shareholder meeting to be re-scheduled in about the third week of March 2007.

February 22, 2007 (9:05a) - Status Report

Two secondary matters worth mentioning from yesterday: CMX released a very positive earnings report for Q4 2006 and Medco stated that it has no interest in entering this situation as a bidder for CMX.

The latter is not a shock, yet interesting in that it highlights Medco's perception that the offers for CMX are already well above the company's actual value. And perhaps it also indicates Medco's awareness of probably competition concerns in any potential CMX-Medco transaction.

The first item, also not terribly surprising, will hopefully solidify CVS's resolve to complete the deal by increasing its offer to the point of at least matching the current ESRX offer. Although there is currently no indication that CVS intends to do this, CMX's earnings report coupled with the current Delawar legal proceedings should motivate the company into taking positive, definitive steps to successfully end this transaction.

February 20, 2007 (9:00a) - DE Chancery Court Status

Delaware Chancery Court Judge William B. Chandler III withheld a decision in this case until at least this Friday, February 23.

Reports out of Delaware indicate the plaintiffs (ESRX and certain CMX investors) argued that the breakup fee of $675 million is excessive and that the CMX Board failed in its duties to negotiate for the best possible deal with CVS or other parties. None of this is in any way a revelation.

On the other hand, CMX argued that ESRX's unsolicited offer is primarily an attempt to ruin the CMX-CVS agreement, with the goal being to weaken its competitor in the process. Again, no revelation here.

It is the opinion of this publication that the breakup fee argument is completely frivolous, if not outright silly. Judge Chandler should reject this aspect of the case without much consideration.

The complaint regarding the CMX Board failure to secure a better deal is more legitimate, but ultimately it is expected that Judge Chandler will decide that shareholders are responsible for determining this at the company shareholder meeting.

In short, the lawsuit against CMX raises no new issues in this case, or in the broader perspective of any other similar case involving disgruntled shareholder and/or a shunned third party. Simply put, there appears to be absolutely no reason for Judge Chandler to intervene beyond his decision to delay the CMX shareholder meeting to March 9.

This publication continues to believe the CMX-CVS transaction will be successfully completed, although there would be a great deal more certainty if CVS would simply increase its offer a small amount with cash (not a special dividend) or stock.

February 16, 2007 (8:45a) - DE Chancery Court Status

Delaware Chancery Court Judge William B. Chandler III will hold a hearing today to decide allegations of misconduct by CMX executive and the Board of Directors. The lawsuits originate from ESRX and certain CMX shareholders.

This publication anticipates a dismissal of both lawsuits, as the Judge's decision to enjoin the CMX shareholder meeting should be sufficient action at this time. Judge Chandler has not shown much inclination towards granting injunctions in the favor of disgruntled shareholders in the past, and there is little reason to expect him to do so in this case.

February 13, 2007 (3:55p) - CMX Shareholder Meeting Enjoined

According to published reports, the Delaware Chancery Court has issued a temporary restraining order effectively stopping the CMX shareholder meeting scheduled for February 20th.

The order will apparently postpone the CMX shareholder until March 9 -- an interesting date given that the HSR waiting period for ESRX's offer expires on March 8.

Chancery Court Judge William B. Chandler III has been quoted with the following statements:

"A reasonable shareholder may consider the revelation that Caremark has considered, on at least three separate occasions, potential transactions with Express Scripts to be highly relevant.

"This is particularly true in the face of Caremark's present protestations that antitrust difficulties loom so large as to prevent the board of directors from even discussing an offer with an admittedly higher dollar value."

As this publication continues to anticipate a second request for the DOJ - despite ESRX's efforts -- the delay in the CMX shareholder vote will only serve to postpone the inevitable, assuming CVS continues to maintain an acceptable offer level. If a second request is issued on March 8, there will be virtually no chance of ESRX successfully derailing the current CMX-CVS agreement.

February 13, 2007 (9:00a) - CVS Offer Increased

CVS has increased the terms of this deal by tripling the "special dividend" created several weeks ago. CMX shareholders will now receive $6 per share condition upon completion of the merger.

The expected move by CVS will probably receive a mixed reception from CMX shareholders and analyst, but ultimately should be enough to secure this transaction. Even if the dividend increase is deemed insufficient by enough CMX shareholders to threaten approval, it is now very clear the CVS intends to guide this deal through to completion.

In other words, if ESRX counters with its own increased hostile offer, CVS will almost certainly bump its offer up again in order to maintain the support of CMX and its shareholders as the CMX shareholder meeting approaches.

February 12, 2007 (4:35p) - ISS Recommends Rejection of CMX-CVS Deal

Institutional Shareholder Services has just issued its recommendation for CMX shareholders to vote against the transaction with CVS.

The ball is now squarely in CVS' court -- there is no reason for the company to delay increasing the terms of the offer if it wants to successfully complete this deal. CVS should be more than aware at this point that CMX will slip away if it does not act quickly.

This publication expects a revised merger agreement within the next 48 hours.

February 12, 2007 (10:30a) - Status Report

As widely reported late last week, proxy firm Glass Lewis & Company announced its opposition to the CMX-CVS transaction, while not openly supporting ESRX's unsolicited offer. The responses from CMX and ESRX were predictable: CMX "disagreed" with the assessment, while ESRX essentially pleaded with CMX to enter negotiations based on the expectation the the Glass Lewis recommendation would resonate with CMX shareholders.

First, there does not appear to be any indication that CMX intends to entertain ESRX's offer as it stands. CMX's resolve to maintain its agreement with CVS has been impressive over the last few weeks and the Glass Lewis recommendation certainly won't have much of an impact on that under the current circumstances. As long as ESRX's offer remains stagnant ($29.25 in cash and 0.426 ESRX shares), it is extremely unlikely CVS will agree to meet with ESRX in good faith negotiations.

Second, the Glass Lewis recommendation seems highly suspect in that it is probably geared toward inciting a higher offer from CVS and/or ESRX, rather than looking out for the long-term interests of CVS shareholders. With that being said, it would not be at all surprising to see CVS increase the offer marginally within the next few days in order to seal this deal. The only factor keeping the current merger agreement in doubt is the current exchange rate, and this can be easily repaired by a small increase in either CVS shares or a cash component, such as the dividend gesture made a few weeks ago.

Absent a small increase, the CMX shareholder vote on February 20 will remain somewhat in doubt, especially if Institutional Shareholder Services seconds the Glass Lewis opinion with its own negative recommendation.

February 8, 2007 (10:10a) - Status Report

Today's revelations involve a very upbeat earnings report from ESRX, coupled with new reports of questionable options activity involving ESRX executives. How these two developments will affect the current battle for CMX is unknown, and it would be blind speculation on the part of this publication to attempt to offer a prediction.

Nonetheless, it will be repeated that the CMX-CVS deal, as currently structured and with all aspects (short and long) considered, remains perceived as the best and most probable outcome here.

Although it is conceivable that ESRX's earnings report will translate into a significantly increase offer (which seems to be the popular concept at this point), it is equally conceivable that CVS will amend its offer to counter any proposition from ESRX -- without necessarily having to match or exceed an ESRX offer.

This publication simply does not foresee CVS allowing CMX to slip away this close to completing the transaction.

February 6, 2007 (1:20p) - Status Report

Over the last week there have been no significant developments in this situation -- only continued publicity stunts on both sides to sway CMX shareholders to either the CVS deal or an ESRX combination.

Quite a few "objective" analytical reports have strongly suggested that ESRX will ultimately win the battle for CMX, based on the assumption that ESRX will again increase its offer before the February 20 CMX shareholder meeting. These reports are purely speculative (obviously) and the vast majority completely discount the probability that CVS would counter any future ESRX increase with another increase of its own. With CVS' strong Q4 results in hand, the company could legitimately increase the stock portion of the deal in order to secure an adequate level of CMX shareholder support for the merger.

In short, this publication does not agree with the mainstream reports favoring ESRX in this particular situation. The rationale for a CMX-CVS combination remains perfectly sound, and a CMX-ESRX will very likely receive a second request, followed by a fairly lengthy review process, regardless of ESRX's "efforts" in working with the FTC to avoid this scenario.

January 31, 2007 (9:25a) - ESRX to Re-file HSR Notification

ESRX has announced that it will withdraw and re-file the HSR notification in its unsolicited bid for CMX on February 2, 2007.

While not at all surprising, this action by ESRX is essentially futile, as a second request from the FTC is a virtual certainty -- re-filing or not. ESRX's stated intention to "clear the transaction without the need for a second request" is wishful thinking from this publication's perspective and is intended to give CMX shareholders the false impression that the FTC review in a CMX-ESRX deal will not be lengthy. All evidence suggests otherwise.

The new HSR expiration date will be March 8, 2007. By that time, the CMX-CVS deal should already be completed unless ESRX raises its offer significantly.

January 29, 2007 (9:10a) - Political Concern Reported (CMX-ESRX)

According to reports published late Friday (1/26), legislators from at least four states have contacted the FTC to voice their concerns about a potential CMX-ESRX combination. The states identified to this point are Arizona, California, Colorado, and Texas.

It will again be noted (see December 15 analysis) that the AdvancePCS (ADVP) - Caremark (CMX) drew similar concerns from Texas and Florida, although those issues ultimately amounted to very little in terms of the companies completing the transaction.

The state concerns in this deal are not all surprising and serve as yet another glaring weakness in the ESRX's attempts to break up the CMX-CVS deal. It is abundantly clear that a CMX-ESRX transaction will receive a long and thorough FTC review if it moves forward. Despite the fact that the current deal obtained FTC clearance without a second request, the CMX-ESRX combination would generate an HSR review of at least four months, and more likely six, which is a factor that CVS and CMX must make clear to shareholders leading up to the CMX shareholder meeting.

If the companies fail to drive this point home over the next few weeks, the outcome of the CMX shareholder meeting will remain somewhat tenuous.

January 23, 2007 (8:45a) - CMX Sends Support Letter to Shareholders

CMX has sent a letter of support for the formal merger agreement with CVS, and rejection of the unsolicited offer from ESRX, to its shareholders. The letter is accessible by following this link.

Not surprisingly, the letter emphasizes the certainty of completing the CVS transaction next month, while warning that the ESRX offer is highly conditional and subject to lengthy delays. This publication, as stated repeatedly, generally agrees with this general assessment, especially where the HSR review is concerned for a CMX-ESRX combination.

This will obviously not be the last publicity effort on either side of this situation. ESRX can be relied upon to refute most of the claims made in CMX's letter (although it would be best to avoid denying potential regulatory delays) and CMX will need to continue to attempt to convince shareholders that the CVS deal is the more desirable transaction.

This publication continues to believe that the CMX-CVS deal will ultimately prevail.

January 22, 2007 (10:10a) - Status Report

As expected, the proxy statement was declared effective on Friday (1/19) , and will be send to shareholders beginning early next week.

Also, several reports have surfaced over the last few days suggesting the deal may be threatened by the perceived inappropriate perks being offered to CMX executives as incentives for continued support of the merger. This seems to far-fetched and perhaps wishful speculation from sources hoping to inject additional controversy into an already volatile situation.

There is obviously nothing new or unethical about executives from a target company receiving substantial, even absurd, rewards for agreeing to a formal merger agreement. It is part and parcel of the process and should not be viewed as anything but standard procedure in this transaction.

ESRX's chances of disrupting the current transaction will only succeed if the company raises its offer significantly and can convince CMX shareholders that the HSR review will not drag on into the summer of this year. ESRX is expected to renew its publicity campaign during the course of this week. It is highly likely that it will increase its offer within the same time frame, although there has been no solid indication of this over the last several days.

January 18, 2007 (9:15a) - Proxy Mailing Date Details / Status Report

CVS filed the third amended proxy statementwith the SEC on yesterday (1/17).

The proxy mailing date is stated as January 19, 2006. Therefore, the proxy will most likely be declared effective later today.

As of this update, CMX shareholder response to the special dividend added to the deal has been lukewarm, at best. However, this lack of enthusiasm seems to be tempered by the continued rejection of shareholder suits filed against the current merger agreement. Although the lawsuits had very little chance of succeeding, the fact that CMX shareholders are being turned away by the courts weighs heavily in favor of momentum continuing for the current transaction.

January 17, 2007 (1:20p) - Shareholder Meeting Details

CVS filed the second amended proxy statement with the SEC on yesterday (1/16).

The CMX shareholder meeting has been scheduled on February 20, 2007. The CVS shareholder meeting will be held on February 23, 2007, assuming CMX shareholders approve the transaction.

The proxy is not expected to go effective within the next five business days and will be mailed to shareholders before the end of this month.

January 17, 2007 (9:20a) - Special Dividend Announced

As expected, the companies announced a cash component in the form of a special dividend of $2.00 to be paid to CMX shareholders after the completion of the transaction. The original terms of the transaction will remain unchanged at this time.

In response, ESRX continues to claims that its offer remains superior despite the new cash component.

This step should demonstrate to CMX shareholders that CMX and CVS fully intend to complete the transaction regardless of ESRX's intrusion. It is unclear at this stage if the special dividend will be enough to appease the existing CMX shareholder concern, but it certainly will help slow any momentum in ESRX's favor. It also opens the possibility of an additional increase the terms, although it is not expected that CVS will be willing to add significantly to the current terms.

January 16, 2007 (8:50a) - ESRX Commences Exchange Offer

ESRX has announced the commencement of an exchange offer for all outstanding shares of CMX for $29.25 in cash and 0.426 shares of ESRXstock.

The current exchange offer expiration is Tuesday, February 13, 2007.

As of this update, neither CMX or CVS has responded to the exchange offer, but both are expected to reaffirm their committment to the current merger agreement at some point today.

This action by ESRX will effectively continue to agitate CMX shareholders against the CMX-CVS transaction and, presumably, will prompt some sort of proactive move by CVS to ensure that the merger moves forward. It will again be speculated that CVS will make an adjustment to the current terms of the transaction, either in the form of a cash component or an increase in the share exchange. Adding a cash component at this juncture would have the most positive affect in motivation CMX shareholders to vote for the merger.

Additionally, CVS stated late last week that it expects the CMX shareholder meeting to be held at some point in February. Naturally, this assumes that SEC consent will be granted within the next two weeks and that no shareholder meeting adjournments are necessary. The SEC obstacle is fully expected to be overcome in time for a late-February CMX shareholder meeting. However, CMX will very likely need to take the necessary steps (i.e. increase the offer) in order to go into the CMX shareholder meeting with the necessary votes.

January 11, 2007 (8:50a) - Status Report

CVS filed an amended proxy statement with the SEC on January 9. The definitive proxy should be out within the next two to three weeks.

Also, ESRX has filed a lawsuit challenging the breakup fee for the formal merger agreement. This is currently percieved as a futile legal effort, yet probably a valid means of obtaining additional publicity and CMX shareholder support. It is extremely unlikely that any court will force the companies to adjust the breakup fee for this transaction.

January 8, 2007 (9:05a) - Status Report

CMX's Board of Directors yesterday reaffirmed the companies commitment to the current formal merger agreement with CVS. Naturally, ESRX has responded by repeating its claim that its unsolicited offer is superior. Interestingly, ESRX does not give much of a rebuttal to CMX's detailed explanations of synergy and related financial benefits of the CMX-CVS deal, but it does state the following regarding the expected HSR issue:

"We believe that Caremark is attempting to use antitrust as a red herring to distract stockholders from the real value differential at issue."

It remains the opinion of this publication that ESRX's claims are hollow and ultimately fail to achieve the company's objective. The only superior aspect of the ESRX offer is the current premium to the CVS terms, which is now approximately 13%. CVS can correct this by adding a cash component to the current formal agreement without actually having to meet or exceed the premium.

If CMX shareholder discontent with the CMX-CVS deal continues to grow -- which is highly likely -- CVS is expected to make a minor revision to the terms of the deal before the CMX shareholder meeting.

January 4, 2007 (8:30a) - CMX Shareholder Status

An unidentified group of CMX shareholders has scheduled an informal meeting today to discuss strategies for terminating the current CMX-CVS merger agreement. The time of this meeting is unknown, but the location is believed to be Nashville, Tennessee.

This development is not at all surprising given the set of circumstances involved, but is currently not perceived as a legitimate threat to the formal merger agreement.

As discussed in previous updates, the rapid HSR clearance for the CMX-CVS transaction should provide ample leverage for the companies to fend off any shareholder discontent (current or future). However, it also would not be at all surprising if the terms are adjusted upwards if only to end any doubts going into the CMX shareholder meeting.

December 26, 2006 (10:25p) - Status Report

On December 23, U.S. District Court Judge Aleta Trauger denied a CMX shareholder motion for force the company to "consider" ESRX's unsolicited offer. The Judge cited CMX's publicly stated intentions to review the offer under the terms of the current merger agreement.

This development is not expected to end CMX shareholder efforts to seek a better deal with CVX or instigate a bidding war involving ESRX. In fact, reports indicate that CMX shareholders will re-file the motion later this week or early next week with revisions to the complaint.

This publication currently anticipates that the CMX-CVS merger will be successfully completed during the first quarter of next year. However, the wide discrapancy between the current CVS terms and the ESRX offer will in all likelihood force the companies to revise the terms upwards in order to appease CMX shareholders. With the unexpected rapid FTC clearance, CVS should have the necessary leverage to proceed with the transaction without having to enter a protracted bidding war with ESRX.

Although some reports are now suggesting that a potential CMX-ESRX deal would also receive FTC approval without delay, this is a wholly unrealistic and uninformed assessment. The FTC will probably issue a second request for CMX-ESRX, as the impact of that combination would have a palpable impact on the PBM industry, while CMX-CVS will have virtually no impact. It is this concept that CVS can be expected to use as propaganda against ESRX in the coming weeks in order to maintain adequate CMX shareholder support.

It is this factor that should allow CVS to complete the deal without having to exceed ESRX's current offer price. Nevetheless, CVS will most likely need to increase the terms -- perhaps adding a cash element -- in order to assure CMX shareholder approval in February or March of next year.

December 20, 2006 (10:45p) - HSR Expiration

Surprisingly -- to this publication and apparently to the companies -- the FTC has cleared this transaction under HSR without the issuance of a second request.

CVS has accordingly revised its closing projection to "as early as the first quarter of 2007."

This projection naturally assumes that no state AG's will intercede in the transaction, which is a distinct possibility given the rapid HSR approval.

December 20, 2006 (2:30p) - Preliminary Proxy Statement Filed

CVS filed the preliminary S-4 for this transaction with the SEC yesterday (12/19).

According to the S-4, the HSR notification was in fact filed on November 20, 2006. Therefore, the anticipated second request should be announced either tomorrow or Friday.

The document also notes the following regarding various state reviews:

"CVS and Caremark have been informed that Arizona, California, Florida, Illinois, Louisiana, Maine, Massachusetts, Missouri, Nebraska, New York, Ohio, Pennsylvania, Rhode Island, Virginia and the District of Columbia are reviewing the merger from an antitrust perspective. CVS and Caremark have and will continue to cooperate with these states in their review."

The involvement of these states is similar to those in the AdvancePCS (ADVP) - Caremark (CMX) deal, where Attorneys General in Florida, Texas, and particularly Connecticut intervened and somewhat impact the HSR review (see December 15 report). Thus, the only surprising aspect of this information is that Connecticut and its highly visible AG have not intervened at this point. More than likely, Connecticut will enter the picture eventually.

Nevertheless, it remains the belief of this publication any antitrust delays for this deal will be caused by the unusual nature of the PBM industry, rather than competition-related issues. The FTC and all state regulators are expected to sufficiently acquaint themselves with the PBM market complexities and this deal's impact on that market, and ultimately conclude that is does not pose an antitrust threat at this time.

December 19, 2006 (8:20a) - Status Report / Additional Research

CVS responded to ESRX' unsolicited offer with the standard statement expressing confidence in its current agreement with CMX. Naturally, CVS did not offer a course of action going forward or timing for a review of the ESRX offer. It can generally be expected that CVS will provide further guidance late this week or early next week. As noted yesterday, this situation does look like one in which a brief bidding war will develop for CMX and CVS will more than likely be forced to increase the exchange rate, perhaps to include a cash element, in valuing CMX above the $60 per share level.

Separately, whichever company ultimately proceeds in acquiring CMX, the DOJ is certain to give at least a cursory look into the market implications of the combination. Within this chapter of a recent DOJ report encompassing the broad pharmaceuticals industry, it is clear that the regulator still does not fully grasp the dynamics of the PBM market, which is not surprising given that apparently no one can claim to possess this knowledge. In previous research, the words "opaque" and "mystery" commonly surfaced in trying to define this enigma of an industry. The DOJ prefers to use the terms "transparency" in its overview -- an overview that views CMX and ESRX as two of the three dominant players in the PBM field. This will be significant if in fact ESRX wins the battle for CMX. It is expected that CVS will use the potential antitrust factor as leverage to maintain its agreement over the coming weeks.

Some interesting excerpts for the DOJ report are as follows:

"It is estimated that there are 60 PBMs operating in the United States today. There are three independent, full-service PBMs with national scope: Medco Health Solutions, Inc. (Medco) (formerly Merck-Medco), Express Scripts, Inc., and Caremark, Inc.. Some PBMs are owned by significant retail supermarket/pharmacy chains, e.g., CVS's PharmaCare, Kroger's Prescription Plans, and Walgreen's Health Initiatives. Many large insurers such as Aetna and Cigna offer in-house PBM functions. In addition, there are many smaller, privately-held PBMs. The relative size and ranking of these companies varies according to the measure used, such as annual prescription expenditures, prescriptions per year, or covered lives. Each measure has its own shortcomings. Overall, however, the market share figures present an industry in which three national PBMs are major players; a large share, anywhere from one-third to one-half, includes health plans and retail pharmacy chains offering PBM services; and local and regional PBMs have a significant presence.

"PBMs appear to compete on price and non-price dimensions. One survey of plan sponsors using PBM services showed the financial terms of the bid (such as the reimbursement rate and dispensing fee paid to pharmacies, the rebates paid to plan sponsors based on formulary drugs utilized, mail order pricing, and administrative fees) often were the key determinants in the selection of the winning bid. This study also found that plan sponsors were concerned about non-price dimensions of service, such as plan design, the extent of the retail network, and mail order components. Each term or feature is balanced against each other and is driven by the needs of the plan sponsor. For example, some want to maximize generic substitution, whereas others want to maximize rebates from manufacturers.

"Vigorous competition in the marketplace for PBMs is more likely to arrive at an optimal level of transparency than regulation of those terms. Vigorous competition is also more likely to help ensure that gains from cost savings are passed on to consumers of health care services, either as lower premiums for health insurance, lower out-of-pocket costs (for that portion of health care expenditures borne directly by consumers through deductibles and co-payments), or improved services. Negotiated limitations on transparency are unlikely to be so severe that health plan sponsors cannot assess the price and quality of the services they are receiving. Just as competitive forces encourage PBMs to offer their best price and service combination to health plan sponsors to gain access to subscribers, competition also encourages disclosure of the information health plan sponsors require to decide on the PBM with which to contract."

December 18, 2006 (8:30a) - ESRX Offer Details

ESRX has announced an unsolicited, competing offer for CMX of $29.25 in cash and 0.426 ESRX shares, valuing CMX at roughly $26 billion. The ESRX offer represents a 15% premium over the current terms offered in the CVS transaction.

ESRX' entrance into this transaction must be considered a legitimate effort and promises to force CMX into reconsidering the formal agreement with CVS. For its part, CVS does not appear likely to back down from the ESRX threat without a fight, so a bidding war for CMX could very well occur in this case. It would not be surprising given the parties involved to see CMX' per share value increased to the $60 level or beyond.

As far as regulator matters are concerned for a potential CMX-ESRX combination, the projected outcome for the CMX-ESRX deal can essentially be directly applied. There is very little difference in terms of competition matters and overall impact to the PBM industry if ESRX prevails. However, further analysis of a CMX-ESRX transaction will be generated in the near future.

December 15, 2006 (2:05p) - Regulatory Status

According to CMX, the companies are not planning to disclose the HSR filing date even though the companies openly anticipate a second request. Although unconfirmed, various sources have identified December 22 as the current HSR expiration date. Thus, a calendar entry will be made to reflect this potential event.

CMX does claim that the first proxy filing is being targeted before the end of the year.

CMX also notes that there is a small possibility that the transaction will be subject to review under Competition Canada. This is due to solely CVS' retail presence in Canada, and therefore a formal review will probably be waived in this case.

December 15, 2006 (9:40a) - Initial Analysis

The first step in assessing this merger requires revisiting the '03/04 AdvancePCS (ADVP) - Caremark (CMX) transaction which provides virtually every possible regulatory scenario that could arise in this case.

In retrospect, the four month HSR review in ADVP-CMX was indeed an educational exercise, spurred on by concerns originating from state attorneys general. This publication stressed throughout that deal that no antitrust issues existed and this turned out to be the case as unconditional HSR clearance was ultimately granted. Why it took so long for the FTC to reach its decision can only be attributed to the nature of the PBM industry and the fact that the regulatory simply chose that deal to fully understand the implications of consolidation.

As to the first concept, the PBM industry is somewhat of an enigma in terms of understanding how the market is viewed. There are no less than three sets of market share data (see below), all of which provide a different overview of the industry. This is never a good thing where the FTC is concerned, especially when the top players are involved in a merger. The ADVP-CMX deal brought together two big players in a highly fragmented and competitive field, but no one (especially the FTC) could precisely define the field. Thus, the lengthy HSR review.

Of the three market share charts below, the only one that really seems to matter is "Enrollment" or "Covered Lives" data. This data essentially represents the actually number of consumers, regardless of type of drug plan or cost, currently managed by each company. As the chart clearly indicates, as of year-end 2005, CMX-CVS had a combined market share of roughly 25% -- mare than twice that of Medco (13%), but by no means in a dominant market position. In fact, the data for covered lives market share is a perfect illustration of a "fragmented" market, even when CMX and CVS is combined.

As to the second concept -- that of FTC education in anticipation of consolidation -- this transaction would appear to be exactly the situation that the ADVP-CMX review was geared to understand. This is not to say that the FTC will not look into this deal -- it certainly will -- but the mechanics of the review should already be in place. What remains uncertain, and perhaps troubling, is that the PBM industry continues to remain somewhat of a mystery even to those within the pharmaceutical industry.

This September 2006 article from Managed Care Magazine provides excellent insight into PBM's unusual status:

"Payers know little of how PBMs function, what deals they cut, how they profit, or even what specific services they perform. That lack of knowledge has led to suspicion. Many plans and employers have come to suspect that it is sleight of hand, and that the wizard may be getting rich at Dorothy's expense.

"PBMs are, in fact, notoriously opaque in how they make their money. Academic and federal studies have found that the companies profit in primarily two ways: on rebates from manufacturers and on the spread (the difference between what the PBM charges the employer or health plan for a prescription and what it pays pharmacies for it, exclusive of the dispensing fee).

"'This is all the result of the [PBM] industry being so competitive,' says Joseph Coffini, RPh, a principal of Trivantage Pharmacy Strategies, a consulting company in Milwaukee. 'Outside of the Medicare population there are precious few new opportunities where a PBM can expand its market share.'"

Just as telling, the same report provides the following chart which demonstrates both the fragmentation discussed above and contradicts the 2005 enrollment/covered lives data below. According to this chart, Medco currently has almost four times the covered lives as CMX (note that CVS' PharmaCare PBM is not included):

Largest PBMs, 2006 (all figures in millions)
Company Revenue Covered Lives
Medco Health $35,400 62
Caremark Rx $25,500 16
Express Scripts $14,500 N/A
Restat $965 3.5
Prescription Solutions $705 5.7
RxAmerica $620 4.9
Catalyst Rx $475 3
BioScrip $300 7
National Pharmaceutical $260 1.5
Health Trans $75 13

On the data alone, there seems to be very little reason for the FTC to even bother looking into this combination. And if the PBM industry did not have the shroud of mystery attached to it, in all likelihood a very quick HSR review could be confidently predicted. But the companies are obviously aware that the "opaque" nature of the PBM industry will generate enough interest to warrant a second request and a potentially lengthy review since, after all, even industry sources can not agree on how to define the market.

This publication feels that the ADVP-CMX transaction does in fact provided the necessary foundation for the FTC to at least understand the basics of the PBM industry and therefore will not need a full year to sort through this case. That just seems absurd, given the available data, regardless of its inconsistencies. Add to this the fact (again, despite the various data) that Medco is very clearly a powerful competitor to CMX, and one that will in no way be severely compromised by this merger (Note that the 2005 ACDO-Medco deal sailed through the HSR review). Even if the FTC lacked a recent reference, it should not take six months to reach the conclusion that this combination does not present any real antitrust issues -- much in the same way that ADVP-CMX did not.

In sum, this transaction will not encounter the long-end of the regulatory review factored in by the companies. A close in six months, or even five, is the current projection.

December 14, 2006 (10:30a) - Market Share Data

PBM Market Share by Number of Prescriptions Per Year (Q1 2005)

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Pharmacy Benefit Management PBM Market Share PBM Market Share by Enrollment (Q1 2005)

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Top 10 PBM's by Revenue (2005)

Company Name

Annual Revenues

Market Share

Medco Health Solutions, Inc.

$2,800,000,000

12.17%

Caremark Specialty Pharmacy

$2,121,000,000

9.22%

Priority Healthcare Corporation

$1,720,013,000

7.48%

Accredo Health, Incorporated

$1,516,868,000

6.60%

Walgreens Specialty Pharmacy

$1,300,000,000

5.65%

PharmaCare Specialty Pharmacy

$1,225,000,000

5.33%

McKesson Specialty Pharmaceutical

$800,000,000

3.48%

Chronimed Inc.

$559,964,000

2.43%

Florida Infusion Services, Inc.

$478,000,000

2.08%

Option Care, Inc.

$401,702,000

1.75%

December 14, 2006 (9:55a) - Timelines -- Recent Related Transactions

Transaction Length
(Days)
$ HSR SEC MISC
Priority Healthcare (PHCC) - Express Scripts (ESRX) 85 1.3b 30 31  
D & K Heathcare Resources (DKHR) - McKesson (MCK)$ 40   10 n/a  
Aventis SA (AVE) - Sanofi-Synthelabo (SNY) 152 65b 115 n/a

EU
49

Syncor International (SCOR) - Cardinal Health (CAH) 203 1.1b 30 91  
Bindley Western (BDY) - Cardinal Health (CAH) 74 2.1b 30 21  
Accredo Health (ACDO) - Medco Health Solutions (MHS) 177 2.2b 30 113  
First Health Group (FHCC) - Coventry Health Care (CVH) 107 1.8b 30 46

MO
48

TX
>60

AdvancePCS (ADVP) - Caremark Rx (CMX) 203 6b 155 133  
AmeriPath (PATH) - Welsh, Carson, Anderson & Stowe 109 839m 14 69  
RightChoice (RIT) - WellPoint Health (WLP) 106 1.3b 26 23

IL DOI
61

MO DOI
59

BCBS
+/- 45

Averages 135.1   51.1    

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