Abood R R
Am J Law Med. 1985;11(3):293-317.
Emphasis on cost containment by third-party payors has intensified economic competition within the health care system, creating powerful market forces which retail pharmacists had not envisioned a few years ago. Hospitals and alternative delivery systems now sell prescription drugs in direct competition with retail pharmacists. These entities are able to purchase their pharmaceuticals from manufacturers at prices far below those of the retailers. Retail pharmacist plaintiffs allege that such activities violate the Robinson-Patman Act which prohibits price discrimination. Retail pharmacists have achieved landmark victories in decisions establishing that nonprofit, state and local governmental hospitals reselling pharmaceuticals in competition with retail pharmacies are not exempt from the Act. This Article demonstrates that despite these victories, plaintiffs will have difficulty proving an actual violation of the Act by manufacturers and hospitals. Plaintiffs must establish competitive injury as well as refute the meeting competition defense. Retail pharmacists might discover that the Robinson-Patman Act is not the ally they had hoped for; instead, they should concentrate on innovative alternatives which will allow them to compete in an evolving health care system.
第三方付款人对成本控制的重视加剧了医疗保健系统内的经济竞争,产生了强大的市场力量,而这是零售药剂师几年前未曾预料到的。医院和其他替代服务系统现在销售处方药,与零售药剂师直接竞争。这些实体能够以远低于零售商的价格从制造商那里购买药品。零售药剂师原告声称,此类活动违反了禁止价格歧视的《罗宾逊-帕特曼法案》。在一些判决中,零售药剂师取得了具有里程碑意义的胜利,这些判决认定,与零售药店竞争转售药品的非营利性州和地方政府医院不能豁免于该法案。本文表明,尽管取得了这些胜利,但原告在证明制造商和医院实际违反该法案方面仍将面临困难。原告必须证明存在竞争损害,并反驳应对竞争抗辩。零售药剂师可能会发现,《罗宾逊-帕特曼法案》并非他们所期望的盟友;相反,他们应专注于创新的替代方案,以便能在不断发展的医疗保健系统中参与竞争。