The FTC sued the health information company Surescripts, alleging that the company employed illegal vertical and horizontal restraints in order to maintain its monopolies over two electronic prescribing, or “e-prescribing,” markets: routing and eligibility. According to the complaint, Surescripts monopolized two separate markets for e-prescription services: The market for routing e-prescriptions, which uses technology that enables health care providers to send electronic prescriptions directly to pharmacies; and the market for determining eligibility, a separate service that enables health care providers to electronically determine patients’ eligibility for prescription coverage through access to insurance coverage and benefits information, usually through a pharmacy benefit manager.The FTC alleges that Surescripts intentionally set out to keep e-prescription routing and eligibility customers on both sides of each market from using additional platforms (a practice known as multihoming) using anticompetitive exclusivity agreements, threats, and other exclusionary tactics. Among other things, the FTC alleges that Surescripts took steps to increase the costs of routing and eligibility multihoming through loyalty and exclusivity contracts.
In July 2023, the FTC filed a proposed order that would resolve the Commission’s charges. The proposed order prohibits Surescripts from engaging in exclusionary conduct and executing or enforcing non-compete agreements with current and former employees. The proposed order also goes beyond routing and eligibility, extending the same prohibitions to Surescripts’ medication history services and the company’s on-demand formulary services.