BRIEF—Independent pharmacies file suit against PBM

15 May 2020

More than 50 independent pharmacies have filed a class action lawsuit against OptumRx, a division of UnitedHealth Group (NYSE: UNH), alleging that the company failed to comply with state pharmacy claims reimbursement law.

The lawsuit claims that the pharmacy benefit manager acted unlawfully by ignoring state legal requirements, paying local pharmacies substantially less than it paid large chain retail pharmacies like CVS or Walgreens, and far below what it paid its own mail order pharmacy for the same prescriptions.

OptumRx is also accused of often knowingly reimbursing local pharmacies below wholesale cost to stock necessary generic prescription drugs.