The Competition Bureau alleges that Express Scripts Canada engaged in patient steering through preferred provider networks that force or induce consumers to use the company’s owned or associated pharmacies instead of a pharmacy of their choice. In addition, the investigation is looking into margin-squeezing activity that reduces the margins of its retail pharmacy competitors by increasing its pharmacy benefit manager (PBM) service fee and requiring a costly and burdensome audit process, according to a Competition Bureau press release.

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The investigation is being conducted under Canada’s Competition Act restrictive trade provisions, which protect against abuse of dominance and agreements or arrangements between businesses that harm competition. The bureau emphasized there is no conclusion of wrongdoing at this time.

The Canadian Pharmacists Association (CPhA) filed a formal complaint with the bureau in February, raising concerns about ESC’s use of its dominant position in the PBM market, including mandatory services fees on pharmacies across the company. The association said it welcomed the Competition Bureau’s announcement.

“PBMs have operated unchecked for far too long, and this investigation marks an important step toward greater accountability,” said Joelle Walker, VP of public and professional affairs at CPhA. “We filed this complaint on behalf of over 40,000 pharmacists in over 12,000 pharmacies across Canada who show up every day to deliver essential health care. This is a clear signal that Canadian regulators are prepared to examine practices that may be harming competition and limiting access to care — and we’re proud to support that effort.”