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

The proposed class action lawsuit alleges the pharmacy benefit manager worked with rival PBMs to exert its influence in the market and fix reimbursement rates and fees.
By Jessica Hagen
12:56 pm

Photo: ljubaphoto/Getty Images

An antitrust lawsuit has been filed against Cigna-owned online pharmacy and pharmacy benefit manager (PBM) Express Scripts by several community, independent pharmacies. The suit alleges the company teamed with rival PBMs to fix pharmaceutical reimbursement rates and fees and collect a portion of the revenue.

PBMs manage pharmacy benefits for healthcare plans, and can negotiate prescription prices to be substantially higher than market value. PBMs are often called the "middlemen," as they obtain drugs at a low price for their clients (i.e., pharmacies, hospital systems, etc.) for a fee, which then influences the end cost of the prescription drug. 

The suit, filed in the Western District of Washington by Berger Montague and cocounsels, claims Express Scripts entered into anticompetitive agreements with rival PBMs Prime, Benecard and Magellan to leverage its power in the market to impose high reimbursement rates and fees on pharmacies. 

The suit claims the company would then collect a share of the revenues garnered by the rival PBMs. 

Plaintiffs include several independent community pharmacies that "seek to represent a proposed class of pharmacies across the nation and recoup hundreds of millions of dollars in wrongful overcharges," according to a statement. 

Express Scripts did not immediately respond to a request for comment.