Florida Attorney General James Uthmeier has issued a subpoena to CVS Health, citing concern about potential anticompetitive practices from the vertically integrated healthcare giant.
CVS Health is the parent company for one of the country's largest pharmacy benefit managers, Caremark, as well as thousands of retail pharmacies, including about 800 locations in the Sunshine State. Uthmeier's office said in an announcement that the probe aims to determine whether CVS is purposefully steering patients to its pharmacies or reimbursing its retail locations at higher rates than independent pharmacies.
The AG is also aiming to investigate if CVS is deploying audits to claw back payments or if it's enforcing contracts that could harm small businesses. Uthmeier's office is seeking "thousands of documents and sworn testimony on reimbursement rates, pharmacy contracts, patient steering, audits, rebates, differential treatment of own versus independent stores, and expansion plans" by July 28, according to the announcement.
“Florida families and seniors deserve access to affordable medication and real pharmacy choices—not a system rigged by one giant corporation that may favor its own stores and squeeze out competitors,” said Uthmeier. “This investigation will uncover the truth and protect fair competition for all Floridians.”
The rhetoric from Florida officials echoes other states that have taken action against vertically integrated conglomerates, with Arkansas and Tennessee implementing laws that bar PBMs from owning or being affiliated with pharmacies operating in their states.
The Arkansas law was blocked by a federal court last summer, while major PBMs like Caremark and Express Scripts as well as the Pharmaceutical Care Management Association, the industry's leading lobbying firm, have sued to challenge the law in Tennessee.
Independent pharmacies have railed against PBMs for years, arguing that they're actively working to put them out of business or squeeze their finances to line their own pockets. Aneesh Lakhani, incoming president of the Florida Pharmacy Association, said in the announcement that the group "will not rest until they are held fully accountable."
“The Attorney General’s action today sends a clear and necessary message: the era of unchecked PBM abuse in Florida is over,” Lakhani said.
A spokesperson for CVS told Fierce Healthcare that the company "will work with the Florida Attorney General to address any concerns." CVS welcomes the chance to partner with regulators and policymakers "to set the record straight" around pharmaceutical pricing dynamics, the spokesperson said.
"CVS Health works every day to put medicine within reach in Florida and across the United States. Drugmakers alone set the price of prescription drugs, and blaming a PBM for high drug prices is like blaming an umbrella for the rain," said the spokesperson.