PBMs, GoodRx Hit With Multiple Class-Action Lawsuits by Pharmacies

In the fall of 2024, at least 3 major lawsuits were filed by independent pharmacies against the drug coupon provider GoodRx and/or several major pharmacy benefit managers (PBMs) including Caremark Corporation, Express Scripts, MedImpact Healthcare Systems, and Navitus Health Solutions. In general, the lawsuits accuse GoodRx of conspiring with PBMs to fix reimbursement rates in a way that benefits PBMs and harms independent pharmacies.

Lawsuit #1

The first lawsuit is an antitrust class action filed in the US District Court in California by Keaveny Drug against GoodRx and the 4 PBMs. The complaint alleges that while the PBMs and GoodRx are ostensibly competitors for pharmacy reimbursements, they have conspired to lower reimbursement rates paid to independent pharmacies. “Rather than compete” states the complaint, “GoodRx and the PBM Defendants agreed to artificially suppress prescription drug reimbursement rates paid to independent pharmacies, and to increase fees charged to pharmacies, on all GoodRx-related transactions. This conspiracy has caused harm to independent pharmacies throughout the United States.”

Lawsuit #2

The second lawsuit, also filed in the US District Court of California, was brought by Michigan-based Community Care Pharmacy against GoodRx. The complaint accuses GoodRx of “orchestrating a horizonal conspiracy among certain pharmacy benefit managers to fix and suppress the rates of reimbursement paid to independent pharmacies for generic drugs.” Similar to the first lawsuit, this antitrust case alleges a price-fixing agreement between GoodRx and PBMs. It is also a class action.

Lawsuit #3

The third lawsuit, another class action, was filed in US District Court for the District of Rhode Island by Pennsylvania-based Old Baltimore Pike Apothecary against GoodRx and the 4 PBMs. The complaint alleges: “The PBM Defendants exert their market power by employing various anticompetitive tactics to restrain competition in the prescription drug dispensing market, forcing independent pharmacies out of business and thereby increasing the market share of the PBMs’ affiliated pharmacies. Among these tactics is a recent scheme devised by Defendants to (i) share real time pricing data with one another using GoodRx as a clearinghouse, and (ii) allocate transactions to one another in order to maximize the number of claims processed using prescription discount cards.”

All 3 lawsuits allege that agreements among the PBMs and GoodRx are a violation of the federal Sherman Antitrust Act. Each case is seeking a jury trial.

The Takeaway

Expect to see increased scrutiny of PBMs with the filing of these lawsuits. The courts will need to determine whether the alleged actions constitute price fixing and suppression of prescription drug reimbursement rates.

References

Keaveny Drug, Inc. v GoodRx. No 2:24-cv-9379. United States District Court of Central District of California, Western Division; 2024. https://fingfx.thomsonreuters.com/gfx/legaldocs/xmpjbrdompr/Keaveny%20Drug%20v.%20GoodRx%20complaint%2010-30.pdf

Community Care Pharmacy, LLC v GoodRx. No 2:24-cv-9490. United States District Court of Central District of California, Western Division; 2024. https://fingfx.thomsonreuters.com/gfx/legaldocs/byvrmkwjxpe/Community%20Care%20v%20GoodRx%20complaint%2011-1.pdf

Old Baltimore Pike Apothecary, Inc. v GoodRx. No 1:24-cv-00453. United States District Court for the District of Rhode Island; 2024. https://fingfx.thomsonreuters.com/gfx/legaldocs/znvnlkabbvl/Old%20Baltimore%20Pike%20v%20GoodRx%20complaint%2011-1.pdf