Competition Bureau investigation potential violations including patient steering, margin squeezing, PPN

By Jim Wilson

Apr 14, 2025

The Competition Bureau has obtained a court order to advance its investigation into an employer over concerns that the company may be engaging in anti-competitive practices within the pharmacy sector.

The order, issued by the Federal Court, compels Express Scripts Canada to produce records, written information, and oral testimony relevant to the Bureau’s investigation.

The Bureau is examining alleged anti-competitive conduct that could prevent or limit competition in the pharmacy retail market, including:

• Patient steering through Preferred Provider Networks that force or induce Canadians to use Express Scripts Canada owned or associated pharmacies instead of their pharmacy of choice; and
• Margin squeezing that reduces the margins of its retail pharmacy competitors by increasing its Pharmacy Benefit Manager (PBM) service fee and by requiring a costly and burdensome audit process.

A PBM provides prescription drug claim processing services for insurance providers and pharmacists.

Preferred Pharmacy Network

Meanwhile, a Preferred Provider Network agreement – also referred to as a Preferred Pharmacy Network agreement or a PPN – aims to establish a network of “preferred” pharmacies for a particular insurance provider. In this agreement, an insured individual is either required or encouraged to fill their prescriptions from a pharmacy operator in...

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