Florida Attorney General James Uthmeier has filed a lawsuit against Express Scripts and Prime Therapeutics, alleging that a partnership the two pharmacy benefit managers formed in 2019 enabled them to illegally fix prices. The complaint centers on claims that the collaboration led Prime to adopt substantially lower pharmacy reimbursement rates, harming local pharmacies and patients who rely on them.
In a statement announcing the lawsuit, Uthmeier said Floridians—particularly seniors and families—depend on local pharmacies for medications, and that the alleged conduct forced many pharmacies to fill prescriptions at a loss. The complaint ties that financial pressure to reduced local pharmacy access when businesses struggle or close.
According to the complaint, Prime’s pharmacy reimbursement rates were roughly 20% higher before the 2019 partnership with Express Scripts. The suit contends that the partnership resulted in Prime adopting far lower reimbursement levels, and that those lower rates can make it unprofitable for pharmacies to dispense medications.
The complaint also alleges that Express Scripts’ involvement led Prime to impose higher fees than it had previously, compounding the financial strain on pharmacies. Plaintiffs argue the combined effect of lower reimbursements and increased fees amounts to an unlawful horizontal price-fixing arrangement.
Uthmeier’s office has framed the partnership as violating the Florida Antitrust Act and the Florida Deceptive and Unfair Trade Practices Act. The state is seeking injunctive relief to stop the alleged conduct, as well as civil penalties and damages.
Those remedies would aim both to halt the practices the state views as anticompetitive and to compensate affected parties, according to the filing.
An Express Scripts spokesperson rejected the allegations, saying the company is “committed to reimbursing network pharmacies fairly and will vigorously defend ourselves against the baseless allegations in this complaint.”
A Prime Therapeutics spokesperson said the lawsuit “focuses on pharmacy profits but overlooks the impact that higher pharmacy costs have on the patients, employers, health plans and taxpayers who ultimately pay for prescription drugs.” The company added that “Prime’s approach has delivered lower costs for patients at the pharmacy counter and substantial savings for individuals, employers and health plans while maintaining broad access to pharmacies.”
This lawsuit is not the first legal challenge to the Express Scripts–Prime partnership. Independent pharmacies sued the PBMs over the partnership in 2023, alleging similar price-fixing conduct. Independent pharmacies also filed a suit against Prime in July, again arguing that the partnership produced collusive behavior and reduced reimbursements. In that July action, Express Scripts was not named as a defendant, per the reporting.
The new complaint from the Florida Attorney General builds on those industry suits by pressing state antitrust and consumer-protection statutes and seeking state-enforced remedies.
Uthmeier’s statement frames the alleged conduct as a threat to patient access to medications. The complaint links lower reimbursement rates and higher fees to pharmacy closures or reduced financial viability, which the state says diminishes local options for patients in need of prescriptions and everyday pharmaceutical care.
Prime’s public remarks counter that lower reimbursement rates at the pharmacy counter have benefited patients and generated savings for employers and health plans, asserting the partnership preserved broad access to pharmacies.
The lawsuit seeks injunctive relief, civil penalties and damages; the timeline for court proceedings was not reported in the source. Express Scripts has pledged to defend itself vigorously, and Prime has defended its approach as producing savings and maintaining access. Further developments will depend on how the case proceeds in Florida courts and on any responses or motions the defendants file.
The dispute highlights continuing tension between pharmacies, pharmacy benefit managers and payers over reimbursement levels, fees and the structure of network contracting. PBMs often arrange networks and negotiate terms with pharmacies and drug manufacturers; when two PBMs collaborate, critics contend those arrangements can concentrate bargaining power and affect reimbursement practices. Supporters of such partnerships point to negotiated discounts and potential consumer savings at the point of sale; critics point to pressures on independent and local pharmacies.
This complaint places those broader industry debates in the context of Florida law, as the state seeks to address the alleged competitive harms resulting from the 2019 partnership between Express Scripts and Prime Therapeutics.
The source did not provide specific pleadings, court filing dates, the precise legal forum or judge assigned to the case, nor financial damage estimates sought by the state. It also did not report a timeline for litigation or any immediate operational changes by the PBMs in response to the filing.
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