Cigna Prevails Over Anthem in $14.8 Billion Drug-Cost Claim
(Bloomberg) -- 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. Â
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.Â
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).
Âİ2022 Bloomberg L.P.
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