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Express Scripts Sues FTC, Demands Withdrawal of PBM Report

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Express Scripts, a subsidiary of The Cigna Group (NYSE: CI), has filed a lawsuit against the Federal Trade Commission (FTC) in federal court in Missouri. The company demands the retraction of the FTC's July 2024 report on the pharmacy benefit management (PBM) industry, claiming it contains false and misleading information. Express Scripts argues that the report ignores evidence provided by PBMs, shows ideological bias, and could lead to higher drug prices for consumers.

The company states it has cooperated with the FTC study for over two years, providing extensive data and information. However, Express Scripts contends that the FTC disregarded this input, resulting in a report with inaccuracies. The lawsuit claims the report violates the Commission's duty to follow due process and serve the public interest.

Express Scripts, una sussidiaria del gruppo Cigna (NYSE: CI), ha intentato una causa contro la Federal Trade Commission (FTC) in un tribunale federale del Missouri. L'azienda chiede il ritiro del rapporto dell'FTC del luglio 2024 sull'industria della gestione dei benefici farmaceutici (PBM), sostenendo che contenga informazioni false e fuorvianti. Express Scripts argomenta che il rapporto ignora le evidenze fornite dai PBM, mostra un bias ideologico e potrebbe portare a prezzi dei farmaci più alti per i consumatori.

L'azienda dichiara di aver collaborato con lo studio dell'FTC per oltre due anni, fornendo dati e informazioni dettagliate. Tuttavia, Express Scripts sostiene che l'FTC ha ignorato questo contributo, risultando in un rapporto contenente imprecisioni. La causa afferma che il rapporto viola il dovere della Commissione di seguire il giusto processo e di servire l'interesse pubblico.

Express Scripts, una subsidiaria del Grupo Cigna (NYSE: CI), ha presentado una demanda contra la Comisión Federal de Comercio (FTC) en un tribunal federal en Missouri. La empresa exige la retractación del informe de la FTC de julio de 2024 sobre la industria de la gestión de beneficios farmacéuticos (PBM), alegando que contiene información falsa y engañosa. Express Scripts argumenta que el informe ignora evidencia proporcionada por los PBM, muestra un sesgo ideológico y podría llevar a precios de medicamentos más altos para los consumidores.

La empresa afirma que ha cooperado con el estudio de la FTC durante más de dos años, proporcionando datos e información extensa. Sin embargo, Express Scripts sostiene que la FTC ignoró esta entrada, resultando en un informe con inexactitudes. La demanda alega que el informe viola el deber de la Comisión de seguir el debido proceso y servir al interés público.

Express Scripts는 Cigna 그룹(NYSE: CI)의 자회사로, 미주리 주 연방 법원에 연방거래위원회(FTC)를 상대로 소송을 제기했습니다. 회사는 2024년 7월 FTC의 약국 혜택 관리(PBM) 산업에 대한 보고서의 철회를 요구하며, 거짓 및 오해를 불러일으키는 정보가 포함되어 있다고 주장하고 있습니다. Express Scripts는 이 보고서가 PBM이 제공한 증거를 무시하고, 이념적 편향이 있으며, 소비자에게 더 높은 약값을 초래할 수 있다고 강조합니다.

회사는 2년 이상 FTC 연구에 협력하여 방대한 데이터와 정보를 제공했다고 밝혔습니다. 그러나 Express Scripts는 FTC가 이 문제를 무시하여 부정확한 보고서가 작성되었다고 주장하고 있습니다. 이 소송은 보고서가 위원회의 정당한 절차를 따를 의무와 공공의 이익을 위해 봉사해야 할 의무를 위반했다고 주장합니다.

Express Scripts, une filiale du groupe Cigna (NYSE: CI), a déposé une plainte contre la Federal Trade Commission (FTC) devant un tribunal fédéral dans le Missouri. L'entreprise exige le retrait du rapport de la FTC de juillet 2024 sur l'industrie de la gestion des avantages pharmaceutiques (PBM), affirmant qu'il contient des informations fausses et trompeuses. Express Scripts soutient que le rapport ignore les preuves fournies par les PBM, montre un biais idéologique et pourrait entraîner une augmentation des prix des médicaments pour les consommateurs.

L'entreprise indique qu'elle a coopéré avec l'étude de la FTC pendant plus de deux ans, fournissant des données et des informations détaillées. Cependant, Express Scripts affirme que la FTC a ignoré cette contribution,aboutissant à un rapport comportant des inexactitudes. La plainte affirme que le rapport viole le devoir de la Commission de respecter les règles de procédure et de servir l'intérêt public.

Express Scripts, eine Tochtergesellschaft der Cigna-Gruppe (NYSE: CI), hat vor dem Bundesgericht in Missouri Klage gegen die Federal Trade Commission (FTC) eingereicht. Das Unternehmen verlangt den Widerruf des FTC-Berichts vom Juli 2024 über die Branche der Arzneimittelmanagementdienste (PBM) und behauptet, dass dieser falsche und irreführende Informationen enthält. Express Scripts argumentiert, dass der Bericht die von PBMs bereitgestellten Beweise ignoriert, ideologischen Bias zeigt und zu höheren Arzneimittelpreisen für die Verbraucher führen könnte.

Das Unternehmen erklärt, dass es mehr als zwei Jahre lang mit der FTC-Studie zusammengearbeitet und umfangreiche Daten und Informationen bereitgestellt hat. Express Scripts ist jedoch der Meinung, dass die FTC diese Beiträge ignoriert hat, was zu einem Bericht mit Ungenauigkeiten geführt hat. Die Klage behauptet, dass der Bericht die Pflicht der Kommission verletzt, das ordnungsgemäße Verfahren einzuhalten und das öffentliche Interesse zu wahren.

Positive
  • Express Scripts achieved approximately $38 billion in savings for clients last year
  • The company passes through over 95% of all rebates and fees to client plan sponsors
  • Express Scripts has pioneered programs to shield patients from high list prices
Negative
  • The lawsuit could potentially damage Express Scripts' relationship with regulatory bodies
  • The FTC's report, if not retracted, may negatively impact public perception of PBMs
  • Legal costs associated with the lawsuit could affect the company's financial performance

Insights

Express Scripts' lawsuit against the FTC represents a significant challenge to regulatory oversight in the pharmaceutical industry. The company's claim that the FTC report is unconstitutional and violates due process raises important legal questions about the limits of agency authority. This case could potentially set a precedent for how regulatory bodies conduct and publish industry studies.

The lawsuit's focus on alleged false statements and misleading insinuations in the FTC report highlights the tension between regulatory findings and industry self-reporting. If successful, this legal action could impact future regulatory reports across industries, potentially requiring more stringent standards for data interpretation and conclusions.

Investors should monitor this case closely, as its outcome could affect not only Express Scripts but also the broader PBM and healthcare sectors. A ruling in favor of Express Scripts might lead to increased scrutiny of regulatory actions, potentially altering the landscape of industry oversight.

This lawsuit underscores the ongoing debate about the role of PBMs in drug pricing. Express Scripts' claim of saving $38 billion for clients last year contrasts sharply with the FTC's critical stance, highlighting the complex dynamics of pharmaceutical cost management.

The company's assertion that it passes through 95% of rebates and fees to clients is a key point in the PBM transparency debate. This lawsuit could potentially lead to more detailed disclosure of PBM practices, which could impact the entire healthcare ecosystem.

The focus on drug manufacturers setting prices, with the median annual list price for new drugs reaching $300,000 in 2023, shifts attention to the broader issue of drug pricing in the U.S. healthcare system. This legal battle may catalyze discussions on comprehensive healthcare reform, potentially affecting policy decisions and market dynamics in the pharmaceutical and insurance sectors.

This legal action by Express Scripts, a subsidiary of The Cigna Group (NYSE: CI), could have significant implications for the company's financial outlook. The outcome of this lawsuit may impact Express Scripts' business model and, by extension, Cigna's revenue streams from its PBM operations.

Investors should consider the potential risks and opportunities this legal challenge presents. A favorable outcome could strengthen Express Scripts' market position and validate its business practices, potentially boosting investor confidence. Conversely, an unfavorable ruling could lead to regulatory changes that might affect the company's profitability and growth prospects.

The focus on the $38 billion in claimed savings for clients last year highlights the substantial financial impact of PBM operations. Any changes to the PBM model resulting from this lawsuit could have ripple effects across the healthcare and insurance sectors, potentially affecting stock valuations and investment strategies in these industries.

FTC's July 2024 report makes unsubstantiated, false and biased claims about the PBM industry; fails to take into account the value that PBMs deliver to consumers and patients

ST. LOUIS, Sept. 17, 2024 /PRNewswire/ -- In a lawsuit filed in federal court in Missouri, Express Scripts by Evernorth, a subsidiary of The Cigna Group (NYSE: CI), demanded that the Federal Trade Commission ("FTC" or the "Commission") retract its July 2024 report, which is filled with false and misleading claims about the pharmacy benefit management (PBM) industry and fails to serve the interests of American consumers.

Information about Express Scripts' lawsuit to protect those it serves is available at https://www.evernorth.com/advocate.

"The FTC has taken unconstitutional actions in publishing a report that ignores the evidence provided by our company and other PBMs, demonstrates clear ideological bias and advances a false and damaging narrative – a narrative that could harm the health care system by removing essential checks and balances which would result in higher drug prices for American consumers," said Andrea Nelson, Chief Legal Officer for The Cigna Group. "We don't take this step lightly, but as advocates working to lower drug prices for millions of Americans and the employers, labor unions, and government agencies that provide their prescription drug benefits, we cannot let the FTC's unlawful actions and false information stand."

For more than two years, Express Scripts fully cooperated with the FTC study into the PBM industry, meeting the agency's extensive demands for data and information. The FTC's report disregarded the millions of documents and terabytes of data produced by Express Scripts and other PBMs. As a result, the report is riddled with false statements, misleading insinuations and violates the Commission's duty to follow due process and serve the public interest.

The Facts About How Express Scripts Lowers the Cost of Prescription Drugs

"Our 18,000 Express Scripts colleagues work every day to improve health and lower the cost of medications for the millions of Americans we serve," said Eric Palmer, President and CEO of Evernorth Health Services. "Our clinicians and clinical programs perform thousands of critical medication safety checks on each prescription, and we are constantly innovating to improve medication access and affordability. In a world where pharmaceutical manufacturers continue to raise the price of medications every year, Express Scripts' work is more important than ever, and we won't let misinformation or false accusations deter us from our mission." 

Express Scripts and other PBMs only exist because they provide real value, driving lower net drug costs for employers, labor unions and other plan sponsors and their members. Express Scripts achieved approximately $38 billion in savings for clients last year alone.

  • Drug manufacturers – not PBMs – set the prices of their drugs. According to a Reuters analysis of 47 medicines, the median annual list price for a new drug was $300,000 in 2023, up from $222,000 in 2022.
  • Express Scripts negotiates with drug manufacturers to lower the net cost of drugs for plan sponsors. Numerous academic and government studies and investigations, including several by the Commission, have demonstrated and quantified the magnitude of these savings to plan sponsors and patients. 
  • Express Scripts has pioneered programs to shield patients from high list prices; supporting access to lower-cost generics and biosimilars; and providing customers with convenient access to personalized information about the cost of their care to help them make more informed decisions.

There is no support for claims that PBMs are responsible for high drug costs.

  • There is no evidence that the alleged power of PBMs has been increasing over time.
  • Express Scripts passes through over 95% of all rebates and fees it receives to its client plan sponsors.
  • PBMs have no incentive to see list prices rise. List prices for branded drugs with rebates have grown less, not more, than list prices for branded drugs with no rebates.

For more information about Express Scripts' work to make medications more affordable and accessible, visit https://www.evernorth.com/express-scripts-facts.

An overview of Express Scripts' complaint, which argues the Commission's report violates the U.S. Constitution and federal law, and the full text are available here.

About Evernorth Health Services
Evernorth Health Services creates pharmacy, care and benefits solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Evernorth capabilities are powered by our businesses, including Express Scripts, Express Scripts® Pharmacy, Accredo, eviCore and MDLIVE, along with holistic Evernorth platforms and solutions that move people and organizations forward. All Evernorth solutions are serviced and provided by or through operating affiliates of Evernorth Health, a wholly owned subsidiary of The Cigna Group (NYSE: CI), or third-party partners. Learn more at evernorth.com.

Media Contact
Justine Sessions
860-810-6523
Justine.sessions@evernorth.com

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SOURCE Express Scripts

FAQ

Why is Express Scripts (CI) suing the FTC in September 2024?

Express Scripts is suing the FTC to demand the withdrawal of the July 2024 report on the PBM industry, claiming it contains false and misleading information that could harm the healthcare system and lead to higher drug prices for consumers.

What savings did Express Scripts (CI) achieve for clients in 2023?

Express Scripts reported achieving approximately $38 billion in savings for its clients in 2023.

What percentage of rebates and fees does Express Scripts (CI) pass through to clients?

According to the press release, Express Scripts passes through over 95% of all rebates and fees it receives to its client plan sponsors.

How does Express Scripts (CI) claim to impact drug prices?

Express Scripts claims to negotiate with drug manufacturers to lower the net cost of drugs for plan sponsors and has pioneered programs to shield patients from high list prices.

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