Specialty pharma Irmat fights back, files suit against UnitedHealth Group in NY
- Irmat Pharmacy is suing Optum Rx, part of UnitedHealth Group, based on allegations that Optum RX wants to force members to only use its pharmacies. The suit was filed on Thursday in the NY Supreme Court.
- According to Optum Rx, however, Irmat was initially approved specifically as a retail-only pharmacy but started to provide pharmaceuticals by mail, breaching the agreement.
- Irmat has said that it has not had any problems with reimbursement from Optum Rx since it started its mail-order business. Irmat is located on Park Avenue in New York City, NY.
It's been less than a month since Valeant severed ties with the mail-order pharmacy, Philidor, but the fall-out has been intense. Since that high-profile incident, PBMs have started to investigate the practices of individual specialty pharmacies, as well as their relationships with pharma companies. These specialty pharmacies often provide drugs via mail order, though they may also have physical locations.
Shortly after Valeant terminated Philidor, Optum Rx followed suit and also ended its relationship with Philidor. Then Express Scripts dropped Linden Care Pharmacy because of concerns about its close ties to Horizon Pharma. Irmat has a lot to protect, considering that its business with Optum Rx has grown appreciably since $2 million in 2012 to $15.3 million in 2014 (forecast of $33 million in 2015 revenue). Part of that revenue came from programs sponsored by Galderma SA and Almirall SA.
Irmat is fighting back by seeking an injunction barring Optum from severing the relationship. According to Irmat, not only could this exclusion drive them out of business but it will also hurt consumers who depend on their relationship with Ormat to procure their medications.