Frost Health LawPharmacy Attorney • Healthcare Executive

Antitrust analysis

The Algorithm and the Handshake

Two pending cases accuse drug middlemen of suppressing what pharmacies get paid. Only one of them needs a computer to explain how.

August 7, 2026 • 5 min read • Algorithmic pricing and pharmacy reimbursement

Two pending cases take opposite routes to the same allegation: unlawful coordination of pharmacy reimbursement rates.1

The first sits in Rhode Island. In April 2025, the Judicial Panel on Multidistrict Litigation consolidated claims against GoodRx and four pharmacy benefit managers before Judge Mary S. McElroy.2 Plaintiffs allege that GoodRx’s platform draws on confidential generic-drug reimbursement rates supplied by CVS Caremark, Express Scripts, MedImpact, Navitus, and other participants.3 For eligible transactions, the platform allegedly applies the lowest participating rate whenever that rate falls below the patient’s copay.4 Plaintiffs plead that arrangement as horizontal price fixing under Section 1 of the Sherman Act.5

The defense answer is that no meeting of the minds occurred. Each benefit manager signed its own contract with GoodRx. Plaintiffs responded in May that this framing misses the mechanism. They allege an automated reduction at the counter, not an information exchange followed by independent human decisions.6 They also point to GoodRx’s description of the program’s effect on independent pharmacies as “painful.”7

Whether the claim survives dismissal may turn on a question developed in another industry: whether the platform pooled competitively sensitive data.

Two rental housing cases show why. In RealPage and Duffy, district courts sustained claims alleging that competitors contributed proprietary data to a shared platform knowing rivals would do the same, then received recommendations informed by the combined pool.8 The Ninth Circuit affirmed dismissal in Gibson, where the complaint did not allege that the software shared any hotel’s confidential information among competing licensees.9 A New Jersey court dismissed an Atlantic City complaint after concluding that it failed to allege pooled or commingled data.10

On July 29, 2026, the Third Circuit reversed that Atlantic City dismissal. The court read the complaint to allege that the platform processed each hotel’s nonpublic data with data from its rivals and generated recommendations from the collective set.11 It emphasized allegations that participants supplied proprietary information knowing competitors would benefit.12 It also treated a break from historical pricing patterns, during conditions that should have encouraged discounting, as support for an inference of agreement.13 The court faulted the district court for overlooking the complexity and novelty of dynamic pricing software, which can facilitate coordination in ways unavailable in 1890.14 Because plaintiffs cannot inspect proprietary software before discovery, the court held that the complaint need not describe the platform’s internal operations in greater detail at the pleading stage.15

The pharmacy theory

The pharmacy theory shares that structure but adds two distinctions:

  • The inputs concern prices paid to suppliers, not retail prices charged to consumers. The alleged coordination therefore suppresses pharmacy reimbursement instead of raising a consumer-facing price.16
  • The alleged mechanism is automatic. The housing and hotel platforms recommended prices that users could accept or reject.8 Plaintiffs allege that the GoodRx platform selects and applies the lowest eligible rate at the point of sale, which strengthens their agreement theory if they establish pooling.16

The second pharmacy case needs no software theory. On July 2, 2026, an entity holding assigned claims from nearly 5,000 independent pharmacies sued Prime Therapeutics in Washington federal court.17 The complaint challenges a 2019 arrangement under which Express Scripts provided Prime with pharmacy-network and contracting services. Plaintiffs allege that Prime then adopted Express Scripts’ lower reimbursement rates and higher fees.18 The story alleges two competitors, one agreement, converging terms, a Sherman Act claim, and a contract claim.19

Together, the cases frame the doctrinal moment. One asks whether software can carry an agreement no executive stated aloud. The other alleges a direct agreement and turns on documents. If both survive dismissal, the decisions will show that pharmacy reimbursement claims can proceed through either theory. If only the Prime case survives, the pooled-data allegation may become a practical pleading requirement for software-based claims.20

When a machine coordinates prices, should antitrust law treat the mechanism differently from a human agreement?

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Source notes

  1. See In re GoodRx & Pharmacy Benefit Manager Antitrust Litigation (No. II), MDL No. 3148 (D.R.I.); Complaint, Protecting Access to Retail Pharmacy, LLC v. Prime Therapeutics, LLC, No. 2:26-cv-02335 (W.D. Wash. July 2, 2026).
  2. In re GoodRx & Pharmacy Benefit Manager Antitrust Litigation (No. II), MDL No. 3148 (D.R.I.).
  3. Plaintiffs’ Omnibus Response to Defendants’ Motions to Dismiss at 9–11, 33–37, In re GoodRx & Pharmacy Benefit Manager Antitrust Litigation (No. II), No. 1:25-md-03148-MSM-AEM (D.R.I. May 7, 2026).
  4. Id. at 9–11.
  5. 15 U.S.C. § 1; Plaintiffs’ Omnibus Response, supra note 3, at 1, 13–16.
  6. Plaintiffs’ Omnibus Response, supra note 3, at 1–2, 9–11.
  7. Id. at 2, 12, 36–37.
  8. In re RealPage, Inc., Rental Software Antitrust Litigation (No. II), 709 F. Supp. 3d 478, 510 (M.D. Tenn. 2023); Duffy v. Yardi Systems, Inc., 758 F. Supp. 3d 1283, 1293 (W.D. Wash. 2024).
  9. Gibson v. Cendyn Group, LLC, 148 F.4th 1069, 1076, 1083–88 (9th Cir. 2025), cert. denied, No. 25-1109, 2026 WL 1052046 (U.S. Apr. 20, 2026).
  10. Cornish-Adebiyi v. Caesars Entertainment, Inc., No. 1:23-cv-02536-KMW-EAP, 2024 WL 4356188, at *4–5 (D.N.J. Sept. 30, 2024), rev’d, No. 24-3006, slip op. (3d Cir. July 29, 2026).
  11. Cornish-Adebiyi v. Caesars Entertainment, Inc., No. 24-3006, slip op. at 35–43 (3d Cir. July 29, 2026).
  12. Id. at 26–27.
  13. Id. at 27–28, 31–35.
  14. Id. at 6–8, 39–43.
  15. Id. at 36–38.
  16. Plaintiffs’ Omnibus Response, supra note 3, at 9–11, 33–37.
  17. Complaint, Protecting Access to Retail Pharmacy, LLC v. Prime Therapeutics, LLC, No. 2:26-cv-02335 (W.D. Wash. July 2, 2026); Civil Rights Complaint, Protecting Access to Retail Pharmacy, LLC v. Prime Therapeutics, LLC, No. 2:26-cv-02335 (W.D. Wash. July 2, 2026).
  18. Complaint, supra note 17.
  19. Id.
  20. Compare Cornish-Adebiyi, No. 24-3006, slip op. at 35–43, with Plaintiffs’ Omnibus Response, supra note 3, at 33–37.