Express Scripts class action claims company fixes pharmaceutical reimbursement rates, related fees

Express Scripts class action overview: 

• Who: Express Scripts is facing a class-action lawsuit over accusations it worked to fix prices on pharmaceutical reimbursement rates. 
• Why: Express Scripts is accused of using its market power to gain favorable reimbursement rates that it then shared with other companies for a fee.
• Where: The Express Scripts class action was filed in federal court in Washington.

Express Scripts is facing a class-action lawsuit claiming that the company used its market power to leverage favorable pharmaceutical reimbursement rates and then shared those rates with smaller companies for a fee.

The Express Scripts pharmaceutical reimbursement rates were lower than the smaller companies could attain on their own and the Express Scripts then charged a fee to the companies whenever the lower rates were used, the lawsuit says.

Express Scripts fees lawsuit claims ‘horizontal conspiracy’ was used

Express Scripts pharmaceutical reimbursement rates “horizontal conspiracy” was shared with Prime, Benecard and Magellan.

“Through the unlawful agreements with Express Scripts, each co-conspirator was able to reduce its reimbursement rates and raise its fees to the levels of the more powerful Express Scripts,” the Express Scripts fees lawsuit says. “In effect, the co-conspirators rented Express Scripts’ market power. These blatant price-fixing agreements have eliminated the normal market forces and have allowed the co-conspirators to enjoy excess revenues at the expense of pharmacies.”

AbbVie has inflated the price of the autoimmune, rheumatologic, and gastrointestinal disease drug Humira to the point where it is no longer affordable for many patients, a May class action lawsuit alleges. 

Do you use Express Scripts for your pharmaceutical coverage? Let us know in the comments.

The plaintiffs are represented by Beth E. Terrell, Amanda M. Steiner and Blythe H. Chandler of Terrell Marshall Law Group PLLC along with Joseph M. Vanek, Paul E. Slater, Phil Cramer,Trevor K. Scheetz and Kathryn M. DeLong of Sperling and Slater LLC, Steve D. Shadowen, Nicholas W. Shadowen and Kathryn Allen of Hilliard Shadowen LLP, Mark R. Cuker of Cuker Law Firm, Joshua P. Davis and Julie A. Pollock of Berger Montague PC and Michael L. Roberts, Erich P. Schork and Kelly Rinehart of Roberts Law Firm U.S. PC. 

The Express Scripts class action lawsuit is Osterhaus Pharmacy Inc., et al. v. Express Scripts Inc., et al., Case No. 2:24-cv-00039, in the U.S. District Court for the Western District of Washington.

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