KANSAS CITY — A federal judge has dismissed a nationwide class action lawsuit accusing major pharmacy benefit managers and affiliated companies of violating federal antitrust laws, ruling that the plaintiffs failed to state legally viable claims despite adequately alleging constitutional standing.
In an order from the United States District Court for the Western District of Missouri, the court granted a motion to dismiss filed by defendants, including UnitedHealth Group, OptumRX, Express Scripts and related entities.
The case challenged industry practices involving prescription drug rebates and pharmacy steering.
The remaining named plaintiffs were Skye Clements, an individual consumer who purchased the brand-name thyroid medication Tirosint through CVS pharmacies in Missouri, and two third-party payors: the Iberia Parish School Board in Louisiana and the City of Laurel, Mississippi.
They alleged that pharmacy benefit managers (PBMs) orchestrated a rebate system that inflated drug prices and steered patients toward affiliated pharmacies, in violation of Section 1 of the Sherman Act and Section 2(c) of the Robinson-Patman Act.
According to the amended complaint, the defendants operate vertically integrated enterprises spanning multiple levels of the pharmaceutical distribution chain, including PBM services and retail or specialty pharmacies.
The plaintiffs alleged that the three defendant groups collectively control nearly 80% of pharmaceutical transactions in the United States and use rebate aggregators to negotiate manufacturer rebates.
Because PBMs receive a percentage of those rebates, the plaintiffs claimed, they are incentivized to favor higher-priced drugs on formularies, resulting in increased wholesale prices and higher costs to consumers and plan sponsors.
The plaintiffs also alleged that defendants engaged in a “steering scheme” by limiting prescription options at unaffiliated pharmacies, imposing higher co-pays at competitors, restricting 90-day prescriptions and targeting consumers with communications encouraging use of affiliated pharmacies.
In addressing standing under Article III of the Constitution, the court rejected the defendants’ argument that the plaintiffs failed to allege injury.
The amended complaint expressly stated that each plaintiff paid higher prices for prescription drugs than they would have absent the alleged schemes.
The court also found the alleged injuries were sufficiently traceable to defendants’ conduct, even though manufacturers set wholesale prices, because plaintiffs alleged those price increases occurred in response to rebate practices imposed by PBMs.
The court further concluded that the named plaintiffs had standing to challenge the broader alleged scheme, even if they did not purchase every drug implicated in the lawsuit.
Because the alleged misconduct involved a unified pricing and rebate structure affecting all drug purchases, the claims were deemed substantially similar for standing purposes. However, the lawsuit ultimately failed on the merits.
While plaintiffs pointed to similar business practices among the defendant groups, the court found the alleged conduct occurred at different times over a span of years and under differing circumstances.
Because the complaint did not allege parallel conduct that tended to exclude the possibility of independent action, the court concluded the Sherman Act claim must be dismissed.
The court also dismissed the Robinson-Patman Act claim brought by the third-party payors.
Although plaintiffs alleged they paid inflated prices as a result of rebate arrangements, the court found that this type of injury was not the kind the statute was designed to prevent.
The Robinson-Patman Act is intended to protect competitors from discriminatory practices tied to purchasing power, not to remedy higher consumer prices resulting from rebate arrangements.
As ultimate purchasers rather than competitors, the third-party payors lacked antitrust standing under that statute.
The order grants the defendants’ motion to dismiss in full, ending the case at the district court level.
U.S. District Court for the Western District of Missouri, Western Division case number: 4:25-cv-00126
