02/04/2026
The settlement requires Cigna’s Express Scripts to eliminate spread pricing, decouple rebates and fees from the list price of drugs, requires Cigna’s GPO, Ascent to relocate from Switzerland to the U.S. (which will bring back to the United States more than $750 billion in purchasing activity over the duration of the order), and submit to FTC monitoring for 10 years. It also forces the company to adopt a cost-plus model for independent pharmacy reimbursement (three pharmacies or fewer) in commercial plans starting in 2027 or sooner.
The Federal Trade Commission secured a landmark settlement with one of the nation’s largest pharmacy benefit managers (“PBMs”), Express Scripts, Inc., and its affiliated entities (collectively “ESI