CI - Cigna Humana accused of price fixing in Ohio - WSJ

2023-03-27 13:40:01 ET

A lawsuit was filed against Cigna ( NYSE: CI ), Humana ( NYSE: HUM ), and Pharmacy Benefit Manager (PBM) Prime Therapeutics on Monday over their role in sharing pricing, and other details to gain the upper hand in negotiations with drugmakers over rebates, The Wall Street Journal reported Monday.

Ohio attorney general Dave Yost filed the litigation in a state court.

According to the lawsuit, the three companies used a Swiss-based group-purchasing organization called Ascent Health Services, owned by Cigna ( CI ) and Prime, to coordinate during negotiations with drugmakers to fix the amounts of rebates.

Ohio attorney alleges that the (PBM) operated by Cigna ( CI ) and Humana ( HUM ), along with Prime Therapeutics, shared drug pricing details through Ascent and used that information to pressure drugmakers to pay the highest rebates.

PBMs maintain lists of drugs covered by health insurers and negotiate rebates in pricing negotiations with pharmaceutical manufacturers.

According to the lawsuit, if a company failed to get a particular rebate, it would independently keep the drugs out of the formularies or give it a lower preference.

“They’re bringing no value to the supply chain,” Yost said in an interview ahead of the litigation. “All they’re doing is inflating the price.” The companies were not immediately available for comments.

“Ascent was, they realized, the perfect vehicle with which to harmonize and increase drug prices, Rebates, fees,” the lawsuit alleges.

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