Louisiana Sues Express Scripts Over Alleged Drug Price Manipulation
Louisiana Attorney General Liz Murrill has filed a federal lawsuit against Express Scripts, a subsidiary of Evernorth Health Services (CI), alleging that the pharmacy benefit manager artificially inflated prescription drug prices, steered patients toward affiliated pharmacies and colluded with a competitor to manipulate fees and reimbursements.
The suit, filed in the Eastern District of Louisiana, names Express Scripts and its affiliate Ascent Health Services as defendants. It centers on an arrangement between Express Scripts and Prime Therapeutics, in which Prime acquired a minority stake in Ascent — a vehicle Express Scripts created to handle price negotiations with drugmakers. Murrill's office contends that rather than using their combined purchasing power to secure lower prices for consumers, the companies instead coordinated to set higher fees — conduct the lawsuit characterizes as a price-fixing arrangement.
Express Scripts administers prescriptions for roughly 71 per cent of Louisiana residents and serves as the benefits manager for Blue Cross Blue Shield Louisiana, the state's largest private health insurer.
"Louisiana families are working harder than ever to pay their bills, and they shouldn't have to fight a profiteering middleman just to afford the medicine prescribed by their doctor," Murrill said. Express Scripts rejected the allegations, calling the lawsuit "meritless" and saying it would "vigorously defend" its ability to provide patients access to medicines at the lowest available cost. Prime Therapeutics, which is not named as a defendant, said the arrangement had delivered billions of dollars in savings and that unwinding it would raise costs for patients and employers.
The lawsuit is the latest escalation in Louisiana's campaign against pharmacy benefit managers, companies that sit between drugmakers and insurers to determine drug coverage and negotiate pricing. State officials, alongside Governor Jeff Landry, have argued that a small number of PBMs exert outsized market power and exploit vertical integration with pharmacy chains to squeeze independent drugstores and inflate costs.
Murrill reached a $45mn settlement earlier this year in three lawsuits against CVS Health (CVS), which owns both pharmacy retail operations and the Caremark PBM. Louisiana's legislature has also passed new laws this year governing PBM service fees and setting higher reimbursement floors for independent pharmacies. The attorney general is seeking a court order to halt alleged anticompetitive behavior, along with civil penalties and damages.