Michigan Attorney General Dana Nessel sued Express Scripts Inc. and Prime Therapeutics LLC, two pharmacy benefit managers (PBMs), in the U.S. District Court for the Eastern District of Michigan on Monday, April 28, 2025.
“PBMs serve as intermediaries between insurance providers, drug manufacturers, and pharmacies. They are tasked with reducing the amount that insurers pay to pharmacies when individuals fill prescriptions.” The Michigan Attorney General alleges Express Scripts and Prime Therapeutics conspired to eliminate competition and realize excess profits by fixing prices that undermined independent pharmacies by suppressing reimbursement rates. The Michigan Attorney General claims this agreement also restricted access to medications in violation of the Sherman Antitrust Act, the Michigan Antitrust Reform Act, and public nuisance laws.
According to the press release issued by the attorney general’s office, “Express Scripts and Prime Therapeutics entered into an agreement for Prime Therapeutics to adopt Express Scripts’ lower reimbursement rates in exchange for accessing Express Scripts’ buying power and pharmacy network, all while paying Express Scripts administrative fees. The Michigan Attorney General asserts that pharmacies not affiliated with Express Scripts or Prime Therapeutics received less money for filling prescriptions as a result, and in some instances, were reimbursed at rates that forced them to operate at a loss. The attorney general’s office asserts that the agreement contributed to the closure of independent pharmacies, creating so-called “pharmacy deserts,” particularly in half of Detroit’s neighborhoods and in parts of northern Michigan.
The state is seeking to void the agreement between Express Scripts and Prime Therapeutics, restore competitive conditions in the pharmaceutical supply chain, as well as treble damages, disgorgement, interest, fees and costs.
