Big news in the Canadian healthcare industry! The nation’s federal competition watchdog, the Competition Bureau, has officially launched an investigation into Express Scripts Canada (ESC), the largest pharmacy benefit manager (PBM) in the country. This comes after allegations from a prominent pharmacists group claiming the corporation has engaged in anti-competitive behavior.

Based in Mississauga, ESC serves as a vital intermediary, facilitating transactions between pharmacies and insurance providers. By streamlining the process, pharmacists can submit electronic claims on behalf of patients, alleviating the financial burden that direct payments could impose on them.

However, tensions escalated last year when ESC implemented a mandatory service fee that left many pharmacies fuming. The Canadian Pharmacists Association (CPhA) stepped up, filing a complaint with the Competition Bureau. They asserted that ESC was abusing its dominant market position to impose "unfair" terms and agreements on pharmacies, providing them minimal room for negotiation.

"By dictating terms to pharmacies, ESC effectively limits the choices and accessibility of healthcare services for Canadians," claimed CPhA in their statement. They warned that such actions not only stifle competition but also threaten the foundational principles of equity and access in the Canadian healthcare system.

ESC operates as a subsidiary of the U.S.-based Express Scripts, which falls under the umbrella of the Cigna Group, a global profit-driven health company.

New developments arose when a federal court ordered the Competition Bureau to press forward with its investigation, which will focus on serious allegations including patient steering and margin squeezing practices that could harm retail pharmacies and competitors. This legal backing will require ESC to produce relevant records and documentation, as well as oral testimony for the Bureau’s scrutiny.

It's essential to note that the Competition Bureau clarified that there are no conclusions of wrongdoing at this stage.

Reactions to the news have been overwhelmingly positive from the CPhA, who labeled the Bureau’s investigation as a significant step toward enhanced accountability in the industry. CPhA Vice-President Joelle Walker emphasized, "PBMs have operated unchecked for far too long. 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."

Walker added, "This is a clear signal that Canadian regulators are ready to investigate practices that may be harming competition and limiting access to care — and we’re proud to support that effort."

As of now, Express Scripts Canada has refrained from providing any comments on this unfolding situation.