PBM quickie: Feds join lawsuit against Medco

The Feds have backed two whistleblower suits against Medco.  The allegations claim that Medco used a variety of techniques to favor Merck (which owned Medco at the time) and was paid $430m in 2001 to switch scripts from Merck’s competitors. Back in March 2003, Milt Freudenheim in the New York Times highlighted Medco’s income from rebates (some $1 billion a year) and its ability to move share towards Merck’s drugs.

PBMs have for a long time made money from rebates, and have also been very economical with the truth to their health plan customers about how much they got from pharma companies for those rebates and how much was passed through to their customers.  However, during the late 1990s their performance seemed very ineffective in keeping down the cost of drugs for their plan and employer clients, either in reducing their usage or by holding down their unit price. For more of my take on PBMs see this post.

Interestingly enough, Medco’s stock price went up over a dollar in the latter part of the afternoon after 2pm when the confirmation (of somewhat old news) came out that the US Attorney’s office was joining the suit.

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9 replies »

  1. I have only been with Medco 3 months. Prior, my condition was well controlled and better than it had been in 10 years. Due to medication delays, claim denials despite having 4 separate preauthorizations/over-limit appeal approvals, changing demands (sometimes several times within one phone call), etc., years of progress is gone. Flare-up of condition known as Trigeminal Neuralgia (known as the suicide disease) due to Medco delays and poor processes, has caused severe pain, unplanned medical procedure to control flare-up (unseccessful), time off work getting into short-term leave, anxiety, need for two additional therapies, additional medications and counseling, impending self-pay at $12,000/month, and on and on.

  2. I have not taken a very important prescription for three weeks because Medco refuses to authorize filling it despite remaining refills and doctor’s orders staying the same. This is by far not the first time this has happened. I would like to participate in a lawsuit.

  3. Please, please , Please , Help me get in on this class action suit because I have almost had a heart attack over the stress that Medco put me under and the cruelest that any dirty rotten company I have ever seen I’d like to know how the people who run this company can sleep at night and do some of them are calling themselves Christians? I could not do this to anyone.! I was on a pain medication thatis a common cross-over for cancer patients. Nothing else has worked. The only way I can describe this pain is ats if someone caught my back on fire and put it out by beating me with a baseball bat . They actually paid for 1 prescription and then sent me a notice that I would have to dispute this finding. I had been on this medication for 8 years and cannot function without it or I am absoutly to the point of suicide the pain is so horendess. I f I could live without this pain medicine I would. for a year I would have. I kept get reassurance from the company my husband worked for Named Adecco that you just have to keep on them. When I worte the letter they then called to tell me that I had to have a doctors letter and pre-approval. I comlpied always with them saying I would be reimbursed all I had to do is save my my receipts and the copy of my payment and so I did this with the guaentee they would reimburse me as soon as they recieved this. I comlied again at the end of 1 year of this I was told that this is now once again denied. I am now out over $50,000.out of my savings . I now have Blue cross Blue shield due to my husband getting another job after being layed off. I am crushed that I cannot work due to the severity of my back pain (I have had 4 surgeries ) I also have a fatal lung disease which I told I only had 2 years to live 10 years ago. I am getting ill again and the day they told me I would get no reimbursement i had a small stroke called a TIA. I could not believe that they were such liars and would stup so low. Then they denied receiveing all this information and what I was told. This means my husband will left whith no money for my medical bills and all I had saved before I got hit by a drunk driver at noon who was uninsured or I would gladly have just suffered threw that year before leaving this earth.and no way to pay or bury me. They could take his house because of me. Please help I dont know how to join this lawsuit byt it would help immensly. This whole thing is literally sick with rashes and constant pain in mt chest thats how much this stress from this horrible place has cost me. Now they’ll probably cost me my life the stress has been so unbelievalbly stressed and bakrupt.
    Laura A. allen

  4. This is the same that happened to me. My doctor gave me a Keppra prescription and when I went through Medco, they converted it to a generic drug saying its FDA approved. I am frustrated with them and their switching medications.

  5. I myself would like to join a classaction lawsuit against Medco.
    I was forced to go to mail order with Medco after they sent me a letter stating they would only cover 3 months worth of long term medications at a local pharmacy. When I did switch to mail order it was a complete headache.
    They switched my EPILEPSY medication to generic when the prescription was written for brand names. Now they stop almost all coverage on them.
    For example my DILANTIN medication for a three month supply through medco is approxitmently $700.00. In January of 2010 they covered a little over $400.oo of that amount. I stretched the rest over 3 months. When I ordered again they ONLY COVERED $97.oo. When I sent the appeal in, WITH A LETTER FROM MY DOCTOR STATING I CANT TAKE GENERIC MEDICATION FOR MY SEIZURES DUE TO PAST EXPERIENCES, they said my coverage plan does not allow that. When I price my meds on there website for BRAND name it says I should only be paying approxitemenly $80.oo for 3 months.
    I have been in contact with a Medco manager there that is in complete awl and does not konw why I dont get my appeal granted for my medications to be priced as generics or discounted better than what they are giving. He also can not get a straight answer out of his boss either.
    Medco is charging what they want to make a profit. If there doing this to me think of how many millions of people out there this is happening to also.

  6. I would like to join in a class action lawsuit against Medco.
    I have suffered month after month problems receiving a controlled substance Adderall. I do not even use Medco and go to Sams Club now. They could never correctly deliver the drug. Presently, I am being denied Seroquel XR 300mg until June 2, 2010. I have seven tablets in my possession. I am on the phone with a pharmacist who is telling me to say: that I did not receive the full amount. I will not say that as I did not count the amount in the bottle.
    My doctor has had to jump thru hoops to get me AmbienCR and this will be the next fight. I am ready to just go and buy them at Sams regardless of cost and then take it off on my taxes.
    I can’t continue with this!!!! It is always the same thing…..you were given 90 pills, what if I lose one, and then they mail it when your script is out and you go one week without meds. I cannot take the highs and lows. The worst case scenario is I could be hospitalized against my will.
    I have sufferred withdrawl, pain and sufferring, outrageous out of pocket expense and extreme aggitation that exhasibirates my psychological condition! I cannot live like this. Medco must be held responsible!!!!
    Please let me know if you are still in litigation against Medco in a class action law suit.

    Please contact:
    Roger Matlin
    Medco settled $155,000,000 with Federal Gov in 2006. This legal action is for individuals (not Feds). Don’t let Medco continue to hurt you and your family.

    Please contact:
    Roger Matlin
    Medco settled $155,000,000 with Federal Gov in 2006. This legal action is for individuals (not Feds). Don’t let Medco continue to hurt you and your family.

  9. Seeking people to join class action against Medco Health Solutions (Medco) for changing prescriptions, modifying doctor prescriptions and shorting medications. Please contact:
    Roger Matlin
    Don’t allow Medco to continue injuring and/or killing people to make a few extra dollars.