Aug 4, 2019

Shameless monopolies are growing in plain sight

illustration of an octopus holding a scale

Illustration: Aïda Amer/Axios

Given all the antitrust scrutiny being aimed at the tech giants, it can be surprising to see other monopolies operating — and even growing via acquisition — with few if any regulatory consequences.

Monopoly 1: EssilorLuxottica is a $50 billion eyewear giant that incorporates everything from lens manufacturers to dozens of brands such as Oakley, Ray-Ban, Varilux, LensCrafters and Pearle Vision. If your frames are from Chanel or Prada or Versace, they are EssilorLuxottica products.

  • The latest giant to be swept up into the EssilorLuxottica monopoly: GrandVision, a chain with more than 7,200 stores globally.
  • European antitrust regulators might force some divestments in France and Belgium, but either way, this deal will only serve to consolidate EssilorLuxottica's global monopoly.
  • Curiously, this $7.9 billion deal is being done while EssilorLuxottica is still searching for a new CEO.
"If the deal goes through, it would strengthen EssilorLuxottica’s ability to charge markups of as much as 1,000% for frames and lenses -- market power that comes from controlling all aspects of production, owning the country’s largest chain of glasses stores and operating a major insurance plan."
David Lazarus, LA Times

Monopoly 2: Surescripts manages about 80% of all prescriptions in America. It's owned by industry giants CVS and Express Scripts, and if your prescription is filled electronically, it's almost certainly filled by Surescripts. In the words of Amazon, Surescripts is "the sole clearinghouse for medication history in the United States."

  • Driving the news: CVS and Express Scripts are facing competition from PillPack, which is owned by Amazon. Now Surescripts won't give PillPack the information it needs to find out what medicines its customers have been prescribed.
  • The FTC is taking legal action against Surescripts, accusing it of forcing pharmacies to use its services. But that doesn't seem to be helping Amazon, whose PillPack product is a masterpiece of design that — by sending your pills in presorted packets that tell you when to ingest them — significantly increases the probability that patients will take all their pills as prescribed.

The bottom line: The world is full of anticompetitive monopolies, many of which operate in plain sight.

Go deeper: The monopolization of patient drug data

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