5 things to know about the end of the $15B Anthem-Cigna PBM lawsuit

5 things to know about the end of the $15B Anthem-Cigna PBM lawsuit

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A sort of six years legal spat between National anthem and Cigna Yes Exceed back A sort of federal Judge rule That Cigna’s Quick Script Do no owe National anthem $14.8 billion exist allegedly prescription drug Overpay.
National anthem archive A sort of litigation exist march 2016 debate That its contract and Express script guarantee This insurance company Competitive price for prescription drug. Express script, which one Cigna get exist In 2018, tip back exist National anthem, compete This insurance company used to be should arrive Production A sort of market analyze of drug price That Will Yes This Base for negotiation.
exist This end, That is how A sort of federal court remain it exist A sort of ruling release Thursday.
Judge Edgardo Ramos of the U.S. District Court for the Southern District of New York partially rejected Anthem’s claim, declaring that That This Express scripted if only obligation Yes arrive negotiation based on exist data This insurance company supply.

“if This contract read ‘Express script Will make sure Competitive benchmark Price,’ the national anthem argument possible have Considerable strength,” Ramos wrote. “but A sort of clearly four corners read Do no support its explain. ”

Ramos Also fired the national anthem separated, $150 million claim That Express script improper submit the national anthem medical insurance part D prescription drug data arrive federal Regulatory Authority and That it Failure arrive solve customer Serve question exist A sort of timely Way.

This Judge did Decide That National anthem Yes contractual have the right arrive claim to reimburse of wrongly officially recognized previously authorized, although This insurance company already no Specified A sort of Dollar number, Ramos Say. National anthem admit exist its litigation That Express script deal with 98% of it claim correct.

Anthem and Cigna did not respond to interview requests.

The ruling ends a long-running dispute between two rival insurers that had planned a $54 billion merger, but a federal court finally blocked.

Here are five things to know about the Anthem-Cigna lawsuit:

  1. PBM withholds billions of dollars in savings and overcharges Anthem by $3 billion a year after allegations against Express Scripts for seven , Express Scripts countersued. In 2017, Anthem announced that it would not renew its contract with Express Scripts. The move was a blow to pharmacy benefit managers, as Anthem accounted for one-fifth of PBM’s revenue at the time. The Evernorth division of Cigna. which contains Express Scripts, and its pharmacy revenue has since grown to $121.4 billion. Pharmacy services accounted for the lion’s share of Cigna’s $174 billion in revenue last year.
  2. legal dispute is Anthem’s IngenioRx In 2019, Anthem partnered with CVS Health to establish PBM. In 2021, IngenioRx’s revenue will rise 16.1% to $25.4 billion, and its net income will rise 23.7% to $1.6 billion.
  3. National anthem ended its contract and Express script 10 moon earlier Compare expected back Cigna Announce it used to be Obtain This PBM.
  4. Last year, Anthem continued to focus on its PBM business by investing nearly $140 million in partnership with Humana to form a new pharmacy benefits management platform. Insurers will take a minority stake in the new joint venture, Named DomaniRx. Fintech company SS&C Technologies owns about 80% of the business.
  5. IngenioRx accounts for one-fifth of Anthem’s revenue, and the insurer is counting on it to help drive growth for self-insured employer clients and sell its services to other Blue Cross and Blue Shield companies. Anthem, which runs Blues program in 14 states, expects $2.67 billion in Blues Antitrust case To slow demand for its pharmacy services, CEO Gail Boudreaux said on the company’s earnings call in January.

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