MESSAGE
| DATE | 2017-06-11 |
| FROM | Ruben Safir
|
| SUBJECT | Re: [Hangout - NYLXS] PBMs and Rebates... lets not just blame Abbott
|
Mylan Sued by Consumers claiming PBM Rebates Are Just Kickbacks
By Ed Silverman
April 03, 2017
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Three consumers filed a lawsuit accusing Mylan Pharmaceuticals of paying
kickbacks to pharmacy benefits managers in order to boost EpiPen sales,
which caused them to unfairly overpay for the allergy-reaction device
that has been at the center of the national debate over the high cost of
medicines.
Their allegations take aim at the convoluted interplay between drug
makers and pharmacy benefit managers, which are middlemen that negotiate
favorable insurance coverage for medicines on behalf of insurers. The
PBMs attempt to extract the best prices from drug makers and, for their
trouble receive rebates, some of which are held back as fees.
The lawsuit, which charges Mylan engaged in racketeering, seeks class
action status and claims that Mylan “gamed the system” and pretended to
blame PBMs for demanding ever-higher rebates for its decisions to
regularly raise the price for EpiPen.
The consumers maintain that Mylan paid continually higher rebates in
order to book larger sales and ensure favorable insurance coverage,
especially as competition to EpiPen arrived. The lawsuit, however,
argued that the rising rebates “saddled” consumers who either did not
have insurance or have high-deductible plans with “crushing
out-of-pocket expenses.”
One of the women who brought the suit, Lisa Vogel of Takoma Park, Md.,
purchased EpiPen Jr. two-packs several time for her son, who is allergic
to peanuts and amoxicillin, according to the lawsuit. Her family has a
high-deductible plan from Aetna and, on June 13, 2014, her out-of-pocket
cost was $351.73. A year later, on June 22, 2015, her share of the cost
$453.49, the lawsuit stated.
The lawsuit also pointed to recent research in the Journal of the
American Medical Association that found between January 2007 and
December 2014, out-of-pocket spending for each EpiPen patient rose
nearly 124 percent, to $75.50 from $33.80. “Mylan’s list price has
become an artificial and phony price established and driven up as part
of a kickback scheme from Mylan to the PBMs,” the lawsuit argued.
“Mylan is no victim,” the lawsuit continued. “Instead, Mylan
participated in and benefited from the high list price scheme and from
paying high rebates or kickbacks to PBMs to ensure EpiPen’s market
dominance. In fact, from at least 2008 until 2011, when Mylan stopped
reporting this information, EpiPen had a 95 percent market share” for
auto-injector allergy devices.
There are no PBMs named as defendants. A Mylan spokeswoman declined to
comment.
The lawsuit, which was filed in federal court in Seattle, comes several
months after EpiPen pricing caused outrage among parents who were
concerned about responding to a child’s serious allergic reaction. Over
the past decade, the list price rose by 500 percent, to $608 for a
two-pack, and some families began complaining vociferously last summer
as the new school year began.
Unlike previous pricing controversies, though, the EpiPen to-do raised
the role of PBMs and rebates. During testimony before Congress last
fall, Mylan chief executive officer Heather Bresch attempted to explain
that growing rebates meant that the company booked lower profits. This
prompted Congress to ask Mylan for PBM contracts and related documents,
although the company has been slow to respond and threatened with subpoenas.
Over the last few months, Mylan began selling a so-called authorized
generic at about $300 and, meanwhile, a rival device called Auvi-Q,
which had briefly competed with EpiPen before being withdrawn due to
product defects, returned to the market.
By the way, the law firm that represents the consumers, Hagens Berman
Sobol Shapiro, is the one of the same firms that filed a lawsuit two
months ago against several drug makers — Eli Lilly, Sanofi and Novo
Nordisk — for allegedly colluding to set prices for insulin. And in
years past, the law firm also successfully brought lawsuits against many
drug makers for inflating their average wholesale prices.
--
So many immigrant groups have swept through our town
that Brooklyn, like Atlantis, reaches mythological
proportions in the mind of the world - RI Safir 1998
http://www.mrbrklyn.com
DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002
http://www.nylxs.com - Leadership Development in Free Software
http://www2.mrbrklyn.com/resources - Unpublished Archive
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http://www.brooklyn-living.com
Being so tracked is for FARM ANIMALS and and extermination camps,
but incompatible with living as a free human being. -RI Safir 2013
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