Suit Claims UnitedHealth Used Secret System To Pocket Excessive Profits Off Prescription Drugs
The lawsuit says that one member paid a $50 co-payment for Sprintec, a contraceptive, while UnitedHealth paid the pharmacy only $11.65. The pharmacy was then required to hand the extra $38.85 over to UnitedHealth under its agreement with the insurer.
Reuters:
Customers Sue UnitedHealth Over Prescription Drug Co-Pay Costs
UnitedHealth Group Inc has been sued by three customers who accused the largest U.S. health insurer of charging co-payments for prescription drugs that were higher than their actual cost and pocketing the difference. The lawsuit, filed Tuesday in federal court in Minnesota by three UnitedHealth customers, seeks to represent a nationwide class that it says could include "tens of thousands" of people insured by UnitedHealth. (Pierson, 10/5)
Bloomberg:
UnitedHealth Accused Of Gouging Customers On Prescription Drugs
Some UnitedHealth Group Inc. customers claim the health insurer defrauded them by setting up a system that secretly overcharged for prescription drugs. UnitedHealth customers made co-payments far in excess of the costs of actual drugs, sometimes paying $50 for a drug that cost the insurer less than $15, according to a lawsuit filed Tuesday in Minnesota. The accusations follow recent scandals over inflated drug prices involving Mylan NV’s EpiPen allergy treatment and former Turing Pharmaceuticals Chief Executive Officer Martin Shkreli’s more than 5,000 percent price hike for the drug Daraprim in 2015. Turing’s medicine treats a rare parasitic disease. (Feeley, 10/5)
Meanwhile, prisons can't afford the pricey hepatitis C medication, so prisoners are going untreated, and KHN offers a graphic to show just how the pipeline of drugs works —
Stat:
Less Than 1 Percent Of State Prisoners With Hepatitis C Get Treated Due To Cost Of Drugs
State prison systems are unable to lock up savings by using new hepatitis C treatments because they can’t afford the high price tags. Less than 1 percent of more than 106,200 inmates in 41 state prison systems were treated as of January 2015 with a new batch of revolutionary medicines, and most prison systems were unable to receive discounts available to other government agencies, according to a study published Wednesday in Health Affairs. The authors surveyed departments of corrections in all 50 states. (Silverman, 10/5)
Kaiser Health News:
Tracking Who Makes Money On A Brand-Name Drug
The path of prescription drugs from the factory to the patient is complicated. KHN's Julie Appleby explains how money flows through the system and contributes to the cost of a 30-day supply of a hypothetical brand-name medicine. (Appleby, 10/6)
And Novartis gets hit again over allegations it's improperly marketing its products —
Stat:
Novartis To Pay $35 Million To Settle Charges Of Illegally Promoting A Drug For Infants
Novartis has agreed to pay $35 million to settle charges of illegally promoting a prescription skin cream for use with infants and toddlers. The deal marks the second time in the past year the drug maker has struck a deal with US authorities to resolve allegations of improperly marketing its medicines. The agreement, announced on Wednesday, stems from a whistleblower lawsuit filed by a former Novartis sales representative, who accused the company of deliberately trying to widen the market for Elidel by encouraging prescriptions for children younger than 24 months, even though the medicine was not approved for that patient population. At one point, regulators issued a warning about the risk of cancer in small children. (Silverman, 10/5)