FTC's July 2024
report makes unsubstantiated, false and biased claims about the PBM
industry; fails to take into account the value that PBMs deliver to
consumers and patients
ST.
LOUIS, Sept. 17, 2024 /PRNewswire/ -- In a
lawsuit filed in federal court in Missouri, Express Scripts by Evernorth, a
subsidiary of The Cigna Group (NYSE: CI), demanded that the
Federal Trade Commission ("FTC" or the "Commission") retract its
July 2024 report, which is filled
with false and misleading claims about the pharmacy benefit
management (PBM) industry and fails to serve the interests of
American consumers.
Information about Express Scripts' lawsuit to
protect those it serves is available at
https://www.evernorth.com/advocate.
"The FTC has taken unconstitutional actions in
publishing a report that ignores the evidence provided by our
company and other PBMs, demonstrates clear ideological bias and
advances a false and damaging narrative – a narrative that could
harm the health care system by removing essential checks and
balances which would result in higher drug prices for American
consumers," said Andrea Nelson,
Chief Legal Officer for The Cigna Group. "We don't take this step
lightly, but as advocates working to lower drug prices for millions
of Americans and the employers, labor unions, and government
agencies that provide their prescription drug benefits, we cannot
let the FTC's unlawful actions and false information stand."
For more than two years, Express Scripts fully
cooperated with the FTC study into the PBM industry, meeting the
agency's extensive demands for data and information. The FTC's
report disregarded the millions of documents and terabytes of data
produced by Express Scripts and other PBMs. As a result, the report
is riddled with false statements, misleading insinuations and
violates the Commission's duty to follow due process and serve the
public interest.
The Facts About How Express Scripts Lowers the
Cost of Prescription Drugs
"Our 18,000 Express Scripts colleagues work every
day to improve health and lower the cost of medications for the
millions of Americans we serve," said Eric
Palmer, President and CEO of Evernorth Health Services. "Our
clinicians and clinical programs perform thousands of critical
medication safety checks on each prescription, and we are
constantly innovating to improve medication access and
affordability. In a world where pharmaceutical manufacturers
continue to raise the price of medications every year, Express
Scripts' work is more important than ever, and we won't let
misinformation or false accusations deter us from our
mission."
Express Scripts and other PBMs only exist
because they provide real value, driving lower net drug costs for
employers, labor unions and other plan sponsors and their members.
Express Scripts achieved approximately $38
billion in savings for clients last year alone.
- Drug manufacturers – not PBMs – set the prices of their drugs.
According to a Reuters analysis of 47 medicines, the median
annual list price for a new drug was $300,000 in 2023, up from $222,000 in 2022.
- Express Scripts negotiates with drug manufacturers to lower the
net cost of drugs for plan sponsors. Numerous academic and
government studies and investigations, including several by the
Commission, have demonstrated and quantified the magnitude of these
savings to plan sponsors and patients.
- Express Scripts has pioneered programs to shield patients from
high list prices; supporting access to lower-cost generics and
biosimilars; and providing customers with convenient access to
personalized information about the cost of their care to help them
make more informed decisions.
There is no support for claims that PBMs are
responsible for high drug costs.
- There is no evidence that the alleged power of
PBMs has been increasing over time.
- Express Scripts passes through over 95% of all rebates and fees
it receives to its client plan sponsors.
- PBMs have no incentive to see list prices rise. List prices for
branded drugs with rebates have grown less, not more, than list
prices for branded drugs with no rebates.
For more information about Express Scripts' work to make
medications more affordable and accessible, visit
https://www.evernorth.com/express-scripts-facts.
An overview of Express Scripts' complaint, which argues the
Commission's report violates the U.S. Constitution and federal law,
and the full text are available here.
About Evernorth Health
Services
Evernorth Health Services creates pharmacy, care
and benefits solutions to improve health and increase vitality. We
relentlessly innovate to make the prediction, prevention and
treatment of illness and disease more accessible to millions of
people. Evernorth capabilities are powered by our businesses,
including Express Scripts, Express Scripts® Pharmacy, Accredo,
eviCore and MDLIVE, along with holistic Evernorth platforms and
solutions that move people and organizations forward. All Evernorth
solutions are serviced and provided by or through operating
affiliates of Evernorth Health, a wholly owned subsidiary of The
Cigna Group (NYSE: CI), or third-party partners. Learn more at
evernorth.com.
Media Contact
Justine Sessions
860-810-6523
Justine.sessions@evernorth.com
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SOURCE Express Scripts