Express Scripts Lawsuit Filed by Three Compounding Pharmacies

According to the plaintiffs in the suit against Express Scripts: Grasso Enterprises, LLC, d/b/a Annie’s Apothecary, NERxD, LLC, d/b/a Cypress Compounding Pharmacy, and Wiley’s Pharmacy and Compounding Services, Inc., filed by their attorneys Quadrino Law Group, P.C. and The Simon Law Firm, P.C., claim “Express Scripts (“ESI”), has recently embarked upon a scheme to deny all claims under health plans seeking payment for “compound” pharmaceutical medications”. According to the complaint, Compounded medicines are customized pharmaceuticals made according to specific prescriptions, written by physicians, where no appropriate alternatives are mass-produced or commercially available. Health plan claims for these compounded medicines have, up to last year, been routinely paid by Express Scripts directly to in network compound pharmacies.

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