Express Scripts pays $9.5M settlement over drug switching

Pharmacy benefit manager Express Scripts has agreed to pay a total of $9.5 million to 28 states and the District of Columbia to settle allegations that it engaged in deceptive prescription-switching practices. The attorneys general involved had been investigating the company, arguing that Express Scripts switched patients to brand-name cholesterol drugs in an attempt to maximize the volume rebates it got from drug manufacturers. While patients were told they'd benefit from the switch, they actually ended up incurring some expenses from the change, according to the Pennsylvania AG's office. In signing the agreement, the company didn't admit any wrongdoing.

Under the terms of the settlement, Express Scripts agrees that it no longer will solicit patient drug switches if the cost exceeds that of the original script, if the original drug has a generic equivalent while the switch doesn't, if the original drug's patent will expire in six months, or if the patient was switched within the last two years. Express scripts also agreed to disclose any financial incentives it may have for soliciting a prescription switch and to reimburse patients for any related costs they might incur.

To learn more about the settlement:
- read this Modern Healthcare piece (reg. req.)

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