Albertson's LLC v. Express Scripts, Inc.

Superior Court of Delaware·Decided August 5, 2026·No. N25C-12-001 KMM CCLD·Published

Opinion

IN THE SUPERIOR COURT OF THE STATE OF DELAWARE

ALBERTSON’S LLC, NEW ) ALBERTSONS L.P., SAFEWAY INC., ) and UNITED SUPERMARKETS, LLC, ) ) Plaintiffs, ) C.A. No. N25C-12-001 KMM ) CCLD v. ) ) EXPRESS SCRIPTS, INC., ) ) Defendant. )

Date Submitted: May 12, 2026 Date Decided: August 5, 2026

Defendant’s Motion to Dismiss – GRANTED, in part, DENIED, in part

MEMORANDUM OPINION AND ORDER

Brian M. Rostocki, Nicholas R. Rodriguez, Evan D. Sweeney, REED SMITH LLP, Wilmington, Delaware; Selina P. Coleman (argued), Alexandra R. Klimkiewicz, REED SMITH LLP, Attorneys for Plaintiffs.

Marisa R. De Feo, HUSCH BLACKWELL LLP, Wilmington, Delaware; Sarah C. Hellmann, Elizabeth A. Bozicevic (argued), HUSCH BLACKWELL LLP, St. Louis, Missouri, Attorneys for Defendant.

Miller, J. I. INTRODUCTION

The facts here are straightforward. Plaintiffs Albertson’s LLC, New

Albertsons L.P., Safeway Inc., and United Supermarkets, LLC (together,

“Albertsons”) and Express Scripts, Inc. (“Express Scripts”) are parties to contracts,

pursuant to which Express Scripts reimburses Albertsons for prescription drugs it

fills for certain of its customers. The parties agreed that the reimbursement for brand

drugs is paid at a higher price than a generic drug. Express Scripts makes a payment

to Albertsons when a prescription is filled. The parties also agreed to an annual

reconciliation which determines the amount, if any, owed to Albertsons on an annual

basis.

The reconciliation is calculated based on the classification of the drugs at the

time of reconciliation—generic or brand. Albertsons asserts that Express Scripts

breached the contracts because it classified certain drugs at the point-of-sale as

“brand,” but then reclassified some of these drugs as “generic” for purposes of the

annual reconciliation. By doing so, Albertsons claims Express Scripts failed to pay

Albertsons millions of dollars.

Alternatively, Albertsons asserts that Express Scripts breached the implied

covenant of good faith and fair dealing because it exercised its contractual discretion

in a manner that deprived Albertsons the benefit of its bargain. Finally, Albertsons

1 asserts a claim for unjust enrichment in the alternative, claiming that Express Scripts

improperly withheld millions of dollars based on the reclassification of drugs.

Express Scripts moves to dismiss under Superior Court Rule 12(b)(6) (the

“Motion”),1 arguing that Albertsons failed to plead cognizable unjust enrichment

and implied covenant claims because valid contracts control the parties’ relationship

and the reconciliation process is governed by the contract, which cannot be rewritten

to grant Albertsons additional rights. Express Scripts argues that the breach of

contract claim is barred by the contractual dispute procedure because Albertsons

failed to initiate this action within the time period provided in the agreement.

Express Scripts finds success on the non-contract claims. The contract

includes a process by which Express Scripts is to calculate the annual reconciliation,

expressly stating the mechanism by which a drug’s classification is to be determined.

The contract does not require that the classification at the point-of-sale control the

classification for the reconciliation payment. Because Express Scripts’ method of

reconciliation is authorized by the agreement, the implied covenant claim must be

dismissed. The Motion is GRANTED on Count II.

Similarly, Albertsons cannot rely on an unjust enrichment claim for recovery

because a valid and enforceable contract governs the parties’ relationship.

Therefore, the Motion is GRANTED on Count III.

1 D.I. 15. 2 Express Scripts’ forfeiture argument, however, fails. Resolution of this

argument requires fact-finding, which defeats the Motion. Therefore, the Motion is

DENIED on Count I.

II. FACTUAL BACKGROUND 2

A. The Express Scripts and Albertsons relationship

As a Pharmacy Benefit Manager (“PBM”), 3 Express Scripts manages

prescription drug benefits for health insurance plans, employers, government

programs, and other entities principally responsible for paying for prescription drugs

(“Sponsors”). Express Scripts is an intermediary between insurance companies,

pharmacies, and drug manufacturers.4 Among other things, Express Scripts

contracts with a network of pharmacies and establishes payment levels for them. 5

Albertsons is a food retailer that operates over 1,700 pharmacies across 35

states and the District of Columbia.6 Express Scripts and Albertsons have a long-

standing contractual relationship through which Albertsons’ pharmacies are “in-

network” pharmacies for members of health plans, for which Express Scripts

administers the prescription-drug benefits (“Plan Members”).7 The Express Scripts-

2 The facts are derived from the Consolidated Complaint, D.I. 6. (“Compl.”), and the documents it incorporates by reference. 3 Compl. ¶ 2. 4 Id. ¶ 3. 5 Id. ¶ 17. 6 Id. ¶ 4. 7 Id. ¶ 44. 3 Albertsons relationship is memorialized in numerous Pharmacy Provider

Agreements (together, the “Provider Agreement”).8

B. The classification of drugs and structure of payments

Under the Provider Agreement, Express Scripts agreed to reimburse

Albertsons for covered medications dispensed to Plan Members. 9 The amount

Express Scripts pays depends, in large part, on whether the drug is classified as

generic or brand. The Provider Agreement defines “Generic Drug” as:

[A] prescription drug – whether identified by its chemical, proprietary, or non-proprietary name – which is pharmaceutically equivalent and interchangeable with a drug containing an identical amount of the same active ingredient(s) and approved by the FDA. 10

To determine whether a drug is a Generic Drug, the Provider Agreement states:

[T]he designation of a product as ‘generic’ … is determined by [Express Scripts], using [Express Scripts’] brand/generic algorithm and/or using data elements provided by First DataBank, Medi-Span, or other sources nationally recognized in the retail prescription drug industry. 11

8 Id. ¶ 45. 9 Id. ¶ 49. 10 Provider Agreement § 1.8. 11 Id. 4 A “brand” drug is “any prescription drug that is not a Generic Drug.”12

Generic and brand drugs are reimbursed at different rates, with brand drugs being

reimbursed at higher rates than Generic Drugs. 13

When a Plan Member fills a drug prescription at Albertsons, it enters the Plan

Member’s information into an electronic system. This information is transmitted to

Express Scripts’ third-party processor to determine whether the drug is a covered

medication under the Plan Member’s plan and the amount of any Copayment due at

the point-of-sale transaction, which Albertsons is required to collect.14 Whether the

drug is generic or brand impacts the point-of-sale price and possibly, the Plan

Member’s Copayment, which is determined by the Sponsor. Albertsons is informed

of the amount Express Scripts is expected to reimburse Albertsons for dispensing

the drug. 15 This is referred to as the claim adjudication process. Express Scripts

makes an initial payment to Albertsons based on the point-of-sale transaction.16

The Provider Agreement requires Express Scripts to pay Albertsons for

covered drugs at “the rates set forth in the applicable rate sheet(s) … less the

applicable Copayment.” 17 The terms for reimbursement are set forth in Exhibit A –

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Albertson's LLC v. Express Scripts, Inc., (Del. Ct. App. 2026).

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