Canada’s Competition Bureau has opened an antitrust investigation into Cigna’s Express Scripts unit, seeking to probe its business practices in the pharmacy sector.
The bureau said in an announcement on Friday that it has secured a court order to examine Express Scripts’ Canadian division, which processes claims for prescriptions and provides other services to insurers and pharmacists in the country.
Under the order, Express Scripts Canada must provide records, written information and oral testimony relevant to the probe.
The Competition Bureau said that “there is no conclusion of wrongdoing at this time.”
The investigation seeks to dig into two main concerns about Express Scripts’ business practices. One, that it uses its preferred provider networks to steer patients to its owned or associated pharmacies, rather than the location of their choice.
In addition, the bureau is digging into potential margin squeezing, where the company would limit the margins of its competitors in the retail pharmacy space by raising its pharmacy benefit management service fees or by requiring pharmacies to go through an onerous audit process.
The bureau said it is conducting the investigation under restrictive trade provisions in Canada’s Competition Act, which “protect against abuse of dominance and agreements or arrangements between businesses that harm competition.”
The Canadian Pharmacists Association said it welcomed the investigation. The organization filed a complaint with the bureau in February 2024 against Express Scripts Canada, expressing concern about the PBM’s market dominance.
“PBMs have operated unchecked for far too long, and this investigation marks an important step toward greater accountability,” said Joelle Walker, VP of public and professional affairs at CPhA, in the press release. “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.”
“This is a clear signal that Canadian regulators are prepared to examine practices that may be harming competition and limiting access to care—and we’re proud to support that effort,” Walker said.
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