Fighting the Drugstore Cowboys

The great captive specialty pharmacy crackdown of 2015 is on. Pharmacy benefit managers and big insurers are on the hunt for sketchy specialty and mail-order pharmacies, and they're squashing them.

It started with Valeant’s very ex-best friend Philidor, the pharmacy accused of existing pretty much entirely to boost Valeant sales by gaming the health insurance system. CVS Health cut ties with Philidor first, followed by everyone else. By getting caught so spectacularly, Philidor ruined things for everyone else in its business. Express Scripts followed up by dropping the hammer on Linden Care, accusing the specialty pharmacy of mostly distributing drugs from Horizon Pharma. At least eight pharmacies have been cut off recently, and PBMs and insurers are still looking for more. They're even tweaking audit algorithms to better track them down.