AHF Files Antitrust Action Against Express Scripts PBM
29 Julio 2024 - 2:30PM
Business Wire
Federal lawsuit asserts PBM’s monopoly power in
Louisiana costs AHF substantial revenues and harms its ability to
provide lifesaving care
AIDS Healthcare Foundation (AHF) – the world’s largest HIV/AIDS
healthcare organization which cares for more than 195,000 people in
the United States and is an essential safety-net provider for
disenfranchised, high-risk HIV/AIDS populations – has filed a
federal lawsuit (U.S.D.C., E.D. Mo., Case No. 4:24-01043) against
the pharmacy benefit manager (PBM) Express Scripts, Inc. and its
subsidiary, Accredo Health Group, Inc.
AHF asserts federal antitrust claims and claims of state unfair
trade practices over Express Scripts’ use of its monopoly power as
a PBM in Louisiana to impose anticompetitive restraints to destroy
competition among specialty pharmacies like AHF’s.
AHF’s lawsuit comes on the heels of a blistering 115-page FTC
report documenting how powerful PBMs like Express Scripts squeeze
mom-and-pop and independent pharmacies, driving many out of
business.
“Express Scripts unilaterally imposes arbitrary contract terms
on specialty pharmacies like AHF and, by extension, our patients,”
said Laura Boudreau, Chief of Operations, Risk Management
and Quality Improvement for AHF. “Yet, because Express Scripts is
the dominant PBM by far in Louisiana, AHF and other specialty
pharmacies have no choice but to accept Express Scripts’ terms
there. As a result, the PBM hinders independent specialty
pharmacies from being able to compete long-term.”
Together, Cigna’s Express Scripts, United Health’s Optum Rx, and
CVS Caremark PBMs currently control 83 percent of the prescription
drug market in the United States. Express Scripts controls access
to more than 70 percent of individuals covered by health plans in
Louisiana, including those who need, or may need, specialty drugs
for treating HIV and hepatitis C as well as other very expensive
specialty drugs not available in most traditional pharmacies.
The lawsuit, prepared by Kesselman Brantly Stockinger LLP of
Manhattan Beach, CA, and filed by McCarthy, Leonard &
Kaemmerer, L.C. of Town & Country, Missouri, was filed Friday
in U.S. District Court, Eastern District of Missouri, on behalf of
AHF.
AIDS Healthcare Foundation (AHF), the world’s largest
HIV/AIDS healthcare organization, provides cutting-edge medicine
and advocacy to more than 2 million individuals in 47 countries in
the US, Africa, Latin America/Caribbean, the Asia/Pacific Region,
and Eastern Europe. To learn more about AHF, visit us online at
AIDShealth.org, find us on Facebook, follow us on Instagram and
Twitter, and subscribe to our Ahfter Hours podcast.
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version on businesswire.com: https://www.businesswire.com/news/home/20240729319947/en/
Media Contact: Ged Kenslea, AHF Senior Communications
Dir. gedk@aidshealth.org (323) 791-5526