Express Scripts has agreed to pay 28 states and the District of Columbia $9.3 million to settle charges that it switched cholesterol-lowering drugs for financial gain.
First it was Medco which settled in 2004. Then it was CVS Caremark, which settled early this year. Now it’s Express Scripts’ turn. The pharmacy benefit manager has reached a settlement with the attorneys general of 28 states and the District of Columbia over its improper statin switching practices. As part of the settlement, Express Scripts agreed to pay $9.5 million to the states and $200,000 to patients (not to exceed $25 per patient) for their physician visits and tests related to the drug switches. In addition, the St. Louis PBM must follow new disclosure and ethical standards, such as informing prescribers if it stands to gain from certain drug switches. State authorities hope that the settlements involving Medco, CVS Caremark, and Express Scriptssome of the country’s largest PBMsoffer a cautionary tale for the PBM industry to uphold ethical standards in their dealings with their clients.