Express Scripts, a subsidiary of The Group, has filed a federal lawsuit against the US Federal Trade Commission (FTC) over a July 2024 report claiming that the report is 鈥渇alse and defamatory鈥� and makes 鈥渕isleading claims鈥� regarding Express Scripts and the pharmacy benefit manager (PBM) industry.
As part of the lawsuit, the US-based PBM has demanded the retraction of the FTC report. The company claims that the report is 鈥渟eventy-four pages of unsupported innuendo levelled against Express Scripts and other PBMs under a false and defamatory headline and accompanied by a false and defamatory press release鈥�.
PBMs manage prescription drug plans for employers and government programs. The industry has faced a huge portion of the criticism regarding the high drug costs in the US, from not just drug pricing advocates but also pharmaceutical industry organisations like PhRMA. The role of PBMs has also been the subject of recent Senate hearings where major PBM CEOs have had to testify in front of a Congressional committee.
The PBM sector is highly consolidated with Caremark, Express Scripts and Optum Rx handling almost 80% of all prescriptions in the US, according to the FTC.
The released by the FTC in July stated that the 鈥渧ertically integrated and concentrated market structure has allowed PBMs to profit at the expense of patients and independent pharmacists鈥�. The US agency also noted that PBMs held 鈥渟ubstantial influence over independent pharmacies鈥� and could impose 鈥渦nfair, arbitrary, and harmful contractual terms鈥� that could impact the independent pharmacy鈥檚 ability to stay competitive.
The lawsuit by Express Scripts alleges that the FTC report ignored 鈥渕illions of documents and terabytes of data produced by Express Scripts and other PBMs鈥�. The lawsuit alleges that the report 鈥渞elies heavily on public comments,鈥� many of which were anonymous and unverifiable yet were treated 鈥渁s fact鈥� by the Commission鈥�.
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By GlobalDataThe company also claimed as part of the lawsuit that the report鈥檚 鈥渨rong findings鈥� were in part a result of FTC鈥檚 commissioner Lina Khan’s and the commission鈥檚 bias against PBMs, and asks that Khan 鈥渞ecuses from further proceeding against the PBMs鈥�.
