Health and Healthcare

Express Scripts Thumped by Short Seller Citron Research

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Around noon on Thursday, short-seller Citron Research offered some free advice to President-Elect Donald Trump: If Trump is serious about cutting prescription drug costs, go after Express Scripts Holdings Co. (NASDAQ: ESRX).

Express Scripts is the country’s largest pharmacy benefits manager (PBM), with over $101 billion in sales in 2015. The company’s biggest customer is health insurer Anthem Inc. (NYSE: ANTM), which filed suit against Express Scripts for around $15 billion in March of this year, claiming that the PBM violated the companies’ contract by charging too much and failing in its operation.

PBMs like Express Scripts negotiate drug prices from manufacturers and then offer to supply these drugs to health insurers like Anthem. To remain competitive in the insurance market, the insurers have to be able to compete on price. According to Anthem’s lawsuit, the insurer figures it is paying Express Scripts about $3 billion annually in excess charges.

Here’s the tweet from Citron that started the tumble in Express Scripts stock on Thursday:

A second tweet followed shortly:

Within half an hour Express Scripts’ stock had dropped about 10% to an intraday low of $68.00. By the end of the trading session the stock had recovered some to close at $70.75, down 6.7% for the day.

Express Scripts responded to a query from Investor’s Business Daily, saying, “We’re nothing like Philidor.” Specialty pharmacy Philidor is alleged to have changed orders in a ploy to increase reimbursements from insurers and boost sales for Valeant Pharmaceuticals International Inc. (NYSE: VRX). Express Scripts and CVS Health Corp. (NYSE: CVS) dropped Philidor from their networks last year.

CVS shares dropped 3% on Thursday, and the timing of the drop is a near carbon copy of the Express Scripts fall, and UnitedHealth Group Inc. (NYSE: UNH), which owns PBM OptumRx, dipped less than 0.1%. The other major U.S. PBM is Prime Therapeutics, a privately held company that serves Blue Cross/Blue Shield insurers around the country.

In after-hours trading Thursday, Express Scripts stock recovered about 1.8%, trading at $72.00. The stock’s 52-week range is $64.46 to $89.00. The consensus 12-month price target is $81.56, well above the $45 price target Citron suggests.

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