For years, PBMs have consistently refused to disclose any information about their secret “deals” with manufacturers to obtain “rebates” – that PBMs presumably pass through – and “other monies” – that PBMs collect from manufacturers but PBMs may retain for themselves.

But now, a new lawsuit filed by Express Scripts against the drug manufacturer kaleo reveals at least some information about Express Scripts secret deals. And the information is shocking. Express Scripts is clearly collecting mega-millions of dollars from manufacturers, and much of that money is labeled “administrative fees” and “price protection rebates” that Express Scripts may not be entirely passing through to its clients or the federal government. Every Plan administrator and fiduciary – and the federal government – should insist on learning more about the millions that Express Scripts and other PBMs are collecting.