BATON ROUGE, La. — Louisiana Attorney General Liz Murrill is taking on one of the most powerful forces in the American healthcare system, filing a lawsuit against Express Scripts, Inc. and its affiliate Ascent Health Services, LLC for manipulating the prescription drug marketplace at the expense of Louisiana families, patients, and independent pharmacies.

Express Scripts and its partners used enormous market power to restrict competition, manipulate pharmacy reimbursement rates, conceal profits, and steer patients toward pharmacies they own or control—all while claiming to deliver savings.

Attorney General Murrill says enough is enough.

“Louisiana families are working harder than ever to pay their bills, and they shouldn’t have to fight a profiteering middleman just to afford the medicine prescribed by their doctor,” said Attorney General Liz Murrill. “PBMs have built a system where they can profit from higher drug prices, squeeze pharmacies in our communities, and limit choices available to patients. Louisiana will not sit on the sidelines while Express Scripts and Ascent put profits ahead of people.”

These consequences extend beyond individual patients. Independent pharmacies have been forced to accept reimbursement rates that can fall below the cost of acquiring medications, while facing substantial fees and other restrictive contract terms. The decline of independent pharmacies threatens access to healthcare, particularly in rural and underserved communities.

The State argues that Express Scripts entered into an unlawful agreement with Prime Therapeutics, a direct competitor, to coordinate pharmacy reimbursement rates and fees while increasing their collective leverage over drug manufacturers. The conduct contributed to higher drug prices, lower reimbursement for independent pharmacies, and reduced competition.

“Patients deserve transparency. Pharmacists deserve a fair marketplace. And Louisiana families deserve to know that the healthcare system is working for them—not against them,” said Murrill.

The State is seeking damages, civil penalties, attorneys’ fees, and an injunction prohibiting unlawful conduct under federal and Louisiana law.

Read the full complaint below.

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