Latest Arbitration Decision Rules in Favor of AHF


Ruling validates antitrust theory, pushes antitrust arbitration against Prime Therapeutics forward.

Red ribbon awareness on human hand with aged wood background with clipping path: World aids day: Symbolic concept for raising awareness campaign on people with HIV concept. Image Credit: Adobe Stock Images/Chinnapong

Image Credit: Adobe Stock Images/Chinnapong

AIDS Healthcare Foundation (AHF), a provider of healthcare to people living with HIV/AIDS, acquired a legal victory in an American Arbitration Association arbitration against Prime Therapeutics LLC, a pharmacy benefit manager (PBM). Per the ruling, AHF will be allowed to move forward against Prime on claims of antitrust violations and other civil wrongs.

In late June, Arbitrator David R. Cohen, Esq., issued his ruling granting in part, denying in part Prime’s motion to dismiss AHF’s case. Arbitrator Cohen retained five of AHF’s seven claims, dismissing only two. This originally dates back to April 2020, when reportedly, Prime had been deliberately aligning its pharmacy reimbursement rates with those of another PBM, Express Scripts, Inc, competing on price to attract pharmacies into provider networks.

"The arbitrator’s ruling is particularly noteworthy for validating AHF’s theory of per-se (automatic) antitrust violations in the nature of price-fixing by Prime. AHF is now preparing to prove those claims in the next phase of the arbitration," says Jonathan M. Eisenberg, deputy general counsel for AHF. "Arbitrator Cohen also deemed unreasonable and refused to enforce Prime’s contractual one-year statute of limitations that might have precluded any of AHF’s claims from even being heard."

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