PBM faces suit over alleged ‘refill pill mill’ scheme

NCPA June 29, 2022

Express Scripts is facing a lawsuit under the False Claims Act on charges that it delivered pointless prescribed drugs to military personnel, bilking the federal authorities and distributors out of billions of dollars. A whistleblower claims the company’s software was allegedly set up to refill 90-day prescriptions on day 60, which means that every Tricare beneficiary obtained 73 percent more tablets than prescribed over the course of 12 months. The suit was filed in a California federal courtroom in mid-2019 and unsealed earlier this month. Express Scripts inflated drug prices for payers and patients via its “refill pill mill” that systematically overcharged the Tricare program for treatment from October 2009 to March 2018, the suit alleges. NCPA has spoken out for years against mail-order pharmacy for many reasons, not the least of which is the waste it produces. Here’s a link to our Waste Not, Want Not document showing examples of this needless waste. If you have a photo to add, send it to Michael Rule.