GoodRx, PBMs accused of suppressing reimbursements

GoodRx and pharmacy benefit managers CVS Caremark, Express Scripts, MedImpact and Navitus Health Solutions are facing class-action lawsuits accusing them of colluding to super press reimbursements to independent pharmacies for generic drug prescriptions. 

Three lawsuits were filed last week, with the first filed by Minnesota-based Keaveny Drug in federal court in California on Oct. 30. A second class-action lawsuit was filed Nov. 1 by Michigan's Community Care Pharmacy in the same court, and the third lawsuit was filed the same day by Pennsylvania's Old Baltimore Pike Apothecary and Smith's Pharmacy in federal court in Rhode Island. 

The lawsuits claim that starting in 2023, GoodRx partnered with PBMs to reroute patient prescriptions to whichever PBM offered the lowest price for generics, bypassing the patient's designated PBM. Pharmacies are charged a fee for these transactions, which is split among PBMs, but receive no reimbursements from dispensing the drugs, which result in financial losses for independent pharmacies, according to court documents reviewed by Becker's

In an email shared with Beckers, a CVS Caremark representative said, "CVS Caremark generally reimburses independent pharmacies at higher levels than chain drugstores, including CVS pharmacies. Our Caremark Cost Saver program also helps lower out-of-pocket drug costs for our clients' members. These lawsuits are entirely without merit and we will vigorously defend against them." 

An Express Scripts spokesperson told Becker's, "The premise of these lawsuits is categorically false. Our partnership with GoodRx helps promote lower prices for patients at the pharmacy counter by directly integrating discount card pricing with pharmacy benefits." 

The plaintiffs argue that these practices amount to price fixing and that PBMs are intentionally pushing independent pharmacies out of the market to benefit larger, affiliated chains.  

Becker's reached out to GoodRx, MedImpact and Navitus Solutions and will update this story if more information becomes available. 

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