A lawsuit was filed against CVS, the country’s largest pharmacy chain, claiming CVS charges customers with insurance more than it does those without. The suit, filed Monday in Rhode Island, accuses CVS Health Corporation of overbilling customers who used insurance to pay for certain generic drugs. The chain also failed to disclose that medicines’ cash price was cheaper than amount billed for those using insurance, Bloomberg reported. The suit’s Plaintiff, Megan Schultz, cited an incident where she paid $166 for a generic drug that would have cost $92 if she had paid cash. In another case, Ms. Schultz paid $101 for a drug that had a cash price of $49.45. It’s alleged in the complaint:
CVS never told her that paying in cash would allow her to pay 45 percent less for the drug; instead, CVS remained silent and took her money – knowing full well that no reasonable consumer would make such a choice.
The suit claims the problem centers on money sent back to pharmacy benefit managers, or PBMs, which serve as the intermediaries between insurance companies and pharmacy chains. PBMs negotiate the prices paid by insurance companies and, in return, receive a portion of the pharmacy’s sales, a process known as “clawbacks.” Customers are left paying the negotiated amount – detailed in confidential contracts – even if that “amount exceeds the price of the drug without insurance,” the suit claims. The lawsuit seeks class-action status.
The affected drugs, according to the suit’s lawyers, include such commonly prescribed ones as amoxicillin, Lexapro, penicillin, prednisone, Tamiflu and Viagra. CVS denies the allegations.
Source: NBC News
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