Alabama Pharmacies File Lawsuits Against PBMs Alleging Anticompetitive Practices

Birmingham, Ala., attorney Archie Lamb last week filed lawsuits in U.S. District Court in Birmingham alleging that pharmacy benefit managers AdvancePCS, Caremark, Express Scripts and Medco Health Solutions have engaged in illegal anticompetitive practices, the Birmingham News reports. The suits, filed on behalf of Jackson County, Ala.-based North Jackson Pharmacy and Big C Discount Drugs, allege that the PBMs have "fixed and depressed prescription drug prices and fees paid to pharmacies" and accepted rebates and "undisclosed incentives" from pharmaceutical companies to promote certain drugs, the News reports. The suit also states that the PBMs promoted their own mail-order services by prohibiting pharmacies from filling more than a 30-day supply of drugs, while PBM mail orders can fill up to a 90-day supply. "The PBMs envision a world where there are no pharmacies, just their 800 number to order prescriptions filled by unnamed technicians," Lamb said, adding "PBMs have demonstrated a willingness to participate in illegal and deceptive practices." Lamb said he is seeking class-action status for the lawsuit and has contacted other independent pharmacies across the nation. Caremark spokesperson Gerard Carney said the company will fight the suit because the allegations "fundamentally mischaracterize Caremark's business practices and are without merit" (Goodman, Birmingham News, 10/7). Spokespersons for the other companies also said they will "defend themselves vigorously against the lawsuits," Reuters reports. Medco spokesperson Jeff Simek said, "If the accusation is that we are too effective in lowering the cost of health care, then we are guilty as charged" (Reuters, 10/3). In a similar but unrelated lawsuit filed in August, the Pharmacy Freedom Fund and the National Community Pharmacists Association allege that AdvancePCS and Medco set artificially low payments to retail pharmacies; prevent them from competing with mail-order pharmacies by prohibiting pharmacies from dispensing more than one-month supplies of medications; and fix prices paid to pharmacies for generic drugs (Kaiser Daily Health Policy Report, 8/18).