Express Scripts returns fire with lawsuit against Anthem

Less than a month after Anthem filed a lawsuit against Express Scripts, the pharmacy benefits manager (PBM) has returned fire with a countersuit, accusing the insurer of violating the terms of their contract, according to the Wall Street Journal.

Anthem filed a lawsuit last month following public accusations that Express Scripts owed as much as $3 billion per year from prescription drug savings that it never passed on to the insurer. In its lawsuit, Anthem is seeking "damages related operational issues" and the right to terminate its contract with the PBM, which is set to expire in 2019.

Express Scripts has denied the allegations publicly, but in its countersuit filed on Tuesday, the PBM doubled-down, demanding unspecified damages for "improperly attempting to rewrite" the contract. ExpressScripts also outlined a more pointed denial of Anthem's allegations, claiming it made five separate repricing proposals over the last 10 months that included savings of $2-2.8 billion through the end of the contract, according to the WSJ.

Last year, Anthem CEO Joe Swedish said the proposed merger with Cigna would bring "significant value and opportunity for the combined company and our customers from a better pharmacy contract," reflecting a notable shift toward internal PBMs. Last year, UnitedHealth acquired Catamaran for $12.8 billion, which positioned the insurer to negotiate better drug prices through OptumRx.  

To learn more:
- read the WSJ article

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