In PBM-Related Lawsuits, Critics Could Discover ‘Ammunition’

  • Aug 09, 2024

    While pharmacy benefit managers are no strangers to litigation, in recent weeks there has been a notable uptick in lawsuits that challenge — both directly and indirectly — PBMs’ ability to ensure clients are able to access the lowest possible drug prices. Sources say that as those suits progress, they could wind up shedding greater light on business practices that have caused PBMs to be caught in regulators’ crosshairs.

    In mid-July, Vermont Attorney General Charity Clark (D) filed a lawsuit against The Cigna Group’s Express Scripts, CVS Health Corp.’s Caremark, and “nearly two dozen affiliated entities,” accusing them of violating Vermont’s Consumer Protection Act by “manipulating the marketplace and reducing access to certain prescription drugs, including lower-cost drugs, through a series of tactics with no transparency in their decision-making process.”

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  • Leslie Small

    Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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