Billions of prescriptions are filled electronically every year. Photo: George Frey/Getty Images

A small pharmacy in New York has filed a class-action lawsuit against Surescripts, alleging that the company conspired with other health technology vendors to keep monopoly control over the market for electronically filled prescriptions.

The big picture: Antitrust litigation is piling up quickly against Surescripts, as the company's customers and federal regulators alike believe it has locked competitors out of a space that has become necessary to fill four out of five drug prescriptions.

Between the lines: A lot of the lawsuit, filed by Falconer Pharmacy, builds on allegations from the Federal Trade Commission and Amazon.

  • Namely, it says Surescripts has forced pharmacies and vendors to use only its electronic prescribing network at noncompetitive rates, or else face even higher prices as "non-loyal" customers.
  • Falconer Pharmacy said in the complaint that it pays "at least 17 cents per routing transaction," but Surescripts has previously revealed that more competitive prices would be between one and three cents per transaction.

But, but, but: The lawsuit goes one step further, naming technology vendors RelayHealth (part of McKesson) and Allscripts as co-conspirators.

  • RelayHealth and Allscripts signed contracts that forced them to use Surescripts exclusively, but Surescripts passed along incentive payments to them in return, according to the complaint.
  • McKesson and Allscripts did not immediately respond for comment.

Surescripts CEO Tom Skelton said the company is "disappointed in the allegations."

  • "We take seriously our role in helping serve patients and the people who care for them, and we remain confident that our business practices support that goal.”

The bottom line: Surescripts is one of the most obvious monopolies in health care. The increasing legal heat raises questions about whether regulators and policymakers would advocate for breaking up the company or mandating price concessions.

Editor's note: This post has been updated to note RelayHealth's pharmacy business remains part of McKesson, not Change Healthcare.

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