Four independent pharmacies in three states filed a class-action lawsuit last week alleging Express Scripts of colluding with Prime Therapeutics to charge higher fees and reimburse pharmacies at lower rates. The complaint, which claims violation of the Sherman Act, argues "that a three-year collaboration agreement announced in 2019 between Express Scripts and Prime Therapeutics was in fact a pretext for fixing reimbursement rates and fees, with no benefit for customers," according to Reuters.

The pharmacies — two in Wisconsin, one in Minnesota, and one in New Jersey — claim "the Agreement does not, and is not intended to, achieve any efficiencies or economies of scale or procompetitive effects in the relevant markets, and the assertion of any such efficiencies or procompetitive effects by either Prime or [Express Scripts] is pretextual," according to the lawsuit, which was filed in Milwaukee federal court. "The Agreement is simply a naked restraint on price competition with regard to Reimbursement Rates and Transaction Fees."

Cigna-owned Express Scripts is one of the largest pharmacy benefit managers in the United States and in April announced efforts to expand health care in rural communities through partnerships with independent pharmacies across the country with "increased reimbursement opportunities."