CPhA files abuse of dominance complaint with Competition Bureau against ESC’s new service fee

The Canadian Pharmacists Association (CPhA) announced the submission of a formal complaint against Express Scripts Canada (ESC) to the Competition Bureau of Canada. In a February 28 press release, the association said the complaint targets “the longstanding and exploitative practices of Express Scripts Canada (ESC), which recently resulted in the unilateral implementation of a new service fee imposed on pharmacies across the country.The text of the announcement follows:“This new mandatory fee, which essentially just allows pharmacists to continue to directly submit claims electronically on behalf of their patients, is the latest in a series of actions by ESC that exploit its dominant position in the market.For years, ESC has leveraged its standing as the largest pharmacy benefit manager (PBM) in Canada to enforce agreements on pharmacies that leave little room for negotiation. These agreements are often subject to changes with minimal notice, leaving pharmacies without any recourse. The recent imposition of a non-optional service fee on pharmacies is a glaring example of this abuse of dominance, compelling pharmacies to accept terms that are not only unfair but also impact their ability to invest in their operations. This is particularly alarming given that ESC owns its own pharmacy.CPhA's complaint underscores the broader implications of ESC's practices, which extend beyond contractual grievances to patient care and access. By dictating terms to pharmacies, ESC effectively limits the choices and accessibility of health-care services for Canadians. This not only restricts competition but also undermines the foundational principles of equity and access in the Canadian health-care system.In bringing this matter to the attention of the Competition Bureau, CPhA seeks not just to address the specific issues related to ESC, but to prompt a thorough examination of the PBM industry as a whole. The practices employed by PBMs have far-reaching consequences for the health-care sector, influencing everything from the availability of medications to the financial sustainability of pharmacies.”Payer-directed care a growing concernThe ESC fees are just one aspect of a growing movement towards what healthcare practitioners are calling “payer-directed care” or healthcare that rewards or punishes pharmacies and/or patients based on adherence to payer policies.Earlier this week (February 26) the CPhA issued a statement calling for all level of government to take actions to regulate payer-directed care and insurer and pharmacy benefit manager practices, to ensure the patient is truly able to have their free choice to use whatever pharmacy they want. Read: CPhA to submit complaint to Competition Bureau around new ESC fee

CPhA files abuse of dominance complaint with Competition Bureau against ESC’s new service fee

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