Florida attorney general sues PBMs Express Scripts, Prime over alleged price fixing

Florida Attorney General James Uthmeier has filed a lawsuit against pharmacy benefit managers Express Scripts and Prime Therapeutics, alleging the pair engaged in illegal price-fixing. According to the lawsuit, the partnership, formed in 2019, allowed Express Scripts to provide Prime with services related to pharmacy networks and drugmaker contracts.

The agreement allegedly forced pharmacies to accept lower reimbursement rates, which can result in pharmacies operating at a loss. Uthmeier's office claims that Prime's reimbursement rates dropped by approximately 20% following the partnership, as pharmacies struggled to fill prescriptions at a loss. "Floridians—especially our seniors and families—depend on local pharmacies for the medications that keep them healthy," Uthmeier stated.

"Prime and Express Scripts colluded to fix prices and underpay those pharmacies, forcing many to fill prescriptions at a loss." The lawsuit accuses the partnership of violating the Florida Antitrust Act and the Florida Deceptive and Unfair Trade Practices Act. Uthmeier seeks injunctive relief, civil penalties, and damages. Express Scripts and Prime Therapeutics have both denied the allegations.

An Express Scripts spokesperson stated they would defend themselves against the "baseless allegations," while a Prime Therapeutics spokesperson claimed the lawsuit overlooks the impact of higher pharmacy costs on patients, employers, health plans, and taxpayers. This is not the first challenge to the legality of the partnership between Express Scripts and Prime, as independent pharmacies have also filed lawsuits alleging price-fixing and imposing higher fees.