[mso] Excel or ???

I have a list that can be in Excel or Access or Word or wherever????

The list consists of several fields

EXAMPLE
Last            First                   Combined
Address
Smith           John                    Mr & Mrs John Smith     123
Someplace, Anywhere AK 56789
Smith           Andrea          Mr & Mrs John Smith     123 Someplace,
Anywhere AK 56789
Jones           Martin          Mr & Mrs Martin Jones   456 Nowhere, There
WA 78956
Jones           Martha          Mr & Mrs Martha Jones   456 Nowhere, There
WA 78956

In a mailing, I just want to send one letter to Combined but in the mail
piece I need each of their First names.

What's the best way to do this?

I know I could do something with Uniques in Access which will give me a list
of Combined with Address but then how do I keep the paperwork in order so
the mail pieces get into the right envelopes?

Right now, the people who do these mailings (and it's hundreds of letters
per day) are manually picking out the "duplicates", creating a waste of
printed mail pieces and envelopes and wasting a huge amount of time.

HELP!!! 
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