Express Scripts, a major player in the pharmacy benefit manager (PBM) industry, has taken legal action against the Federal Trade Commission (FTC) over its interim report on PBMs, released in July 2024. The report accuses dominant PBMs of driving up drug prices and harming smaller, independent pharmacies.
In its lawsuit filed on Sept. 17, Express Scripts seeks declaratory and injunctive relief, claiming that the report is biased and defamatory. The FTC characterizes PBMs as “middlemen” who negotiate terms and conditions for access to prescription drugs for millions of Americans.
Express Scripts vehemently denies the allegations, describing the report as “seventy-four pages of unsupported innuendo” and stating that the claims made against it and other PBMs are false and defamatory.
The FTC’s report, released as part of a broader investigation, highlights how three major PBMs—CVS Caremark, Express Scripts, and OptumRx—dominate nearly 80 percent of prescriptions filled nationwide. The agency alleges that this market concentration allows PBMs to inflate consumer costs and put pressure on independent pharmacies, especially in rural areas.
Express Scripts’ lawsuit, filed in the U.S. District Court for the Eastern District of Missouri, argues that the FTC’s report disregarded substantial evidence and instead relied on unverified comments from companies that PBMs negotiate with to lower drug costs.
The company asserts that it is committed to reducing costs and negotiating lower drug prices for health plan sponsors, ultimately making medications more affordable for consumers. It criticizes the FTC’s report as biased and politically motivated, leading to unwarranted harm to its business and reputation.
The PBM industry warns that limiting their negotiating power could benefit pharmaceutical manufacturers, resulting in fewer options for consumers and higher overall healthcare costs. FTC Commissioner Melissa Holyoak also criticized the report, stating that it lacked evidence-based, objective, and economically sound analysis.
Express Scripts is seeking to have the FTC’s report vacated and remove FTC Chair Lina Khan from any further PBM-related proceedings. The company emphasizes the ongoing reputational harm and legal challenges it faces unless the report is withdrawn. Please rephrase this sentence.
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