Ohio Attorney General David Yost has sued pharmacy benefit managers (PBMs) Express Scripts and Prime Therapeutics for conspiring to illegally increase prescription drug prices and force pharmacies to accept low reimbursement rates. Cigna Group and Humana were also named in the lawsuit.
Yost alleges that Cigna-owned Express Scripts, responding to criticism of its pricing model, formed the group purchasing organization Ascent Health Services in 2019. Express Scripts then granted competing PBM Prime Therapeutics ownership in Ascent, which soon relocated to Switzerland, further obscuring the pricing model.
The result of these machinations? The PBMs allegedly used Ascent to share pricing, discount and rebate information with each other and Humana’s PBM, successfully driving up drug costs and negatively affecting pharmacies, patients, employers, and even drugmakers.
“PBMs are modern gangsters,” Yost said in a statement. “They were designed to protect and negotiate on behalf of employers and consumers after big pharma was criticized for overpricing medications, but instead they have absolutely destroyed transparency, scheming in the shadows to control drug prices on all sides of the market.”