Press Release: Michigan AG Sues Pharmacy Benefit Managers for Anticompetitive Practices
LANSING – Michigan Attorney General Dana Nessel has initiated a lawsuit against pharmacy benefit managers (PBMs) Express Scripts, Inc. and Prime Therapeutics LLC, alleging their anticompetitive conduct has severely impacted independent pharmacies across Michigan. This alleged behavior has created "pharmacy deserts," reducing patient access to essential medications and increasing prescription drug costs.
The lawsuit claims that Express Scripts and Prime Therapeutics unlawfully collaborated to suppress reimbursement rates to independent pharmacies. This not only led to excessive profits for the PBMs but also contributed to pharmacy closures nationwide. “Michigan residents shouldn’t have to travel great distances for essential medications,” Nessel stated, emphasizing the destructive impact of the PBMs’ practices on community health.
PBMs act as intermediaries between insurance providers, drug manufacturers, and pharmacies, tasked with reducing insurers’ costs. However, according to the lawsuit, in December 2019, Express Scripts and Prime Therapeutics reached an agreement to adopt lower reimbursement rates that financially favored Express Scripts, further harming independent pharmacies. Some pharmacies reportedly faced reimbursements so low that they were losing money on prescriptions.
This situation has allegedly led to the disappearance of pharmacies in half of Detroit’s neighborhoods and various northern Michigan communities. Nessel asserts that these practices violate both the Sherman Antitrust Act and the Michigan Antitrust Reform Act, among other laws.
The lawsuit aims to terminate the suspect agreement between the two PBMs and seeks remedies to ensure Michiganders have reliable and affordable access to their medications. Nessel concluded, "We are committed to putting an end to these harmful practices."
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