By House Republicans want to know whether pharmacy benefit manager (PBM) CVS Caremark violated federal antitrust laws by threatening independent pharmacies to keep them from using money-saving tools outside the PBM’s network.
In a letter to CVS obtained by The Hill, House Judiciary Committee Chair Jim Jordan (R-Ohio) asked the company for documents and communications about pharmaceutical hubs, a type of digital pharmacy service that can streamline the process of accessing and managing complex, high-cost specialty medications for patients.
Jordan expressed concern that CVS prevents independent pharmacies from participating in hub arrangements, because the company wants to head off potential competition. If an independent pharmacy works with a hub outside the PBM, it could be excluded from the PBMs network.
Pharmaceutical hubs are often sponsored by drugmakers, and they serve as go-betweens for the manufacturers and specialty pharmacies to assist patients.
“By foreclosing a pharmacy’s access to pharmaceutical hubs, a PBM can choke off would-be competitors before they enter the market and lower prices for consumers,” Jordan wrote.
“If CVS Caremark is eliminating opportunities for patients to access such services through an independent pharmacist, this practice raises significant concerns for patient welfare and innovation across the nation,” he wrote.
PBMs are the drug industry intermediaries, and have come under increasing scrutiny by lawmakers and regulators. PBMs negotiate the terms and conditions for access to prescription drugs for hundreds of millions of Americans.
PBMs negotiate prices with drug companies, pay pharmacies and create formularies that determine which drugs patients can access and how much they cost.