Frier Levitt, Llc said on March 12 that some pharmacy benefit managers (PBMs) are placing hospital pharmacies into separate, lower-reimbursement networks that may violate the law and reflect broader abusive PBM practices.
The firm said these network structures could have significant implications for hospital pharmacies and the broader healthcare market. Frier Levitt says certain PBMs are using separate network structures in Alabama to reimburse hospital pharmacies at lower rates than similarly situated pharmacies, a practice the firm characterizes as discriminatory. The article frames the issue as part of a broader PBM playbook in which network design and payment terms are used to pressure providers, limit fair competition, and shift leverage toward the middlemen controlling access and reimbursement according to Frier Levitt.
The Federal Trade Commission (FTC) has also raised concerns about PBM practices. The FTC said in July 2024 that the six largest PBMs manage nearly 95 percent of all prescriptions filled in the United States, describing a highly concentrated and vertically integrated market. The agency said that structure has allowed PBMs to profit at the expense of patients and independent pharmacies, reinforcing concerns that discriminatory network practices can have broad market effects according to an FTC report.
In January 2025, the FTC said the Big 3 PBMs marked up numerous specialty generic drugs by hundreds or thousands of percent at affiliated pharmacies, generating more than $7.3 billion in revenue above estimated acquisition costs from 2017 to 2022. The report also said PBM-affiliated pharmacies captured 68 percent of specialty-drug dispensing revenue in 2023, up from 54 percent in 2016 according to another FTC report.
Frier Levitt describes itself as a national boutique law firm focused on healthcare, life sciences, and pharmacy. On its firm profile page, it says it has operated for 25 years and has more than 50 attorneys, many of whom are also licensed healthcare professionals. That sector-specific positioning helps explain why the firm is closely tracking PBM reimbursement, contracting, and network practices according to Frier Levitt.
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