Anthem believes it is paying Express Scripts too much for prescription medications. In addition, the insurer claims it’s “not benefiting from rebates [Express Scripts] has negotiated with drugmakers,” according to the report.
Per their contract, Anthem and Express Scripts were set to negotiate prices in December. However, after negotiations, Anthem wasn’t happy with the pricing situation.
In January, Anthem CEO Joseph Swedish said Express Scripts wasn’t giving his company enough money in savings, and that Anthem would consider looking for another pharmacy partner if Express Scripts didn’t acquiesce. At the time, Mr. Swedish said Anthem was “entitled to improved pharmaceutical pricing that equates to an annual value capture of more than $3 billion.”
Express Scripts disagreed, saying “Anthem is not entitled to $3 billion.”
Now Anthem is more seriously considering terminating its contract with Express Scripts. The health insurer said Express Scripts “has deliberately delayed the repricing for months” and “refused to negotiate, let alone in good faith,” according to the lawsuit.
But Express Scripts denied such allegations. “We believe that Anthem’s lawsuit is without merit,” the company said in a statement emailed to NPR. Express Scripts said it “has consistently acted in good faith and in accordance with the terms of its agreement with Anthem.”
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