PBM hit with $10 million verdict in in price-fixing arbitration and other notes from around the interweb:

• PBM hit with $10 million verdict in in price-fixing arbitration. The AIDS Healthcare Foundation won a legal battle against pharmacy benefit manager Prime Therapeutics LLC in an arbitration ruling on Jan. 17. Arbitrator Stuart Widman found that Prime violated federal and state antitrust laws by engaging in price-fixing agreements with Express Scripts, another major PBM, according to a Jan. 23 news release from the foundation. The ruling awarded AHF $10,309,707 in treble damages and granted injunctive relief, permanently blocking Prime from continuing the price-fixing collaboration with Express Scripts regarding reimbursements for drugs and services provided by AHF. Prime, which administers pharmacy benefits for around 38 million people, in April 2020 was found to have aligned its reimbursement rates with Express Scripts, the release said.

• FTC Second Interim Staff Report Finds PBMs Charge Significant Markups. The Federal Trade Commission today published a second interim staff report on the prescription drug middleman industry, which focuses on pharmacy benefit managers’ (PBMs) influence over specialty generic drugs, including significant price markups by PBMs for cancer, HIV, and a variety of other critical drugs. Staff’s latest report found that the ‘Big 3 PBMs’—Caremark Rx, LLC (CVS), Express Scripts, Inc. (ESI), and OptumRx, Inc. (OptumRx)—marked up numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent. Such significant markups allowed the Big 3 PBMs and their affiliated specialty pharmacies to generate more than $7.3 billion in revenue from dispensing drugs in excess of the drugs’ estimated acquisition costs from 2017-2022.

• DOJ hits Walgreens with lawsuit for filling ‘unlawful’ opioid prescriptions. The Department of Justice (DOJ) hit drugstore chain Walgreens with a lawsuit this week for filling “unlawful” opioid prescriptions that had no “legitimate” medical purpose for over a decade. The lawsuit, which was filed in U.S. District Court for the Northern District of Illinois, alleges that Walgreens’ pharmacists filled millions of prescriptions despite “red flags” indicating that they were likely to be unlawful and that it pressured its pharmacists to fill prescriptions while not taking the necessary time to “confirm their validity.” Walgreens allegedly ignored substantial evidence from multiple sources that its stores were dispensing unlawful prescriptions, including from its own pharmacists and internal data,” the DOJ said in a press release.”

• How a Duty To Spend Wisely on Worker Benefits Could Loosen PBMs’ Grip on Drug Prices. Ann Lewandowski knows all about pharmacy benefit managers, or PBMs, the companies that shape the U.S. drug market. Her job, as a policy advocate at drugmaker Johnson & Johnson, was to tell patient and physician groups about the PBMs’ role in high drug prices. Armed with that knowledge, Lewandowski filed a potentially groundbreaking lawsuit in February. Rather than targeting the PBMs, however, she went after a big company that uses one — her own employer, Johnson & Johnson. Lewandowski charges in her lawsuit that by contracting with the PBM Express Scripts, which is part of the insurance giant Cigna, Johnson & Johnson — which fired her in April — failed in its duty to ensure reasonable drug prices for its more than 50,000 U.S. employees.

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