The ongoing legal case has shed new light on the motivations behind, and the execution of, OptumRx’s 2016 requirement.
OptumRx did not perform extensive research on the impact of requiring the VAWD Accreditation®.
Some OptumRx team members may have learned about the VAWD Accreditation® through a Google search.
OptumRx did not understand some of the basics of how regulation of the industry works.
OptumRx was in direct communication with a Big 3 wholesaler and they confirmed with them that they would have an indefinite grace period to achieve VAWD Accreditation® for all facilities, as long at least one facility has VAWD Accreditation®.
OptumRx has mulled over requiring independent pharmacies to obtain an Accreditation specific to independent pharmacies.
At least one senior executive at OptumRx considers independent pharmacies as a significant threat to the integrity of the supply chain.
The Real Motivation?
By enforcing the VAWD requirement, OptumRx has at least significantly reduced the amount of Market Arbitrage Activity (MAA) taking place in the industry. Specifically, MAA is passing along discount pricing from high volume pharmacies to low volume pharmacies. As of 2016, there were an estimated 400 drug wholesalers dedicated to MAA. Naturally, the Big 3 wholesalers did not like MAA because it generally depresses generic drug pricing for independent pharmacies, the most profitable sector of wholesale drug distribution.
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