Michigan Sues PBMs for Price-Fixing — A Win for Independent Pharmacies and Patients

RescueMeds applauds this bold step toward prescription drug transparency

National Community Pharmacists Association (NCPA) Article (May 5, 2025) 

In a major step toward pharmacy reform, Michigan Attorney General Dana Nessel has filed a lawsuit against two of the largest Pharmacy Benefit Managers (PBMs): Express Scripts Inc. (ESI) and Prime Therapeutics. The case accuses both companies of price-fixing and anticompetitive practices that have hurt independent pharmacies and compromised patient access statewide.

What the Lawsuit Says

According to the filing, the two PBMs colluded to control pharmacy reimbursement rates, limiting patient choice and manipulating drug access behind the scenes. The lawsuit alleges that:

• PBMs coordinated pricing formulas and reimbursement “guardrails”

• These tactics slashed profits for small, independent pharmacies

• Patients experienced delays and increased costs for essential medications

Attorney General Nessel stated:

“The unlawful, anticompetitive agreement… handed these PBMs unprecedented control over which pharmacies receive medication, how quickly residents get their prescriptions, and how much they’re forced to pay.”

Background: PBM Collusion and Its Impact

The lawsuit traces back to 2019, when Prime Therapeutics allegedly agreed to adopt Express Scripts’ pricing formulas—a move that drastically reduced payment rates to pharmacies.

This case echoes another legal action: Osterhaus v. Prime, which also alleges PBM collusion and recently survived a motion to dismiss.

Here’s why this is critical:

• Express Scripts controls nearly 89% of Michigan’s PBM market

• That power influences which pharmacies are in-network and what patients pay

• It also determines how quickly injured or ill patients get needed medication

Why This Matters to You

At RescueMeds, we witness the daily impact of PBM control—especially in workers’ compensation. When PBMs cut reimbursement rates or restrict networks, patients suffer.
Delays in prescriptions mean delays in healing. And unfortunately, many patients have no idea PBMs are the reason their medications are denied or delayed.

This isn’t just a business dispute—it’s a healthcare access crisis.

A National Crisis, Not Just Michigan

Michigan’s lawsuit is a major step in a growing movement. More and more states are waking up to the unchecked power of PBMs and the harm they cause to independent pharmacies and the people they serve.

We also commend the work of attorney Natasha Fernandez-Silber of Edelson, who is leading a class-action suit on behalf of NCPA members against GoodRx for similar price manipulation practices.

Each legal challenge brings us closer to:

• A transparent pharmacy system

• Better access to care for injured and vulnerable patients

• A level playing field for independent pharmacies

RescueMeds Will Keep Fighting

We support every effort to hold PBMs accountable—whether in Michigan, Maryland, or any other state. RescueMeds stands for:

• Patient-first care

• Fair pharmacy access

• Transparent pricing

• Real choices for injured workers and their advocates

We believe it’s time to stop letting middlemen profit at the expense of patient care.