The Competition Bureau of Canada has initiated an investigation into Express Scripts Canada, the country’s largest pharmacy benefit manager (PBM). The investigation comes after the Canadian Pharmacists Association (CPhA) filed a complaint with the commissioner, alleging that the company had engaged in anti-competitive practices. Express Scripts Canada, a subsidiary of the U.S.-based pharmacy benefit manager Express Scripts, is under fire. Critics claim that the company takes advantage of its PBM monopoly.
Express Scripts Canada serves as a third-party intermediary between pharmacies and insurance providers, offering processing services essential for the functioning of these entities. The CPhA’s complaint alleges that the company has imposed “unfair” terms and agreements on pharmacies, leaving them with “little room for negotiation.” This behavior, the association argued, limits pharmacy practice and reduces Canadians’ access to health care.
CPhA Vice-President Joelle Walker reiterated how Express Scripts Canada’s practices have hurt pharmacists all over the country.
“We filed this complaint on behalf of over 40,000 pharmacists in over 12,000 pharmacies across Canada who show up every day to deliver essential health care,” – Joelle Walker, CPhA Vice-President.
The Competition Bureau’s investigation will have to center on the allegations of patient steering and margin squeezing. Moreover, these practices may have the effect of eroding the competitive nature of pharmacy service provision in Canada. As part of the inquiry, Express Scripts Canada will have to produce documents and other evidence requested by the bureau. Additionally, their representatives will be expected to provide oral testimony.
According to the CPhA, Express Scripts Canada’s moves risk downstream patient care.
“By dictating terms to pharmacies, ESC effectively limits the choices and accessibility of health-care services for Canadians,” – Canadian Pharmacists Association (CPhA).
While this is obviously an improvement in tone, we still don’t know if the Competition Bureau has reached any conclusion of wrongdoing. The agency has opened an investigation to determine whether the plaintiffs’ allegations have merit. Depending on their findings, they will determine follow-up actions.
Adding to its growing power inside this controversial pharmacy benefit management sector, Express Scripts Canada runs four mail-order pharmacies across Canada. The outcome of this investigation could have significant repercussions for both the company and the wider healthcare landscape in Canada.
