Express Scripts and FTC Announce Settlement

On Feb. 4, Express Scripts and the Federal Trade Commission (FTC) announced a comprehensive resolution settlement that addresses concerns raised by the FTC. Details of the global settlement include:

• As enforced by the settlement, our new, transparent pharmacy benefits model ensures that our patients pay the lowest available cost for their medicines, whether it is our negotiated cost, their copay, or a cash discount price.
• TrumpRx pricing will be covered for our members so that purchases through TrumpRx will count towards their deductible upon relevant legal and regulatory changes.
  • Express Scripts is the first PBM to partner with TrumpRx, and this would be the first time TrumpRx pricing is available to patients as part of their pharmacy benefits.
• Ensure Express Scripts’ new industry-leading and transformative price discount (rebate-free) model is widely available to employers and health plan sponsors to lower the cost of all brand medications for their members as our new standard model.
• Ensure our new reimbursement model based off the pharmacy’s actual acquisition costs is available to retail community pharmacies, and that retail community pharmacies are compensated for other essential clinical services (e.g., certain diagnostic testing and vaccinations).
• Ensure more lower-priced medicines, including insulins, are covered across all Express Scripts standard formularies – and that our Patient Assurance Program that caps the monthly cost of insulin at $25 is the standard for Express Scripts’ clients.
• Support the American economy by moving rebate contracting operations conducted on Express Scripts’ behalf to the U.S. 

These are meaningful steps toward making prescription drugs more affordable for millions of families and advancing the goals we share with the administration of full transparency into prescriptions drug costs. This settlement enables us to keep moving forward, and we appreciate the Administration’s reinforcement of our commitment to pharmacy benefits that put Americans first.