Nine patients have sued Accredo Health Group along with Express Scripts, Evernorth Health, and The Cigna Group in what is shaping up to be the most significant Accredo specialty pharmacy lawsuit to date, alleging the companies operate an illegal monopoly that traps patients with serious and rare conditions into a single pharmacy delivering delayed, damaged, and dangerously mismanaged care. The complaint, Wolf et al. v. Accredo Health Group, Inc. et al., was filed January 6, 2026 in the U.S. District Court for the Northern District of Illinois and could represent a class of millions of Accredo customers nationwide.
What the Lawsuit Alleges
The core claim is straightforward: Cigna owns Evernorth, which owns both Express Scripts (one of the country’s largest pharmacy benefit managers) and Accredo (its specialty pharmacy). The plaintiffs say that structure lets Express Scripts steer patients covered by Cigna, several Blue Cross Blue Shield affiliates, and the military health program TRICARE into filling their specialty prescriptions exclusively at Accredo, with no other in-network option.
Specialty drugs, as the complaint uses the term, include biologics, transplant anti-rejection medications, oral chemotherapy, and treatments for multiple sclerosis. These are medications where interruptions in therapy can cause irreversible harm.
Filed by the Chicago firm Loevy & Loevy, the case brings eleven counts spanning the Sherman Antitrust Act, state consumer protection statutes, negligence, and public nuisance, on behalf of three proposed classes covering privately insured patients, TRICARE beneficiaries, and a common law class.
The Service Problems Patients Describe
The plaintiffs say the captive arrangement lets Accredo deliver what they call “shockingly poor healthcare services” without any competitive check. Specific problems described in the complaint include:
- Week-long refill delays.
- Orders canceled without notice.
- Broken cold-chain deliveries that ruin heat-sensitive biologic medications.
- A website that blocks online refills, forcing patients onto jammed phone lines.
- Surprise four-figure bills on accounts that previously carried a zero balance.
Doctors calling on behalf of their patients, the complaint alleges, are routed through the same customer support lines and left on lengthy calls with representatives the plaintiffs describe as poorly trained. When shipments arrive damaged, the suit says, Accredo refuses to replace them without making the patient restart the entire prior authorization process.
How Patients Say They Have Been Harmed
The plaintiffs contend these failures carry life-threatening consequences. Named plaintiff Heather Lisser, a Wisconsin resident, reported needing emergency room treatment after Accredo failed to deliver her organ transplant rejection medication on time. More broadly, the complaint alleges that missed or delayed doses have led to disease progression, emergency hospitalizations, drug resistance developing in patients on biologics, and organ failure linked to delayed anti-rejection drugs.
The medications at issue include adalimumab (the generic for Humira), Revlimid, tacrolimus, and various MS injectables. All treat conditions where gaps in therapy can be medically irreversible.
Why Corporate Structure Is Central to the Case
The lawsuit’s theory rests on vertical integration. The same corporate family decides which drugs a patient’s plan covers, sets the rules for where those drugs can be filled, and then fills them at its own pharmacy. Regulators have reached similar conclusions about how that structure operates in practice.
A July 2024 interim staff report from the Federal Trade Commission found that the three largest PBMs, including Express Scripts, manage roughly 79% of all U.S. prescription drug claims, and their affiliated pharmacies account for nearly 70% of all specialty drug revenue. The FTC concluded that vertically integrated PBMs have the “ability and incentive” to steer patients toward their own pharmacies, and found that 72% of specialty generic prescriptions with markups above $1,000 were dispensed at PBM-affiliated pharmacies during the period studied.
A follow-up FTC report in January 2025 found that the three largest PBMs charged markups of “hundreds and thousands of percent” on specialty generic drugs at their affiliated pharmacies, generating more than $7.3 billion in dispensing revenue above estimated drug acquisition costs between 2017 and 2022. The same report found those PBMs reimbursed their own pharmacies at higher rates than they paid unaffiliated pharmacies on “nearly every specialty generic drug examined.”
Cigna’s Response
Cigna called the allegations “unfounded” and said the company would “vigorously defend” itself. It also disputed the mandatory-channeling claim, stating that “clients of Express Scripts, our pharmacy benefits services company, have full control of their benefit design and are never required to use Accredo as their exclusive in-network specialty pharmacy.”
As of early 2026, the defendants had not yet filed a formal response to the complaint.
Other Legal and Regulatory Pressure on Accredo
The class action is not the only front. Several related actions target the same or adjacent conduct.
The FTC’s Express Scripts Settlement
On February 4, 2026, Express Scripts settled a separate FTC administrative action that had accused the company and two other major PBMs of anticompetitive rebating practices that inflated insulin prices. The settlement requires Express Scripts to end spread pricing and list-price-based compensation and to pass rebates through to patients at the point of sale. Express Scripts did not admit to any legal violation.
The settlement applies only to retail community pharmacies and explicitly excludes mail-order and specialty pharmacies. That carve-out means the consent order does not address Express Scripts’ ability to steer patients toward Accredo, which is the practice at the center of the class action. The administrative case against Caremark Rx and OptumRx remains unresolved.
Vermont’s Consumer Protection Lawsuit
In July 2024, Vermont Attorney General Charity Clark sued several PBMs and their affiliated entities, including Accredo, in Vermont Superior Court, alleging violations of the state’s Consumer Protection Act. The complaint accused the defendants of granting formulary placement to drugs with the highest list prices and largest manufacturer rebates while excluding lower-cost alternatives, and of requiring patients with chronic or serious illnesses to fill prescriptions exclusively at the PBMs’ in-house pharmacies. One example: Express Scripts allegedly charged $4,409 for a generic version of the cancer drug Tarceva that was available elsewhere for $73 per month. Vermont is seeking restitution, civil penalties of $10,000 per violation, disgorgement, and a permanent injunction. The case remained active as of mid-2025.
TRICARE and Military Health Concerns
In 2022, Cigna and Express Scripts designated Accredo as the sole in-network specialty pharmacy for TRICARE beneficiaries. Pharmacy industry groups reported that military patients experienced missing doses and denials of sterile supplies needed to administer certain IV medications. Senator Jon Tester of Montana wrote to the Department of Defense about the network restrictions, and Representatives Buddy Carter of Georgia and Mike Rogers of Alabama raised similar objections. Express Scripts responded that Accredo was a “best-in-class specialty pharmacy” and that fewer than 1% of TRICARE members required specialty pharmacy services.
The SaveOnSP Copay Accumulator Case
A separate case, Gurwitch v. SaveOnSP LLC, Express Scripts, Inc., and Accredo Health Group Inc., targets a different piece of the business. The plaintiff alleges the three companies run a “copay maximizer” program that reclassifies certain specialty medications as non-essential health benefits, exempting their costs from the Affordable Care Act’s annual out-of-pocket cap. Patient copays are set at levels designed to exhaust manufacturer copay assistance, and the assistance funds are diverted to the health plan sponsor rather than counted toward the patient’s cost-sharing limit; the defendants retain 25% of the diverted funds as fees. The complaint alleges Accredo withholds prescriptions from patients who refuse to enroll. The case asserts claims under ERISA, the ACA, and RICO, and the proposed class reaches back to November 2017.
Where the Case Stands
The class action, case number 1:26-cv-00098, was assigned to Judge Andrea R. Wood with Magistrate Judge Laura K. McNally. The defendants have not yet answered the complaint, and the case is in its earliest stages. Patients who have filled specialty prescriptions through Accredo under Cigna, Blue Cross Blue Shield, or TRICARE coverage would fall within the proposed classes if certification is granted, though class certification decisions typically come months or years into a federal case of this size.