Retail pharmacies are accusing Express Scripts and Prime Therapeutics of monopolizing the pharmacy benefit manager market and conspiring to extort pharmacies, according to court documents.
The two PBMs entered an "anticompetitive and unlawful horizontal agreement" in 2020 that reduces reimbursement fees through Express Scripts and increases transaction processing fees through Prime Therapeutics, the lawsuit alleges. Four pharmacies — two in Wisconsin, one in New Jersey and another in Minnesota — filed the class-action suit over anticompetitive accusations.
The pharmacies have "suffered injury to their business or property and have sustained damages in amounts that are presently undetermined but will be subject to discovery and presented at trial," the suit says.
Express Scripts accounts for 24% of the PBM market share, and Prime Therapeutics makes up 5%, according to an analysis of 2022 claims managed by PBMs.
A spokesperson for Express Scripts told Becker's, "We are committed to reimbursing network pharmacies fairly and will vigorously defend ourselves against the baseless allegations in this complaint."
Becker's has reached out to Prime Therapeutics and will update the story if more information becomes available.