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CVS Health Is Sued Over ‘Clawbacks’ of Prescription Drug Co-Pays

Accepted submission by Fnord666 at 2017-08-11 03:44:36
Techonomics

CVS Health Corp. and Walgreens Boots Alliance Inc. were sued by California customers who accused the drugstore operators of charging co-payments for certain prescription drugs that exceed the cost of medicines.

CVS, the largest U.S. pharmacy chain by number of stores, overbilled consumers who used insurance to pay for some generic drugs and wrongfully hid the fact that the medicines' cash price was cheaper, Megan Schultz said in her lawsuit. Schultz said in one case she paid $166 for a generic drug that would have cost only $92 if she'd known to pay cash.

[...] In her suit, Shultz accused CVS of clawing back her co-pay because the chain was in cahoots with the pharmacy benefit managers who got the extra money. The practice was part of CVS's agreements with benefit managers, such as Express Scripts Holding Co. and CVS Caremark, according to the suit filed Monday in federal court in Rhode Island. CVS is based in that state.

"CVS, motivated by profit, deliberately entered into these contracts, dedicating itself to the secret scheme that kept customers in the dark about the true price'' of drugs they purchased, Schultz's lawyers said in the suit, which is seeking group status.

[...] The lawsuits follow at least 16 other cases around the U.S. targeting drugstore chains' alleged co-pay clawback practices. The clawback occurs when patients hand over co-payments set by a pharmacy benefit manager that exceed the actual cash cost of the drug. The benefit managers pocket the difference, according to the complaints.

Most patients never realize there's a cheaper cash price because of clauses in contracts between pharmacies and benefit managers that bar the drugstore from telling people there's a lower-cost way to pay, according to the complaints.

[...] The cases are Megan Schultz v. CVS Health Corporation, 17-cv-359, U.S. District Court for the District of Rhode Island (Providence); and David Grabstald v. Walgreens Boots Alliance Inc., 17-5789, U.S. District Court, Northern District of Illinois (Chicago).

Source: Bloomberg [bloomberg.com]

Also at The Boston Globe [bostonglobe.com], The Chicago Tribune [chicagotribune.com], The Los Angeles Times [latimes.com], and NBCNews [nbcnews.com]


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