Louisiana Attorney General Liz Murrill announced she has filed a lawsuit against Express Scripts, Inc. and its affiliate Ascent Health Services, LLC, for manipulating the prescription drug marketplace. The complaint argues ESI entered into an unlawful agreement with its competitor Prime Therapeutics to coordinate pharmacy reimbursement rates and fees while increasing their collective leverage over drug manufacturers. This agreement allowed ESI and Prime to use their market power to restrict competition, manipulate pharmacy reimbursement, conceal profits, and steer patients toward pharmacies they own or control. These practices, the state says, have resulted in significant harm to independent pharmacies, increased costs for patients, and reduced patient choice.
Ascent is a group purchasing organization established by Cigna, the owner of ESI, to negotiate rebates with drug manufacturers on behalf of PBMs and is partially owned by both ESI and Prime. Louisiana is seeking damages, civil penalties, attorneys’ fees, and an injunction prohibiting unlawful conduct under federal and Louisiana law.
Read Murrill’s announcement here. Late last month, Florida Attorney General James Uthmeier filed a similar lawsuit against Express Scripts; read more about that here.
With Florida, Michigan (see here), and now Louisiana challenging the Express Scripts-Prime arrangement, a clear pattern is emerging. The concerns being raised by multiple state attorneys general closely resemble issues that have also been the subject of private litigation, including Osterhaus v. Express Scripts and TRUST LLC's case against Prime. NCPA has been raising alarms about these practices for years and supporting private litigation to boot. The growing interest from state antitrust enforcers suggests those concerns are finally receiving increasing scrutiny.
