Aetna sues Express Scripts over specialty pharmacy

PHILADELPHIA Last month, in the U.S. District Court in Philadelphia, Aetna filed a lawsuit accusing Express Scripts of “knowing, malicious, willful, deliberate and bad faith misrepresentations and outrageous misconduct” in allegedly interfering with pacts between Aetna and Priority Healthcare in the specialty pharmacy market, according to the Associated Press.

Express Scripts acquired Priority Healthcare in 2005, the year after Aetna and Priority had joined together to start a specialty pharmacy venture, Aetna Specialty Pharmacy. After Express Scripts acquired Priority, Aetna exercised its option to buy out Priority’s stake in the joint venture for $75 million, making Aetna Specialty Pharmacy a subsidiary of the health insurer.

Now, Aetna is looking to recover that $75 million plus punitive damages and injunctive relief to make Express Scripts honor the original agreement between Priority and Aetna.

Aetna alleges that Express Scripts, by violating the law and the agreements for the Aetna-Priority joint venture, has “gained an unfair competitive advantage” that precludes the health insurer and its specialty pharmacy business from “prospective advantageous relationships and markets.” Among its claims, Aetna says that its special pharmacy business has been wrongly denied access to certain limited-availability drugs, which has limited its opportunities to develop new markets.

Aetna also alleges that even before the pharmacy benefits manager announced its acquisition of Priority Healthcare in 2005, Express Scripts aimed to injure or destroy Aetna’s efforts to establish a “best of class,” standalone, independent specialty pharmaceutical business by depriving it of best-pricing guarantees in Aetna’s joint-venture agreements with Priority and the benefit of Priority’s supplier and vendor contracts.

Express Scripts has not yet filed a response.