Michigan Attorney General Dana Nessel is taking on two major pharmacy benefit managers (PBMs) for what her office alleges are harmful monopolistic practices. In a lawsuit filed against Express Scripts, Inc. and Prime Therapeutics LLC, Nessel claims these companies are suppressing payment rates to independent pharmacies, contributing to a rise in pharmacy deserts — areas with limited access to such services — and inflating the cost of prescription drugs for residents.
As reported by the Michigan Attorney General's Office, the substance of the lawsuit concerns an agreement made between the two pharmacy benefit managers (PBMs), which has reportedly had a dire impact on local pharmacies. These independent outlets, allegedly receiving diminished reimbursements for prescriptions, are struggling to stay afloat. The challenged agreement involves Prime Therapeutics adopting Express Scripts' reimbursement rates in 2019, a move that, while expanding their negotiation power, reportedly comes at the expense of these small businesses.
"Michigan residents should not have to drive 45 minutes, or sometimes even farther, to pick up the insulin, heart medication, or antibiotics they need," Michigan Attorney General Nessel said. This affirms the lawsuit's stance that the agreement in question grants PBMs undue influence over medication distribution, at times delaying access and driving up prices for the end consumer.
PBMs, such as Express Scripts and Prime Therapeutics, generally act as intermediaries between insurers, pharmacies, and drug manufacturers, helping to navigate the costs of medications. However, Nessel's lawsuit puts forward the allegation that these two companies, through their collaboration, have manipulated the system to profit at the detriment of those dependent on readily available and affordable medication.
