Ohio Attorney General Files Lawsuit Against PBMs


On March 27, 2023, the Ohio Attorney General filed a lawsuit against Express Scripts, Prime Therapeutics, and Humana Pharmacy Solutions, alleging that these Pharmacy Benefit Managers (PBMs) used a Switzerland-based company to increase the cost of prescription drugs and push these increased costs to health care consumers. The lawsuit also names Cigna Group (parent company of Express Scripts); Evernorth Health (another Cigna subsidiary); and Humana (parent company of Humana Pharmacy Solutions), as co-defendants in the case.

The lawsuit accuses the PBMs of using a “complex ‘play to play’ rebate system” that forced manufacturers to increase drug prices in order to receive preferred placement on the PBM formularies. The lawsuit also alleges that this scheme pushed pharmacies to accept low drug reimbursement rates and pay excessive administrative fees in order to stay within insurance networks.

Lastly, the lawsuit alleges that this conduct violates the Valentine Act, Ohio’s antitrust law, which prohibits price fixing, controlled sales and other arrangements that restrain trade and competition, and harm consumers. The Ohio Attorney General stated that he hope the lawsuit would end the “secret and anticompetitive conduct and strong-arm tactics that have prevented free-market forces from ensuring that Ohio’s most vulnerable citizens can afford the prescription drugs on which their lives depend.” Learn more about this lawsuit here.

Last Updated on April 3, 2023 by Aimed Alliance


Comments are closed.