Bob Herman Nov 20
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Corporate lawsuit over drug savings pulls in another party

Express Scripts' feud with Anthem is roping in Optum, a competitor. Photo: Jeff Roberson / AP

Anthem and Express Scripts are embroiled in lawsuits, each accusing the other side of being a bad business partner. And now court documents show Optum, a health care company owned by UnitedHealth Group, is getting dragged into the mix.

Why it matters: This is more than just a corporate brouhaha in a far-off courtroom. Three massive health care companies are spending consumers' premium dollars on legal teams to fight over prescription drug rebates — an issue that continues to pinch people's wallets when they pick up their medicine.

The details: Health insurer Anthem originally sued pharmacy benefit manager Express Scripts in March 2016 for $15 billion, alleging Express Scripts was reaping "an obscene profit windfall" from negotiations with drug makers and was not passing enough savings back to Anthem. Express Scripts countersued and said Anthem was not acting in good faith.

New legal filings detail how UnitedHealth got involved with the two feuding parties.

  • After Anthem sued Express Scripts, Anthem reached out to OptumRx, UnitedHealth's pharmacy benefit manager and a competitor to Express Scripts.
  • Anthem wanted Optum to provide a "pricing proposal" of drug savings in case Anthem decided to end its contract with Express Scripts, according to Optum, which obliged with the request.
  • But Express Scripts said Anthem and Optum created the proposal solely as a way to justify the alleged $15 billion worth of damages.
  • Express Scripts demanded Optum reveal internal documents and analyses to understand how Optum made the proposal.
  • Optum handed over the pricing proposal, which outlined the services and prices Optum was offering Anthem, but has not provided the "highly confidential" documents.
  • Express Scripts said Optum has acted "to both harm a competitor...and ingratiate Optum with a potential future client." (Anthem is partnering with CVS on its own pharmacy benefit manager.)
  • Optum countered that Express Scripts "concocted a conspiracy theory" and has no legal grounds to obtain internal processes from a competitor.

The bottom line: The lawsuits are full of mud-slinging but also confirm the contracts between health insurers and pharmacy benefit managers are incredibly complex and lucrative documents. Anthem, Express Scripts and Optum did not comment.

Lauren Meier 53 mins ago
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Facebook's growing problems

Illustration: Rebecca Zisser/Axios 

Facebook is caught in the middle of a rapidly unfolding scandal over Cambridge Analytica's improper gathering of data on millions of users, and what that exposed about the company's data collection. The fiasco has drawn the interest of lawmakers and regulators and rekindled the debate over its role in the 2016 presidential election.

Why it matters: The bad headlines continued to pile up; "A hurricane flattens Facebook" said Wired, "Silicon Valley insiders think that Facebook will never be the same" per Vanity Fair, "Facebook is facing its biggest test ever — and its lack of leadership could sink the company" from CNBC, and — as we've yet to hear from the company's top leaders — "Where is Mark Zuckerberg?" asks Recode.

Dave Lawler 7 hours ago
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What Trump and Putin did and didn't discuss

President Trump spoke with Vladimir Putin this afternoon, and congratulated him on winning re-election on Sunday. After the call, Press Secretary Sarah Sanders was asked whether Trump felt the election had been free and fair, and said it wasn’t up to the U.S. to “dictate" how Russia holds elections.

The bottom line: Trump is not alone in congratulating Putin — leaders in France, Germany and elsewhere have done so this week, as Barack Obama did in 2012. But past administrations certainly have seen it as America’s role to call balls and strikes when it comes to elections abroad, and weigh in when democratic institutions are being undermined. A departure from that approach would be welcomed not only by Putin, but other leaders of pseudo democracies around the world.