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Canada Probes Express Scripts Over Alleged Anti-Competitive Conduct

 |  April 13, 2025

Canada’s Competition Bureau has initiated a formal investigation into Express Scripts, the pharmacy services division of U.S.-based health insurer Cigna, over concerns that its business practices may be undermining competition in the nation’s pharmaceutical retail sector.

According to Reuters, the bureau is examining whether Express Scripts engaged in “patient steering,” a tactic that may involve directing patients to use pharmacies affiliated with its Canadian operations rather than allowing them to choose their preferred drugstore. The investigation also includes scrutiny of business practices that could be eroding profit margins for independent retail pharmacies across the country.

While Cigna has not yet issued a response to a request for comment from Reuters, the inquiry places new pressure on one of the largest pharmacy benefit managers operating in Canada. Express Scripts is responsible for managing prescription drug claims and related services for insurers and pharmacists. It also operates four mail-order pharmacies nationwide, with the exception of Quebec, per Reuters.

The Canadian Pharmacists Association (CPhA), a vocal critic of Express Scripts’ operations, had previously filed a complaint with the Competition Bureau, accusing the company of “longstanding and exploitative practices.” However, it remains unclear whether the bureau’s current investigation is directly tied to the CPhA’s complaint.

As part of the investigation, the agency has obtained a federal court order compelling Express Scripts Canada to provide records, written documentation, and oral testimony relevant to the inquiry. The bureau emphasized that there is no finding of misconduct at this stage of the investigation.

Per Reuters, Express Scripts holds a dominant position in the pharmacy benefits management sector, raising broader questions about how its market influence may affect both consumer choice and competition among pharmacies in Canada.

Source: Reuters