Jan 23 (Reuters) - Oklahoma's attorney general has

accused CVS's Caremark pharmacy benefit manager unit of

under-reimbursing pharmacies for prescription drugs.

The complaint, announced Thursday by Oklahoma Attorney

General Gentner Drummond, marks the first case against a

pharmacy benefit manager brought before an administrative law

court within the attorney general's office. The administrative

procedure for enforcement actions against pharmacy benefit

managers was established in November 2023.

Pharmacy benefit managers, or PBMs, act as intermediaries

between drugmakers and consumers. They negotiate volume

discounts, or rebates, and fees with drugmakers, create lists of

medications covered by insurance, and reimburse pharmacies for

prescriptions.

The complaint identifies 200 individual prescriptions for

which Caremark paid 15 independent Oklahoma pharmacies less than

the drugs' acquisition cost, violating Oklahoma law. The law

allows the state to seek restitution from a PBM on behalf of

pharmacies that were underpaid, impose a fine of up to $10,000

per violation and revoke the PBM's license to operate in the

state.

"Collectively, these pharmacies lost thousands of dollars to

fill these prescriptions and help patients get the medications

they needed," Drummond said in a statement. "It is critical that

we have a safe and fair marketplace for pharmaceuticals in

Oklahoma."

"Caremark delivers value daily to our Oklahoma clients and

their members," CVS Caremark said in a statement. "We are

reviewing the allegations in the complaint and will respond to

them in due course."

PBMs have drawn scrutiny from state authorities in recent

years for their role in prescription drug pricing and

availability. All 50 states passed at least one law directed at

PBMs between 2017 and 2023, according to a U.S. Government

Accountability Office report.

The laws include measures aiming to ensure that PBMs do not

underpay pharmacies, charge patients excessive co-pays or

discriminate against independent pharmacies.

States including Vermont, Hawaii, California, Ohio and

Kentucky have filed lawsuits alleging that PBMs inflate

prescription drug prices to boost their profits.

The U.S. Federal Trade Commission said in a Jan. 14 report

that the three largest PBMs - Caremark, UnitedHealth Group's ( UNH )

Optum, and Cigna's ( CI ) Express Scripts - netted $7.3 billion in

revenue by marking up the prices of certain drugs.

The case is State of Oklahoma v. Caremark, PBM-2025-0001,

Administrative Court, Office of Oklahoma Attorney General.

For Oklahoma: Michael Leake and Mackenzie Kennedy of the

Attorney General's office

Read more:

US FTC finds major pharmacy benefit managers inflated drug

prices for $7.3 billion gain

Vermont latest state to sue PBMs for allegedly driving up

drug prices

(Reporting By Brendan Pierson in New York)