MCDANIEL SETTLES CLAIMS AGAINST EXPRESS SCRIPTS INC.
LITTLE ROCK-Attorney General Dustin McDaniel announced today that Arkansas joined 29 states and the District of Columbia in entering into a settlement of consumer protection claims against Express Scripts, Inc., one of the nation's largest pharmacy benefits management (PBM) companies. As part of the settlement, Express Scripts is required to significantly change its business practices. In addition, Express Scripts will pay $9.3 million to the States and up to $200,000 in reimbursement to patients who incurred expenses related to certain switches between cholesterol-controlling drugs. Arkansas will receive at least $130,000 from this settlement.
PBMs, like Express Scripts, enter into contracts with employers and government health plans to manage prescription drug claims for drugs provided to patients enrolled in the health plan. The States asserted that Express Scripts engaged in deceptive business practices by encouraging doctors to switch patients to different brand name prescription drugs and representing that the patients and/or health plans would save money. But, doctors were not adequately informed of the effect this switch would have on costs to patients and health plans.
The settlement ensures Express Scripts will modify how they handle drug switches by, among other things, requiring the company to inform patients and prescribers what effect a drug switch will have on a patient's co-payment, to obtain express authorization from the prescriber for all drug switches, and to reimburse patients for out-of-pocket expenses for drug switch-related health care costs.
The states participating in today's settlement Express Scripts are: Arizona, Arkansas, California, Connecticut, Delaware, District of Columbia, Florida, Illinois, Iowa, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nevada, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, and Washington.