DECISION AND ORDER AS TO RESPONDENTS EXPRESS SCRIPTS, INC., EVERNORTH HEALTH, INC., MEDCO HEALTH SERVICES, INC., AND ASCENT HEALTH SERVICES LLC (Full settlement document)

Its standard formulary can no longer favor high WAC drugs over low WAC alternatives

Patient out-of-pocket costs will be based on net price, not list price

Plans and beneficiaries have access to direct-to-consumer pricing via TrumpRx

Point-of-sale rebates must be passed to patients

Manufacturer’s fees must be delinked from list prices

Plan sponsors will get substantially more transparency

Retail pharmacies will receive cost-plus reimbursement