Case Overview: A class action lawsuit claims GoodRx, CVS, Express Scripts, and others conspired to fix generic drug prices, harming independent pharmacies.
Consumers Affected: Independent pharmacies in the United States.
Court: U.S. District Court for the Central District of California
A new lawsuit accuses pharmacy giants GoodRx, CVS Caremark, Express Scripts, MedImpact, and Navitus of conspiring to suppress reimbursement rates for independent pharmacies. The lawsuit alleges the companies colluded to artificially lower generic drug reimbursement rates and increase transaction fees, leveraging a scheme called the Integrated Savings Program (ISP) to maximize profits at the expense of small pharmacies.
According to the allegations, the pharma giants used real-time proprietary pricing data and GoodRx’s algorithms to set artificially low reimbursement rates, leaving pharmacies with unsustainable margins. The companies are also accused of implementing a clawback fee system, extracting additional money from struggling independent pharmacies to boost their own revenues.
According to the lawsuit, the ISP allegedly manipulated generic drug prices by having pharmacy benefit managers (PBMs)—middlemen that negotiate drug prices for health plans—collaborating with GoodRx to share sensitive pricing data. This enabled PBMs to reimburse pharmacies at the lowest rate among their competitors, effectively suppressing payments below competitive levels.
GoodRx’s algorithm, central to the program, dictated rebates and reimbursement rates in real time. This arrangement allowed the companies to avoid bidding against each other, a practice that would typically benefit pharmacies. Instead, GoodRx and the PBMs allegedly profited by reducing what they paid pharmacies while collecting additional fees on prescriptions.
For small, independent pharmacies, the scheme has been devastating, according to the lawsuit. These businesses rely on being part of PBM networks to survive, as they depend on reimbursements from health plans that cover most Americans. However, the alleged price-fixing left pharmacies operating on razor-thin margins—sometimes losing money on prescriptions.
The plaintiff, Esco Drug Co. in New York City, claims the scheme caused substantial economic harm. Across the nation, many independent pharmacies have been forced to shut down, reducing competition and limiting patient access to affordable medication. The lawsuit contends that this consolidation benefits the defendants at the expense of consumers and small businesses.
This lawsuit isn’t the first legal challenge faced by GoodRx. In 2023, the Federal Trade Commission fined the company $1.5 million for improperly sharing consumer health data with third parties like Facebook and Google. Meanwhile, PBMs and other pharmaceutical companies have also been embroiled in antitrust cases. For example, Pfizer recently settled allegations of conspiring to delay a generic version of its antidepressant Effexor XR, agreeing to pay $25.5 million.
Antitrust cases like these highlight broader concerns about corporate consolidation and its impact on competition. Critics argue that unchecked practices often harm consumers while enriching powerful players.
In its lawsuit, Esco Drug Co. wants to represent all pharmacies in the United States that were reimbursed for generic prescription medication pursuant to the GoodRx ISP program. It is alleging violations of the Sherman Antitrust Act and is seeking damages, fees, costs, and interest.
Case Details
Plaintiffs' Attorneys
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