ST. LOUIS — Ohio's attorney general this week brought suit against St. Louis-based Express Scripts, alleging the pharmacy benefit manager breached its contract with the state and pocketed millions of dollars in overcharges.
A statement from Attorney General Dave Yost said Express Scripts, in a contract with the Ohio Highway Patrol Retirement System, failed to satisfy pricing guarantees in a schedule, overcharging the system on thousands of claims. Express Scripts had been the pharmacy benefit manager for the system since 2010, and the suit makes the claim about overcharges for each year except 2011-2012.
The suit also said that the company misclassified generic drugs as brand drugs, thereby increasing what it could charge. The litigation seeks unspecified damages.
Yost said in a statement that "PBMs have been keeping secret their prescription pricing in order to evade public scrutiny and rake in revenue."
An Express Scripts spokeswoman, Jennifer Luddy, said the company "denies the allegations in the complaint and intends to vigorously defend itself as the matter proceeds."
Ohio previously sued another pharmacy benefit manager, alleging $16 million in overcharges by OptumRx.
Healthcare Dive reported on the latest Express Scripts lawsuit. It noted that Ohio has taken aim at so-called spread pricing, when pharmacy benefit managers keep a portion of the amount paid to them by health plans for prescription drugs instead of passing the full payments on to pharmacies. Ohio's Department of Medicaid in 2018 terminated contracts with pharmacy benefit managers using the method, switching instead to a pass-through pricing model.
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