Express Scripts, a subsidiary of The Cigna Group, has filed a federal lawsuit against the US Federal Trade Commission (FTC) over a July 2024 report claiming that the report is “false and defamatory” and makes “misleading claims” regarding Express Scripts and the pharmacy benefit manager (PBM) industry.

As part of the lawsuit, the US-based PBM has demanded the retraction of the FTC report. The company claims that the report is “seventy-four pages of unsupported innuendo levelled against Express Scripts and other PBMs under a false and defamatory headline and accompanied by a false and defamatory press release”.

PBMs manage prescription drug plans for employers and government programs. The industry has faced a huge portion of the criticism regarding the high drug costs in the US, from not just drug pricing advocates but also pharmaceutical industry organisations like PhRMA. The role of PBMs has also been the subject of recent Senate hearings where major PBM CEOs have had to testify in front of a Congressional committee.

The PBM sector is highly consolidated with Caremark, Express Scripts and Optum Rx handling almost 80% of all prescriptions in the US, according to the FTC.

The interim report released by the FTC in July stated that the “vertically integrated and concentrated market structure has allowed PBMs to profit at the expense of patients and independent pharmacists”. The US agency also noted that PBMs held “substantial influence over independent pharmacies” and could impose “unfair, arbitrary, and harmful contractual terms” that could impact the independent pharmacy’s ability to stay competitive.

The lawsuit by Express Scripts alleges that the FTC report ignored “millions of documents and terabytes of data produced by Express Scripts and other PBMs”. The lawsuit alleges that the report “relies heavily on public comments,” many of which were anonymous and unverifiable yet were treated “as fact” by the Commission”.

The company also claimed as part of the lawsuit that the report’s “wrong findings” were in part a result of FTC’s commissioner Lina Khan's and the commission’s bias against PBMs, and asks that Khan “recuses from further proceeding against the PBMs”.