No PBMs are listed as defendants in the lawsuit, but the complaint is critical of their role in inflating the list price of EpiPens. It outlines the system in which pharmaceutical companies like Mylan hike the list price of a drug in order to pay larger kickbacks or rebates to PBMs. In return, the company’s product gets favorable placement on insurers formularies, ensuring that it gets prescribed instead of a competitor.
“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 complaint says.
PBM industry groups have pushed back against drug makers who blame price increases on the rebate system.
"Mylan has spent the past year blaming Washington, the prescription drug supply chain, and competitors for its unusual pricing practices. It's time for them to look in the mirror and take responsibility for their own actions," the Pharmaceutical Care Management Association, an organization representing PBMs, said in response to the lawsuit.
IN-DEPTH REPORT: Consumers kept in the dark over drug pricing
The lawsuit brings claims under the Racketeer Influenced and Corrupt Organizations Act, a federal law historically used against organized crime.
This news organization has reached out to Mylan for comment.
Reporter Katie Wedell has written extensively on the relationship between PBMs and drug makers and its effect on out-of-pocket consumer costs.
Read more from the series here:
Who’s really controlling your drug prices? 5 things to know
Dayton man lead plaintiff in drug suit alleging price-gouging
Insulin makers accused of price-fixing scheme
$180,000 price tag for Miami Twp. boy’s prescription
How do prescription drug prices get set?
Do you have a tip or story about prescription drug prices?
Contact Katie Wedell at email@example.com, (937) 328-0353, @KatieWedell.
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