Florida Attorney General James Uthmeier is suing Express Scripts and Prime Therapeutics, alleging that a partnership between the two pharmacy benefit managers allows them to illegally fix prices.
Express Scripts and Prime entered into a partnership in 2019, through which Express Scripts would provide Prime with certain services related to retail pharmacy networks and contracting with drugmakers. In the lawsuit, Uthmeier's office argues that the collaboration has led Prime to adopt far lower pharmacy reimbursement rates.
Prime's reimbursement rates were about 20% higher before the partnership with Express Scripts, which can lead pharmacies to fill prescriptions at a loss, per the lawsuit.
“Floridians—especially our seniors and families—depend on local pharmacies for the medications that keep them healthy,” Uthmeier said in an announcement. “Prime and Express Scripts colluded to fix prices and underpay those pharmacies, forcing many to fill prescriptions at a loss. When pharmacies struggle or close, patients lose local options and access to care."
The lawsuit argues that the partnership violates the Florida Antitrust Act as a horizontal price-fixing arrangement, and that it also runs afoul of the Florida Deceptive and Unfair Trade Practices Act. Uthmeier is seeking injunctive relief as well as civil penalties and damages.
"We are committed to reimbursing network pharmacies fairly and will vigorously defend ourselves against the baseless allegations in this complaint," an Express Scripts spokesperson said in a statement.
A spokesperson for Prime Therapeutics said that the lawsuit "focuses on pharmacy profits but overlooks the impact that higher pharmacy costs have on the patients, employers, health plans and taxpayers who ultimately pay for prescription drugs."
"Prime's approach has delivered lower costs for patients at the pharmacy counter and substantial savings for individuals, employers and health plans while maintaining broad access to pharmacies," the spokesperson said.
The lawsuit isn't the first challenging the legality of the partnership between Express Scripts and Prime. A group of independent pharmacies sued the PBMs over the partnership in 2023, also alleging price-fixing behaviors.
Independent pharmacies also sued Prime in July, similarly arguing that the PBMs colluded to fix prices through the partnership. The pharmacists allege that in addition to lower reimbursement rates, Express Scripts led Prime to impose higher fees than it had previously.
Express Scripts was not named as a defendant in the July lawsuit.