Pharmacy and medical organizations lauded a new class action lawsuit against CVS Health and Walgreens, alleging the two pharmacy chains colluded with pharmacy benefit managers (PBMs) to drive up the cost of generic drugs.
Pharmacy and medical organizations lauded a new class action lawsuit against CVS Health and Walgreens, alleging the two pharmacy chains colluded with pharmacy benefit managers (PBMs) to drive up the cost of generic drugs.
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Plaintiffs-pharmacy customers-state in the Rhode Island suit that they paid more out of pocket for drugs when they used their health insurance than if they had paid cash, due to collusion with third parties such as PBMs.
CVS and PBMs take part in “a fraudulent scheme,” through agreements based on “secret, undisclosed contracts”, the complaint states. In addition, these “secret” agreements could result in customers being charged more in copays than the price of the drug.
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Goldberg
"Unfortunately. This is nothing new. It’s everyday business practice for large PBMs to control what consumers pay and to pressure pharmacists into silence when it happens,” Robert Goldberg, PhD, co-founder and vice president of the Center for Medicine in the Public Interest and a medical economist, told FormularyWatch.
“What is really upsetting is the fact that patients deserve access to the best medical care and innovative medications that their doctor’s prescribe and PBMs should not act as barriers to a patient’s best possible medical care," Goldberg said.
“Fraud, waste and abuse is one of the single most important drivers of escalating costs in any business, and healthcare is no exception. Especially in matters of life or death-like healthcare-fraud, waste and abuse of any kind should not be tolerated,” said Sheila Arquette, executive director of the National Association of Specialty Pharmacy, in a statement.
“Unfortunately, the current market dynamics and lack of transparency make it very difficult for patients and healthcare providers to navigate the increasingly complex healthcare and drug delivery system,” Arquette added.
NASP is working with Washington, individual states, and others to institute reforms, and is hopeful that “PBMs will join us at the table, so we can work together to contain prescription drug costs,” Arquette said. “More transparency from big PBMs, along with others in the prescription drug supply chain, are critical to this important effort.”
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