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February 19, 2010; St. Louis Today | A St. Louis-based pharmaceutical distributor thinks changing its status to nonprofit can help remedy some of the problems in the nation’s ailing health care system. Express Scripts, which operates one of the largest pharmacy benefit companies in America, says it plans to turn its Rx Outreach unit, which was started in 2004 to provide cheap prescriptions to the poor, into an independent 501(c)3. According to Michael Holmes, who will head the new effort, “The transition of Rx Outreach from a for-profit business unit to an independent nonprofit charitable organization will allow us to develop partnerships with branded and generic pharmaceutical manufacturers, community health centers, rural clinics and faith-based charities. It will serve as a catalyst for bringing public and private resources together in ways not available to a publicly held, for-profit corporation.” Holmes cites several examples of benefits nonprofit status will offer: “By increasing the percentage of drugs donated, we would be able to further lower the costs for low-income patients. We could start developing alliances with health care organizations and associations to raise awareness among the patients they serve. And we could customize programs for free clinics to enable them to serve patients better. We have not seen other major pharmacy benefit managers offer a similar service model or establish nonprofit organizations to address this need.” At NPQ we have long cautioned that marrying nonprofits too closely either to politics or business can lead to problems of intent. This will be worth keeping an eye on.—Bruce Trachtenberg