NCPA cheers cheered a class action lawsuit filed yesterday against Express Scripts, alleging that the massive PBM one of the colluded with several smaller PBMs to rig reimbursement rates and shake down pharmacies for higher fees. The lawsuit, filed by Berger Montague and several other law firms, claims that Express Scripts used its dominant market position to push rival PBMs to impose excessive back-end fees on pharmacies and then share the revenue with Express Scripts. Express Scripts announced one such arrangement in 2019 with Prime Therapeutics, a smaller PBM. NCPA warned then that the relationship would lead to unfavorable terms for community pharmacies—something NCPA CEO Douglas Hoey flagged in a 2020 letter to stat attorneys general.
“We saw this coming three years ago,” says NCPA CEO Douglas Hoey, “and their collaboration is collusive to enhance already one-sided negotiating leverage and fix reimbursement rates and related fees. Now, Express Scripts has the same kind of sweetheart deal with multiple PBMs and many more pharmacies are affected. The goal of these non-merger mergers was to create collusive and anticompetitive price fixing arrangements and the effects have been devastating to independent pharmacies. We applaud these NCPA members for taking on this issue on behalf of our industry.”
Stay tuned to qAM for more as this story develops.
