Updated: FTC charges Surescripts with monopolizing e-prescription market

[Editor’s note: This update includes a response from SureScripts CEO Tom Skelton.]

The U.S. Federal Trade Commission on Wednesday announced that it is charging Surescripts with illegal monopolization of the market for e-prescriptions. 


“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,” the FTC explained in a statement. “Among other things, the FTC alleges that Surescripts took steps to increase the costs of routing and eligibility multihoming through loyalty and exclusivity contracts.”  

FTC said it aims to achieve three things with the lawsuit: to undo Surescripts competitive methods and prevent them from happening again in the future, to restore competition in the marketplace and to provide “monetary redress to consumers.”


“For the past decade, Surescripts has used a series of anticompetitive contracts throughout the e-prescribing industry to eliminate competition and keep out competitors,” said Bureau of Competition Director Bruce Hoffman. “Surescripts’s illegal contracts denied customers and, ultimately, patients, the benefits of competition – including lower prices, increased output, thriving innovation, higher quality, and more customer choice. Through this litigation, we hope to eliminate the anticompetitive conduct, open the relevant markets to competition, and redress the harm that Surescripts’s conduct has caused.” 


From CEO Tom Skelton: “Surescripts is very disappointed at the allegations made today by the Federal Trade Commission. For more than 18 years, we have operated fairly in an innovative and dynamic marketplace to increase patient safety, lower costs and ensure quality healthcare. Surescripts pioneered the use of two-sided networks that enable the safe and secure exchange of patient health information. Since 2009, Surescripts has reduced the cost of electronic prescribing by 70 precent. And, since 2016 we have driven a 64 percent improvement in the accuracy of the more than 5 million electronic prescriptions we process each day.

“We are making an important change to our e-prescribing business agreements with pharmacies by removing the loyalty provisions in those contracts. This step addresses one of the FTC’s chief concerns while reflecting the current dynamics of the healthcare industry and the state of electronic prescribing today.

“Surescripts has been cooperating with the FTC throughout its investigation, and we remain focused on meeting our customers’ needs. We take seriously our role in helping medical professionals better serve patients, who are the ultimate beneficiaries of our nationwide health information network.”


In its complaint, the FTC cited the case against SureScripts as the latest example of its work to end anticompetitive tactics that harm consumers and ultimately raise the cost of care.

The agency pointed to settlements with Teva Pharmaceuticals and Impax Laboratories over reverse-payment patent settlements as well as the court order that AbbVie pay $448 million to people who overpaid for its Androgel testosterone replacement drug “because of AbbVie’s illegal tactics to maintain its monopoly over the drug.”

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