The class action lawsuit against CVS Health, Caremark, and Aetna was announced earlier today.
Editor’s Note: This is a developing story and will be updated with more information as it becomes available.
Update, 9/27/23: In a statement to Drug Topics’ sister site Formulary Watch, a CVS Health spokesperson said, “We believe the allegations are without merit, and intend to defend ourselves vigorously.”
A class action lawsuit has been filed against vertically consolidated businesses CVS Health, Caremark, and Aetna with the goal to “recoup for independent pharmacies millions of dollars” in what lawyers are calling “wrongful back-end penalties for Medicare Part D prescriptions,” or direct and indirect remuneration (DIR) fees, according to a press release from the National Community Pharmacists Association (NCPA).1
The lawsuit was announced today by Berger Montague PC and Cohen & Gresser LLP. The lawsuit claims that Caremark, which is the largest pharmacy benefit manager (PBM) in the country, as well as a subsidiary of CVS Health, has “been assessing pharmacy DIR fees in violation of federal antitrust laws and state laws governing contracts. The lawsuit also poses a challenge to “Caremark’s agreements to arbitrate claims as being unfair and unenforceable.”
“Finally, community pharmacies have a chance to recover DIR fees that were unfairly taken,” said B. Douglas Hey, NCPA CEO, in the news release. “PBMs have been gaming the system for a long time, and it’s time to turn the tables.”
In 2021 and 2022, arbitrations were successfully awarded to litigants against Caremark. In 2021, a judgment of $23 million was awarded to the AIDS Healthcare Foundation after finding that Caremark “breached the covenant of good faith and fairness” in implementing DIR practices. In 2022, another judgment of $2.1 million was awarded in wrongfully collected fees, as well as an additional $1.5 million in attorney’s fees and interests, due to the Caremark contract being “unconscionable.” Two district courts confirmed these awards in 2022 and 2023, respectively. READ MORE
Print Page
Email to a Friend