In yet another attempt to keep PBMs accountable, Michigan Attorney General Dana Nessel sued Express Scripts Inc. and Prime Therapeutics last week for alleged price-fixing of pharmacy reimbursement rates in the state. The AG’s suit mirrors many of the allegations in the Osterhaus v. Prime lawsuit that recently overcame a motion to dismiss by ESI. General Nessel alleges the PBMs’ anticompetitive behaviors have caused those pharmacies financial harm.
"The unlawful, anticompetitive agreement that the lawsuit alleges has handed these PBMs unprecedented control over which pharmacies receive medication, how quickly residents get their prescriptions, and how much they're forced to pay—crippling small, independent pharmacies and restricting access to lifesaving medications in the process," Nessel said.
Prime agreed to adopt ESI reimbursement rates in December 2019, including setting “guardrails” for pricing. ESI controls around 89 percent of the PBM market in Michigan. Michigan is represented in the matter by Natasha Fernandez-Silber of the Edelson law firm. She is NCPA’s counsel in its price-fixing class action against GoodRx.
