(Replaces older statement from CVS Caremark that was mistakenly

used in paragraph 6 with current statement)

By Brendan Pierson

Nov 27 (Reuters) - Two independent pharmacies are

seeking to centralize in Rhode Island federal court at least

four proposed class action lawsuits accusing drug coupon

aggregator GoodRx and pharmacy benefit managers, including CVS

Caremark and Cigna's ( CI ) Express Scripts, of

attempting to push small pharmacies out of the market by

depriving them of payments for generic drugs.

In a motion filed on Tuesday before the U.S. Judicial Panel

on Multidistrict Litigation, Pennsylvania-based Old Baltimore

Pike Apothecary and Smith's Pharmacy said that the court in

Providence was a convenient venue because CVS Caremark is

headquartered there, and because it has a relatively light

docket and is easily reachable by plane and train.

In a lawsuit filed in the Rhode Island court, the two

pharmacies accused GoodRx, CVS Caremark, Express Scripts and

privately-held PBMs Navitus and MedImpact of working together to

suppress reimbursements to small pharmacies for generic

prescription drugs.

Three other similar lawsuits have been filed in federal

court in Los Angeles, California, near GoodRx's Santa Monica

headquarters. If the judicial panel grants Tuesday's motion,

those cases would be transferred to a newly created

multidistrict litigation in Rhode Island for pretrial

proceedings.

The lawyers seeking the MDL also filed a new class action in

the Rhode Island court on Tuesday on behalf of Hunnington

Pharmacy in Alabama. That case is not included in the motion to

centralize the cases.

"In nearly all cases, CVS Caremark reimburses independent

pharmacies at higher levels than chain drugstores, including CVS

pharmacies," said CVS Caremark spokesperson Phillip Blando.

"These lawsuits are entirely without merit, and we will

vigorously defend against them."

Navitus declined to comment, as did a lawyer for one of the

California plaintiffs. Other defendants and the other California

plaintiffs' lawyers did not immediately respond to requests for

comment.

PBMs negotiate prescription drug prices between insurers,

pharmacies and drugmakers, and directly reimburse pharmacies for

prescription drugs under the terms of the plans they have

negotiated. They also offer discount cards that patients can use

at their pharmacy networks, which were historically often used

by people without insurance to pay for drugs out of pocket.

Until recently, according to the lawsuits, patients could

choose to use a discount card instead of their insurance plan if

it offered a lower price, but the payment would not be counted

toward their deductible. GoodRx is a service that patients can

use to check what discounts are available for a drug at a

particular pharmacy.

The plaintiffs allege that, starting last year, the PBMs and

GoodRx entered into agreements in which the PBMs would use

GoodRx's software to compare all available discounts for all

patients' generic drug prescriptions, and route each purchase

through the PBM with the lowest price - even if it was different

than the patient's PBM.

The pharmacy pays a fee, which under the new agreement is

split between the patient's PBM and the PBM that handles the

purchase. The PBMs do not reimburse pharmacies for these

transactions, meaning the patients' cash payment represents the

pharmacies' only revenue, and PBMs' profits increase, the

lawsuits say.

Large pharmacies, including those directly affiliated with

PBMs, such as CVS, can weather the lower reimbursements, but

independent pharmacies cannot, the lawsuits say. They allege

that the scheme aims to drive smaller pharmacies, which compete

with larger PBM affiliates, out of the market, violating federal

antitrust law.

The plaintiffs are seeking unspecified damages and court

orders stopping the allegedly anticompetitive conduct.

The California plaintiffs are Minnesota-based Keaveny Drug,

Michigan-based Community Care Pharmacy and Florida-based Ethos

Wellness Pharmacy.

PBMs' business practices have drawn increasing scrutiny in

recent years, including by the U.S. Federal Trade Commission

accusing the three largest PBMs of driving up the cost of

insulin drugs.

The case is In re: GoodRx and Pharmacy Benefit Manager

Antitrust Litigation, U.S. Judicial Panel on Multidistrict

Litigation, No. 74.

For Rhode Island plaintiffs: Gregory Asciolla of DiCello

Levitt, Stephen Prignano of McIntyre Tate and Joshua Grabar of

Grabar Law Office and others

For Keaveny Drug: Heidi Silton of Lockridge Grindal Nauen,

Bobby Pouya of Pearson Warshaw and others

For Community Care Pharmacy: Halley Josephs of Susman

Godfrey; Natasha Fernandez-Silber of Edelson and others

For Ethos Wellness: Mark Richards of the Clarkson Law Firm,

Jason Sultzer of Sultzer & Lipari and others

For GoodRx: David Lender of Weil, Gotshal & Manges and

others

For CVS Caremark: Robert Atkins of Paul, Weiss, Rifkind,

Wharton & Garrison and others

For MedImpact: Michelle Lowery of McDermott Will & Emery and

others

For Navitus: Michael Jusczyk of Greenberg Traurig and others

For Express Scripts: Not available

Read more:

GoodRx, PBMs accused of suppressing reimbursements to

independent pharmacies

Why are US pharmacy benefit managers under fire?