Medicaid Monitor
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Medicaid Monitor
Policy Intelligence
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Legal·July 7, 2026

5,000 Independent Pharmacies Sue Prime Therapeutics for Alleged Antitrust Violations

Nearly 5,000 independent pharmacies filed a federal antitrust lawsuit on July 2, 2026, in the U.S. District Court for the Western District of Washington against Prime Therapeutics, alleging the PBM conspired with Express Scripts to suppress pharmacy reimbursement rates and increase fees. The complaint claims violations of federal antitrust law through coordinated pricing practices. The lawsuit targets PBM reimbursement methodologies that affect pharmacy network economics. This litigation follows broader scrutiny of PBM pricing practices and their impact on pharmacy access.

Why it matters for managed care

Medicaid managed care plans contracting with Prime Therapeutics or Express Scripts may face network adequacy risks if independent pharmacies exit networks or if litigation leads to court-ordered changes in PBM reimbursement models.

Pharmacy · Managed Care

Read the full article at beckershospitalreview.com

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