Anthem sues Express Scripts to save $3B on prescription drugs — 5 things to know

Health insurer Anthem is suing Express Scripts, a pharmacy benefit manager, to receive a larger share of savings on prescription medicines, according to npr.

Here are five things to know:

1. Anthem claims it is overpaying for pharmaceuticals and not receiving the benefits from rebates Express Scripts negotiated with drug manufacturers.

2. In January, Anthem CEO Joseph Swedish said the payer could save nearly $3 billion in drug costs if Anthem reworked its contract with Express Scripts. Anthem has warned it will terminate its contract if the payer does not receive the price break it seeks.

3. An Express Scripts spokesman countered the company does not believe Anthem is entitled to $3 billion.

4. In 2009, Anthem sold its own PBM to Express Scripts, and the payer agreed to use Express Scripts for 10 years. However, the contract called for the two companies to renegotiate prices in December 2015.

5. In the suit, Anthem alleges Express Scripts has refused to negotiate prices in 'good faith.' Thus, the payer is seeking damages to compensate for overpaying for prescription drugs.

More articles on coding & billing:
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Making a theory a reality: A look into value-based payments' challenges, opportunities

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