Your business may have been victimized by a scheme to fix prices and cheat you out of a fairly negotiated reimbursement.
Keller Rohrback is investigating allegations that pharmacy benefit managers (PBMs) have conspired, under the direction of prescription discount rate aggregator GoodRx, to suppress the prices paid to independent pharmacies for generic drugs. Several class action lawsuits have been filed to date following revelations that at least four PBMs, including CVS Caremark, Express Scripts, MedImpact, and Navitus, and likely more, have agreed to participate in GoodRx’s Integrated Savings Program (ISP).
The innocuously-titled Integrated Savings Program involves outsourcing decisions on pharmacy reimbursement rates for generic drugs to third-party agent, GoodRx. Simultaneously, through the ISP agreements, PBMs agree not to outbid each other on the prices they pay pharmacies for these drugs. This setup enables GoodRx—armed with sensitive reimbursement rate data from the PBMs—to manipulate the reimbursements paid to pharmacies dispensing generic medications. Independent pharmacies receive less reimbursements than they are entitled to. Such an arrangement constitutes price-fixing, imposing an unlawful and unwarranted burden on pharmacies and, ultimately, their customers.
If you own an independent pharmacy and have experienced shortcomings in your reimbursements for generic drugs, we’d like to hear from you. Please contact us at 800-776-6044, or [email protected] for a free no-obligation consultation to learn more about your legal rights. You may also use the secure form on this page.
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Keller Rohrback is investigating allegations that generic drug coupon provider, GoodRx, and several pharmacy benefit managers (PBMs) have conspired to suppress the prices paid to independent pharmacies for generic drugs, profiting from this collusion at the expense of independent pharmacies.
Why are lawsuits being filed?
It is alleged that GoodRx and the PBMs used proprietary algorithms to share confidential pricing data and ultimately engage in price-fixing when it comes to the reimbursements offered for generic prescription drugs.
GoodRx and the PBMs introduced an "Integrated Savings Program," which integrates GoodRx's software and real-time pricing data from competing PBMs into the PBMs' systems. When a pharmacy submits a reimbursement request, the PBMs' algorithm, utilizing GoodRx's technology, compares prices across competitors and determines the pharmacy's payout based on the lowest available rate.
This arrangement artificially lowers pharmacy reimbursements while simultaneously increasing fees, enabling GoodRx and the PBMs to benefit financially at the expense of independent pharmacies.
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