An NBC News report detailing a tragic asthma death highlights that Express Scripts, one of the major pharmacy benefit managers identified in an FTC report, has been part of a system that abruptly inflated essential medication prices—practices which contributed to a loss of access for patients and ultimate harm.

Express Scripts, together with CVS Health, filed a lawsuit challenging an Arkansas law that prohibits PBMs from owning pharmacies. The company argues that the legislation will force closures and disrupt access to medications, despite the law's intent to counter corporate greed and protect consumer interests.

Express Scripts filed a federal lawsuit against Arkansas challenging Act 624, a new law banning PBMs from owning pharmacies. The company argues the legislation is unconstitutional, violating commerce protections and endangering services to TRICARE beneficiaries, while critics see the move as a corporate effort to undermine local pharmacy protections and fair market competition.

Express Scripts, alongside CVS, filed a lawsuit challenging an Arkansas law that restricts pharmacy benefit managers from owning or operating pharmacies. The company argues the law will have 'devastating consequences', potentially leading to pharmacy closures and disrupting established patient-pharmacist relationships.

OpenSecrets published a profile of Express Scripts detailing its campaign contributions and lobbying expenditures. The report highlights figures such as $2,204,331 in campaign contributions during the 2018 cycle and $3,235,000 in lobbying expenses, based on data released by the FEC, IRS, and Senate Office of Public Records. This level of political engagement may raise concerns over disproportionate corporate influence in democratic processes.

On September 20, 2024, the Federal Trade Commission filed an administrative complaint against Express Scripts, alleging that the company, alongside others, manipulated the insulin rebate system to inflate drug prices, harming patients. In response, Express Scripts filed a defamation suit against the FTC, dismissing the claims as ideologically driven.

Express Scripts filed a lawsuit in federal court demanding that the FTC retract a report which they claim is filled with false and misleading claims about the pharmacy benefit management industry. The legal complaint accuses FTC Chair Lina Khan of ideological bias and alleges that the report was engineered using cherry-picked public sources and anonymous comments, thereby undermining rigorous regulatory oversight and harming consumer interests.

The FEC report for Express Scripts Inc. Political Fund (a.k.a. Express Scripts PAC) indicates that the fund is registered and operational, but shows zero contributions, independent expenditures, or party-coordinated expenditures. This suggests that while the organization maintains a political action committee, there is no current demonstrated financial support toward any political entity.

Data from OpenSecrets indicates that Express Scripts spent $3,235,000 on lobbying activities during 2018, raising concerns regarding its influence on public policy.