A key figure in AIPW’s lawsuit which demonstrates the consolidation and power of major PBMs:
Summary of the Transcript:
1. Plaintiff takes aim at pharmacy purchasing (page 6 lines 24 to 25) and its benefits (page 7 lines 6 to 10)
4. Count One discussion with Plaintiff (page 25 to page 34)
5. Count Two discussion with Plaintiff (page 34 to 37)
6. Count Four through Six with Plaintiff (page 37 to page 40)
7. Defendant (OptumRx) gives background on VAWD requirement (page 40 to 42)
8. Defendant seeks dismissal (page 42 to 59)
9. Court questions association standing (page 59 to 61)
10. Defendant comments (61 to 88)
11. Plaintiff response (88 to 98)
12. Defendant discusses California claims (page 98 to 115)
13. Plaintiff closes (page 115 to 120).
1. Count One: Violation of The Administrative Procedure Act (“APA”) (Against HHS Defendants)
2. Count Two: Declaratory Judgment (Against OptumRx And HHS Defendants)
As the court notes in the transcript, the plaintiff here (AIPW) does not actually have a direct contract with OptumRx. It merely feels the effect of Optum’s contract. The court questions plaintiff’s ability to even bring this claim because it has no real direct “stake” in the matter.
3. Count Three: Violation of The Regulatory Flexibility Act, 5 U.S.C. § 601 Et Seq. (As to The HHS Defendants)
Once again this count rests on the assumption that OptumRx is acting as an agent of the federal government and thus subject to the same rules and requirements that all federal agencies are. As stated above, to find this would have a massive ripple effect. For this claim to be found valid, the court will have to very narrowly tailor its ruling to apply just to OptumRx and this scenario.
In the case of the federal claims being dismissed, it would most certainly be best to transfer the case to a California federal court, as such a court would be much better suited to handle claims based solely on California law. Additionally, even if the federal claims were not dismissed, the court could sever the California based claims and have them transferred to a California court. Both the court and the Plaintiff acknowledge that a California court would most likely have jurisdiction over OptumRx, so in either scenario, a transfer of venue might be the best way forward.
In either case, it seems most proper that the California based claims be transferred to a federal court in California, as such a court would be most qualified to make a ruling based on California law. This would also help to dissuade plaintiffs from lumping on tangentially related state law claims in cases dealing mostly with federal matters and law.
Based just outside of Philadelphia, Five Rivers RX provides actionable guidance and excellent administrative services with a focus on client care across Compliance, Commercial, and Quality solutions. Our mission is to improve the health and welfare of the American public by providing solutions and implementing best practices for companies in the pharmaceutical supply chain.