Drug coupon platform GoodRx and several major pharmacy benefit managers (PBMs) face multiple class-action lawsuits accusing them of engaging in anticompetitive practices that reduce reimbursement rates to independent pharmacies, potentially threatening their survival. These lawsuits, filed by independent pharmacies from Minnesota, Michigan, Pennsylvania, and Rhode Island, claim that the defendants have been coordinating to suppress payments for generic prescription drugs, violating federal antitrust laws.
The lawsuits argue that GoodRx, a popular service that allows patients to search for the lowest drug prices, collaborated with PBMs, including CVS Caremark, Express Scripts, MedImpact, and Navitus Health Solutions. The plaintiffs allege that, starting last year, the PBMs began using GoodRx’s software to analyze discount prices for generic prescriptions and consistently select the PBM offering the lowest reimbursement to the pharmacy, irrespective of the patient’s primary PBM provider.
Under this alleged arrangement, independent pharmacies, which are often less financially resilient than large chain pharmacies, receive only the patient’s cash payment as revenue, as the PBMs do not reimburse the pharmacies for these transactions. This, according to the lawsuits, disproportionately benefits large pharmacies affiliated with PBMs, such as CVS, which can more easily manage these reduced reimbursements. By driving down independent pharmacies’ revenue, the lawsuits claim, the scheme seeks to eliminate smaller competitors in the market.
In a statement responding to the allegations, CVS Caremark spokesperson Mike DeAngelis asserted that CVS reimburses independent pharmacies at rates higher than those paid to chain drugstores, including CVS itself, and dismissed the lawsuits as meritless. Other defendants have not yet responded to requests for comment.
Pharmacy benefit managers are intermediaries in the pharmaceutical supply chain, negotiating drug prices and managing pharmacy reimbursements. Historically, PBMs have also offered discount cards for uninsured patients, allowing them to pay cash at network pharmacies. According to the lawsuits, recent changes now enable PBMs to route every discount card transaction through a network with lower reimbursement rates, effectively creating a “price-fixing” model that drives down compensation for smaller pharmacies.
The plaintiffs, representing proposed classes of similarly affected pharmacies, contend that these agreements violate the Sherman Antitrust Act by facilitating price-fixing and market manipulation. The lawsuits seek both injunctive relief to prevent further anticompetitive practices and unspecified damages.
In recent years, PBMs have faced increased scrutiny over their impact on drug pricing, with the Federal Trade Commission investigating their influence on insulin prices. The current lawsuits add to a growing list of complaints, highlighting the need for regulatory oversight to protect the viability of independent pharmacies and prevent further consolidation of market power.
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