J&J Sues Cigna Units for Depleting its Drug Copay Funds

Controversial third-party programs by companies such as SaveOnSP LLC and Prudent Rx provided by leading pharmacy benefit managers (PBMs) have led to a recent lawsuit by Johnson & Johnson (J&J).

These programs are accused of draining patient copay assistance programs offered by pharmaceutical companies to help patients afford their medications but instead increase the costs of drugs for patients.

Johnson & Johnson has sued divisions of health insurer Cigna, accusing them of working with a drug-benefit middleman to drain J&J financial-assistance funds earmarked for patients taking some of its pricier drugs, according to a recent story in the Wall Street Journal.

The move by J&J widens litigation the healthcare giant initiated in 2022 against a middleman, SaveOnSP LLC, and is a new flare-up of long-running tension over drug prices among manufacturers, insurers, pharmacy-benefit managers and other middlemen in recent years.

J&J added Express Scripts, which is a PBM, and specialty pharmacy Accredo—both units of Cigna—as defendants in an amended lawsuit that J&J filed under seal in federal court in New Jersey earlier this year. The amended lawsuit was unsealed in late November.

The pharmaceutical company claims that the Cigna units worked on a program with SaveOnSP LLC that caused J&J to pay more than $100 million in drug copay assistance than it would have otherwise. J&J is seeking monetary damages in an amount to be determined at trial, and a court order that the companies stop the program.

Accredo is often the exclusive specialty pharmacy distributor of certain specialty drugs for patients with complex and chronic health conditions, including cancer, hepatitis C, HIV, bleeding disorders and multiple sclerosis.

SaveOnSP LLC administers employer plan benefit designs that deliver cost-savings. SaveOnSP’s single focus is on helping employer plan sponsors and their participants manage the skyrocketing costs of specialty medications.

PrudentRx was founded to help health plans of any size manage the rising cost of specialty medications. PrudentRx’s analytical techniques help identify the areas where management of a client’s specialty healthcare plan spending can be improved.