Express Scripts sued for allegedly colluding with rival PBMs to fix prices

Numerous community-owned and independent pharmacies have initiated an antitrust lawsuit against Express Scripts, an online pharmacy and pharmacy benefit manager (PBM) owned by Cigna. The legal action alleges that the company collaborated with rival PBMs to manipulate pharmaceutical reimbursement rates and fees, subsequently claiming a portion of the generated revenue.

PBMs play a pivotal role in managing pharmacy benefits for healthcare plans and possess the authority to negotiate prescription prices, often resulting in rates significantly above market value. Referred to as "middlemen," PBMs secure drugs at lower prices for their clients, such as pharmacies and hospital systems, charging a fee that impacts the final cost of prescription drugs.

The lawsuit, filed in the Western District of Washington by Berger Montague and co-counsels, contends that Express Scripts engaged in anticompetitive agreements with competing PBMs, namely Prime, Benecard, and Magellan. These alleged agreements allowed Express Scripts to exploit its market influence, imposing elevated reimbursement rates and fees on pharmacies. The legal action asserts that the company would then partake in a portion of the revenues acquired by the rival PBMs.

The plaintiffs consist of several independent community pharmacies aiming to represent a nationwide class of pharmacies. Their goal is to recover hundreds of millions of dollars in allegedly wrongful overcharges, as stated in an official statement.

Express Scripts has not promptly responded to requests for comments on the lawsuit.