Pharmacy Groups File Suit Against PBMs

Published Online: Wednesday, October 1, 2003

    Two groups of pharmacy owners have filed separate lawsuits in the US District Court in Philadelphia against pharmacy benefit managers (PBMs) Medco Health Solutions Inc and AdvancePCS alleging violations of antitrust law. The plaintiffs hope to have the suits certified as class actions.

    The Pharmacy Freedom Fund and the National Community Pharmacists Association claim that the PBMs, which administer prescription-drug benefits for private insurers and employers, treat pharmacies unfairly and steer customers toward mail-order services, which are more profitable for prescription managers.

    The pharmacy groups said that the PBMs act as the ?common agent? for their clients, and they cover roughly 140 million Americans between them, giving them more control over prices. In addition, they said that the PBMs fix prices that are paid to pharmacies for generic drugs and forbid pharmacies from providing patients with more than a 1-month supply of medication, leaving longer-term supplies in the hands of the mail-order pharmacies they own.

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