In a lawsuit filed on Monday, Ohio Attorney General Dave Yost accuses pharmacy benefit managers Express Scripts and Prime Therapeutics of using a little-known, Switzerland-based company to illegally drive up drug prices and ultimately push those higher costs onto patients who rely on lifesaving drugs such as insulin. This collusion, the lawsuit maintains, has been made possible by PBM market consolidation, which has left the three largest PBMs, including Express Scripts, in control of more than 75% of the drug market and the three next largest in control of much of the rest. In marketing its services, Express Scripts touts its ability to leverage its significant market power to extract lower drug prices from drug manufacturers and promises to deliver cost savings to health insurers and employers – a promise that "is knowingly false," the lawsuit says. Rather, Express Scripts has used its dominance solely for its own financial gain, creating "a complex ‘pay to play’ rebate system that, perversely, pushes manufacturers to increase drug prices in order to be placed on, or receive, preferred placement on PBM formularies." The savings that PBMs claim from the inflated list prices are illusory. Yost’s lawsuit alleges multiple violations of the Valentine Act, Ohio’s antitrust law, which prohibits price fixing, controlled sales and other agreements that restrain trade and hurt competition. Yost’s further lawsuit states, Express Scripts and Prime Therapeutics have used Ascent Health Services to share pricing, discount and rebate information with each other and with Humana Pharmacy Solutions, an Ascent customer – driving drug prices up even higher. In addition to Express Scripts, Prime Therapeutics, Ascent and Humana Pharmacy Solutions, Yost’s lawsuit names as co-defendants: Cigna Group (CI), parent company of Express Scripts; Evernorth Health, another subsidiary of Cigna; Humana (HUM), parent company of Humana Pharmacy Solutions. Reference Link
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