Express Scripts Lawsuit Against the FTC and Its Implications for PBMs

Express Scripts Takes a Stand

In a bold move, Express Scripts has initiated a lawsuit against the Federal Trade Commission (FTC), aiming to redefine the narrative surrounding pharmacy benefit managers (PBMs). This action follows increasing claims of malpractice and bias against PBMs in the wake of the FTC's scrutiny.

Background of FTC's Investigation

The FTC began its investigation two years prior, which culminated in a critical interim report that emerged in July 2024. The report accuses the PBM sector of benefitting at the cost of patients and independent pharmacists. Key concerns raised by the FTC include:

• Vertical integration within the PBM industry.
• Conflicts of interest leading to preferential treatment of proprietary pharmacies.
• Unfavorable contracts for independent pharmacies.

These allegations cast a shadow on the entire PBM sector, prompting Express Scripts to counter with a 58-page defamation lawsuit. This legal challenge may set a new precedent for how PBMs operate amidst regulatory pressures.

Response and Reactions

The response from the PBM trade association, known as the Pharmaceutical Care Management Association (PCMA), stands firm in defending the industry’s practices. They deem the FTC's assessment as lacking factual basis.

Express Scripts maintains that the agency’s report reflects a bias against PBMs, citing FTC Chair Lina M. Khan's known stance on industry matters.

Looking Ahead

This lawsuit by Express Scripts signifies more than just a legal battle; it marks a critical moment for PBMs in the healthcare landscape. As the situation evolves, it will be pivotal for stakeholders to observe how the legal outcomes influence the industry dynamics and patient care.