The dispute has led to a lawsuit by Prime Aid against Express Scripts, one that highlights the escalating showdown between independent specialty pharmacies and industry giants. A half-dozen independent pharmacies have filed similar lawsuits against big pharmacy benefit managers in the last year.
At stake is a piece of a booming $100 billion market. Specialty pharmacies sell many of the country's most expensive drugs, which have become particularly lucrative in the past two years with the arrival of medicines to treat diseases like hepatitis C and cystic fibrosis. These have list prices of hundreds of thousands of dollars a year.
