Cigna's PBM, Two Others Sued in Ohio Over Drug Price Fixing

By Brendan Pierson

March 28, 2023

(Reuters) - Ohio on Monday filed a lawsuit accusing Cigna Group, Humana Inc and others of colluding to drive up prescription drug prices by charging exorbitant fees for pharmacy benefit management services.

The lawsuit, filed by Ohio Attorney General Dave Yost in the Delaware County Common Pleas Court, comes amid growing scrutiny by state and federal regulators of pharmacy benefit managers (PBMs) like Cigna's Express Scripts unit, which is named as a defendant. PBMs negotiate drug prices with manufacturers, health plans and pharmacies.

Yost in a statement called the companies "modern gangsters" and said that they had "absolutely destroyed transparency, scheming in the shadows to control drug prices on all sides of the market."

His lawsuit also targets Prime Therapeutics, a PBM jointly owned by multiple Blue Cross health insurance companies, and Ascent Health Services, a Swiss entity that Express Scripts created and partly owns with Prime.

Prime declined to comment. The other defendants did not immediately respond to requests for comment.

PBMs were originally intended to negotiate lower drug prices on behalf of health plans.

Yost alleges that the largest PBMs, including Express Scripts, instead use their market power to push drug companies to increase prices, some of which goes to PBMs in the form of fees. He says that the drug companies participate in this "pay to play" scheme in order to secure placement on the formularies of covered drugs that PBMs maintain for health plans.

Ascent, created by Express Scripts in 2019, bills itself as performing the same kind of negotiating services as traditional PBMs to help health plans get lower costs. Yost alleges that it is in fact a vehicle for Express Scripts, Prime and Humana's PBM arm, an Ascent customer, to share information in order to collude on prices.

The lawsuit accuses the companies of violating Ohio's antitrust law and seeks an unspecified amount of money damages.

(Reporting by Brendan Pierson in New York and Mariam Sunny and Raghav Mahobe in Bengaluru; Editing by Devika Syamnath, Maju Samuel and Cynthia Osterman)