Florida Attorney General James Uthmeier
TALLAHASSEE – Florida Attorney General James Uthmeier’s office has filed a lawsuit alleging two competing pharmacy benefit managers entered into an illegal price-fixing agreement that threatens Floridians’ access to affordable medications.
The lawsuit was filed August 27 in Polk County Circuit Court against Prime Therapeutics LLC and Express Scripts, Inc.
“Floridians – especially our seniors and families – depend on local pharmacies for the medications that keep them healthy,” Uthmeier said in announcing the filing. “Prime and Express Scripts colluded to fix prices and underpay those pharmacies, forcing many to fill prescriptions at a loss.
“When pharmacies struggle or close, patients lose local options and access to care. My office is holding them accountable to protect Florida patients.”
According to the complaint, the competitors announced a “collaboration” in December 2019 under which Prime adopted Express Scripts’ significantly lower reimbursement rates. The agreement took effect in April 2020, has been extended multiple times, and remains in effect today. Prior to the deal, Prime’s reimbursement rates were roughly 20% higher.
Afterward, reimbursement rates declined for around 80% of branded drugs and 70% of generic drugs, turning many prescriptions into losses for the pharmacies patients rely on, according to the complaint.
The AG’s office claims these cuts jeopardize pharmacies’ ability to serve their communities.
For example, it says a pharmacy outside Orlando saw its reimbursement for one drug drop 45%, turning a profit into a $15.45 loss per prescription – increasing the risk that Floridians will face fewer local options for critical medications. Prime valued the first three years of the arrangement at $2.5 billion in “cost savings” extracted from those pharmacies.
The lawsuit alleges violation of the Florida Antitrust Act as horizontal price-fixing, as well as unfair methods of competition under the Florida Deceptive and Unfair Trade Practices Act.
Uthmeier’s office seeks injunctive relief, civil penalties, disgorgement, damages and other remedies.
