We have removed the Linden Care pharmacy from our network. In our research, we found that it predominantly dispensed Horizon prescription drugs and did not fulfill key components of our pharmacy network agreements.
We are also evaluating several other pharmacies that appear to be predominantly dispensing Horizon prescription drugs. In addition, we are reviewing and evaluating all similar captive pharmacy arrangements that we know of and will work to identify others. By captive pharmacies, we mean those pharmacies that derive the vast majority of their prescription volume from one manufacturer and/or one product.
It is important to clarify the difference between 1) niche pharmacies that are designated by manufacturers to push a particular product, and 2) specialty pharmacies like Accredo that deliver a superior level of specialized care for patients living with complex, specialty conditions. These two business models are very different.
We routinely monitor our network and take action when we see pharmacies trying to circumvent solutions, like formulary management, that protect payers and patients from wasteful drug spend.
In addition, one other thing regarding Horizon:
Express Scripts has filed a complaint seeking to recover approximately $140 million from Horizon Pharma USA, Inc. ("Horizon"), which has refused to honor certain contractual obligations it owes under a pharmaceutical manufacturer rebate agreement with Express Scripts. The complaint alleges claims for declaratory relief and breach of contract against Horizon. Express Scripts has requested, over the past several months, for Horizon to fulfill its agreement. Because of Horizon's continued non-compliance with the agreement, Express Scripts is taking this action to recover money rightfully due its clients.