'Modern gangsters': Ohio sues 3 PBMs for alleged price fixing

The Ohio attorney general's office has filed a lawsuit against three pharmacy benefit managers, accusing them of sharing pricing and other information gathered by a Swiss subsidiary to gain leverage during negotiations with drugmakers for rebates, The Wall Street Journal reported March 27. 

The lawsuit, filed in state court, takes aim at alleged collusion by Cigna's Express Scripts business, Humana Pharmacy Solutions and Prime Therapeutics, which is owned by 19 Blue Cross Blue Shield plans, according to the report.

Cigna set up a group purchasing organization called Ascent Health Services in Switzerland in 2019, according to the report. Prime Therapeutics later took a minority ownership stake. Humana's PBM is a customer of Ascent. 

The lawsuit alleges the companies used Ascent to coordinate their negotiations and fix the amounts of rebates, according to the report. 

The attorney general's office alleges the companies restricted coverage of some insulins and other medicines due to the collusion, according to the report. If they did not get the desired rebate, the companies would not pay for the drugs or would favor competitors. 

"PBMs are modern gangsters," Ohio Attorney General Dave Yost said in a March 27 news release from his office. "They were designed to protect and negotiate on behalf of employers and consumers after Big Pharma was criticized for overpricing medications, but instead they have absolutely destroyed transparency, scheming in the shadows to control drug prices on all sides of the market."

Cigna and Humana did not immediately respond to the Journal's request for comment, according to the report. Prime Therapeutics said it was part owner of the Swiss firm so it could negotiate drug savings and improve affordability for health plans and their members.

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