Florida Attorney General sues pharmacy benefit management companies, alleges price-fixing agreement

Florida Attorney General James Uthmeier has filed a lawsuit against two pharmacy benefit management companies alleging the two "colluded" with one another to fix prices and underpay pharmacies, which financially harmed local pharmacies and limited Floridians' access to affordable medications.

The backstory:

Florida filed the lawsuit against Prime Therapeutics and Express Scripts alleging per se violations of Florida's Antitrust Act and Florida's Deceptive and Unfair Trade Practices Act.

There are three charges:

• Count 1: Violation of Florida Antitrust Act: Conspiracy in restraint of trade
• Count 2: Violation of Florida Deceptive and Unfair Trade Practices: Act For Conduct Before Jan. 1, 2024
• Count 3: Unjust enrichments

According to the complaint, Prime Therapeutics and Express Scripts allegedly entered into an agreement in December 2019, in which Prime adopted Express Scripts' lower reimbursement rates. 

The state alleged that the agreement went into effect in April 2020 and has been extended multiple times, and that it remains in effect.

Under the alleged agreement, reimbursement rates for brand-name and generic drugs dropped significantly, by 80% and 70%, respectively, – and sometimes at a loss to local pharmacies, according to the lawsuit.

Uthmeier is suing for injunctive relief, civil penalties, damages greater than $50,000, and a jury trial, according to the complaint. 

What they're saying:

"Floridians—especially our seniors and families—depend on local pharmacies for the medications that keep them healthy," said Attorney General James Uthmeier in a statement.

 "Prime and Express Scripts colluded to fix prices and underpay those pharmacies, forcing many to fill prescriptions at a loss. When pharmacies struggle or close, patients lose local options and access to care. My office is holding them accountable to protect Florida patients."

The other side:

Prime Therapeutics released the following statement on the Florida lawsuit: 

"The Attorney General's complaint focuses on pharmacy profits but overlooks the impact that higher pharmacy costs have on the patients, employers, health plans and taxpayers who ultimately pay for prescription drugs. Prime's approach has delivered lower costs for patients at the pharmacy counter and substantial savings for individuals, employers and health plans while maintaining broad access to pharmacies," the statement read.

Evernorth, the parent company of Express Scripts, described the allegations as "baseless":

"We are committed to reimbursing network pharmacies fairly and will vigorously defend ourselves against the baseless allegations in this complaint," the statement read.