Nearly 5,000 independent pharmacies have filed a federal lawsuit against Prime Therapeutics, alleging the pharmacy benefit manager conspired with Cigna’s Express Scripts to suppress pharmacy reimbursement rates and increase fees in violation of federal antitrust law. The complaint was filed July 2 in the U.S. District Court for the Western District of Washington.
The plaintiffs, led by Protecting Access to Retail Pharmacy, doing business as Trust, allege Prime entered into a price-fixing agreement with Express Scripts in 2019. The lawsuit claims the agreement allowed Prime to match Express Scripts’ reimbursement rates and fees, resulting in lower payments and higher costs for participating pharmacies. The complaint also alleges the arrangement violates the Sherman Antitrust Act and constitutes a breach of contract. Plaintiffs are seeking treble damages, attorneys’ fees, costs and other monetary relief.
The allegation isn’t new. Four pharmacies filed a similar class-action suit against the two PBMs in 2023, alleging the companies entered an “anticompetitive and unlawful horizontal agreement” that cut reimbursement through Express Scripts while raising transaction processing fees through Prime. An arbitrator has already ruled against Prime in 2025, finding Prime violated federal and state antitrust laws by price-fixing with Express Scripts, awarding the AIDS Healthcare Foundation $10.3 million in treble damages and permanently barring Prime from continuing the arrangement.
In a statement shared with Becker’s, a Prime spokesperson said the company “has played an integral role in bringing down prescription drug costs” and strives “to balance cost savings for patients with equitable reimbursement for pharmacies.” Prime said the lawsuit is “misguided” and argued it “would roll back those savings and have real cost implications for patients and payers.”
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