Across the country, upstart pharmacies are turning the prescription drug business on its head, offering digitally enabled mail-order offerings and more convenient ways for customers to get, and take, their medications. Massachusetts company PillPack, for instance, is pre-sorting drugs into daily regimens and shipping them to customers nationwide; another business, Capsule, is filling prescriptions on demand and delivering them to homes and workplaces across New York City.
But their ability to grow is largely controlled by existing competitors, including major pharmacy benefit managers who have been accused of twisting contract terms to block pharmacies’ access to their millions of U.S. customers.
Now, however, the Centers for Medicare and Medicaid Services has fired a warning shot. In a rule issued this week, the agency is telling PBMs and large insurers that participate in its Part D prescription drug program that they cannot selectively define the pharmacies they’ll work with to undercut unconventional companies.
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