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Business
Legal


CIGNA PREVAILS OVER ANTHEM IN $14.8 BILLION DRUG-COST CLAIM


Cigna CEO on Buyback, Federal Collaboration and Ukraine
By

John Tozzi

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April 1, 2022, 2:39 PM GMT


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Cigna Corp. won a key part of a six-year legal dispute in which Anthem Inc.
claimed it was overcharged for pharmacy benefits services, fending off the rival
health insurer’s bid for $14.8 billion in damages.

Anthem isn’t entitled to the billions it claimed were owed over prescription
drug prices charged by Cigna’s Express Scripts unit, a federal judge in New York
ruled Thursday.

The ruling opens the door for Cigna to resolve the dispute that began in 2016
when Anthem accused Express Scripts, then an independent pharmacy benefits
manager, of failing to provide promised drug discounts. Anthem subsequently
dropped Express Scripts, which later merged with Cigna, as a client.  




The court ruled that the contract didn’t require Express Scripts to guarantee
competitive prices based on benchmarks, but only that it had to negotiate in
good faith.




A representative for Anthem didn’t respond to an email seeking comment Friday. 



The dispute’s history dates back to 2009 when Anthem sold its own pharmacy
benefits management unit to Express Scripts. As part of the deal, Express
Scripts offered to pay a higher upfront sum for the acquisition in exchange for
providing lower drug discounts over a long-term drug benefits management
contract with Anthem, according to the court opinion. After ending the deal with
Express Scripts, Anthem formed its own pharmacy benefits manager, called
IngenioRx.

The case is Anthem v. Express Scripts, 1:16-cv-02048-ER, Southern District of
New York (Foley Square).





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