A recent analysis by 46brooklyn Research, a nonprofit focused on drug pricing, has raised serious concerns about the pricing practices of Quallent Pharmaceuticals, a subsidiary of Cigna Group. Cigna, a dominant player in the healthcare sector, not only sells insurance but also operates the nation’s largest pharmacy benefit manager (PBM), an entity responsible for negotiating drug prices between manufacturers, health plans, and pharmacies. This dual role, where Cigna negotiates drug prices through its PBM while simultaneously profiting from the generic medications sold by its own Quallent unit, has come under growing scrutiny.

Quallent Pharmaceuticals, a four-year-old company based in the Cayman Islands, produces and sells its own versions of several generic drugs. While PBMs typically argue that they help lower prescription costs, 46brooklyn Research’s findings suggest the opposite may be true in Quallent’s case. The report revealed that Quallent’s generic drugs are often priced at the higher end of the market, contradicting Cigna’s public stance on affordability.

Antonio Ciaccia, chief executive officer of 46brooklyn, remarked: “They are telling you they hate high prices, they are telling you they work to get the lowest prices. This data suggests the opposite is occurring.”

The analysis further found that Quallent’s drugs are, on average, 33 times more expensive than the cheapest available options in their respective categories. While rarely the cheapest, Quallent’s products were sometimes the most expensive, averaging over 80% of the market’s maximum price. The study focused on the Average Wholesale Price (AWP), a key metric that determines how much health plans pay for medications, rather than the public “list price.”

According to Ciaccia, a higher AWP can artificially inflate costs, since many health plan contracts with PBMs stipulate payments as a discount off the AWP. Ben Link, president of 46brooklyn, explained that when pricing is structured this way, companies have an incentive to raise the starting point to extract higher profits, a behavior he suggests is evident in Quallent’s pricing model.

However, the 46brooklyn analysis also identified a pattern of selective pricing behavior, where Quallent’s drugs were strategically priced higher in markets with limited competition but more moderately in categories crowded with low-cost generics. This indicates a targeted approach aimed at maximizing profit margins, rather than delivering consistent savings. The researchers warned that such practices undermine the cost-cutting mission PBMs claim to uphold, and could intensify calls for greater regulatory oversight of vertically integrated healthcare giants like Cigna.