{"id":120,"date":"2024-07-22T14:36:26","date_gmt":"2024-07-22T18:36:26","guid":{"rendered":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/?p=120"},"modified":"2024-07-22T14:36:26","modified_gmt":"2024-07-22T18:36:26","slug":"vermont-attorney-general-sues-two-of-largest-pbms-for-driving-up-drug-prices","status":"publish","type":"post","link":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/2024\/07\/22\/vermont-attorney-general-sues-two-of-largest-pbms-for-driving-up-drug-prices\/","title":{"rendered":"Vermont Attorney General Sues Two of Largest PBMs for Driving Up Drug Prices"},"content":{"rendered":"<p>On July 17, 2024, the Vermont Attorney General, Charity R. Clark, filed a <a href=\"https:\/\/www.law360.com\/articles\/1859367\/attachments\/0\">lawsuit<\/a> in Vermont Superior Court against two of the largest pharmacy benefit managers (\u201cPBMs\u201d) in the country, CVS Caremark and Express Scripts.\u00a0 The suit alleges that these two PBMs\u2014which, according to the complaint, together control approximately 95% of the commercial PBM market in Vermont\u2014have violated the Vermont Consumer Protection Act by engaging in deceptive and unfair practices that have had the effect of driving up pharmaceutical prices for consumers and squeezing independent pharmacies.<\/p>\n<p>PBMs act as\u00a0intermediaries in the health care system\u2014they manage prescription drug benefits, including by negotiating discounts, rebates and fees with drug manufacturers, creating drug formularies (lists of medications that are covered by insurance) and policies, and reimbursing pharmacies for drugs covered by prescription-drug plans.<\/p>\n<p>The Vermont AG\u2019s complaint alleges that because they control which drugs are placed on the formularies, CVS Caremark and Express Scripts are able to extract payments from the manufacturers in return for favorable placement, which the PBMs retain as profits instead of passing along to payors and patients.\u00a0 It alleges that these PBMs drive up drug prices by giving preference on their formularies to drugs with high list prices\u2014and correspondingly high manufacturer payments\u2014over lower priced drugs.\u00a0 The complaint also alleges that CVS Caremark and Express Scripts pay lower reimbursement rates to pharmacies that are not affiliated with them, resulting in harm to independent pharmacies.<\/p>\n<p>The allegations in the Vermont complaint echo the Federal Trade Commission\u2019s <a href=\"https:\/\/www.duanemorris.com\/alerts\/federal_trade_commissions_interim_report_documents_harmful_impact_pharmacy_benefit_0724.html\">interim conclusions<\/a> of its ongoing study of the PBM industry.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>On July 17, 2024, the Vermont Attorney General, Charity R. Clark, filed a lawsuit in Vermont Superior Court against two of the largest pharmacy benefit managers (\u201cPBMs\u201d) in the country, CVS Caremark and Express Scripts.\u00a0 The suit alleges that these two PBMs\u2014which, according to the complaint, together control approximately 95% of the commercial PBM market &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/2024\/07\/22\/vermont-attorney-general-sues-two-of-largest-pbms-for-driving-up-drug-prices\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Vermont Attorney General Sues Two of Largest PBMs for Driving Up Drug Prices&#8221;<\/span><\/a><\/p>\n","protected":false},"author":341,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"ppma_author":[8],"class_list":["post-120","post","type-post","status-publish","format-standard","hentry","category-general"],"authors":[{"term_id":8,"user_id":341,"is_guest":0,"slug":"chcasey","display_name":"Christopher H. Casey","avatar_url":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-content\/uploads\/sites\/69\/2024\/06\/caseychris-100x100.jpg","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/posts\/120","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/users\/341"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/comments?post=120"}],"version-history":[{"count":0,"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/posts\/120\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/media?parent=120"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/categories?post=120"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/tags?post=120"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/stateattorneysgeneral\/wp-json\/wp\/v2\/ppma_author?post=120"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}