BATON ROUGE — Louisiana Attorney General Liz Murrill has filed a lawsuit against Express Scripts Inc. and its affiliate Ascent Health Services LLC, accusing them of manipulating the prescription drug marketplace at the expense of Louisiana patients and independent pharmacies.

The state argues Express Scripts used its market power to restrict competition, manipulate pharmacy reimbursement rates, conceal profits and steer patients toward pharmacies it owns or controls.

"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 in a prepared statement. "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."

The state also claims 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. According to the lawsuit, that conduct contributed to higher drug prices, lower reimbursement for independent pharmacies and reduced competition.

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

"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," Murrill said.

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