Woman sues CVS over generic drug co-pay 'clawbacks'

A California woman filed a lawsuit Aug. 7 against CVS Health Corp. for charging customers co-pays higher than the actual cost of medications, reports Bloomberg.

Megan Schultz purchased a generic drug from her local CVS for $165.68 under her insurance. She later found out the drug would have only cost $92 if she paid out of pocket, according to the suit. CVS pharmacists did not share this information with Ms. Schultz when she filled her prescription.

The lawsuit, which is seeking class action status, alleges CVS "remained silent and took her money" due to agreements with pharmacy benefit managers, who receive the extra co-pay money. The industry refers to these funneled payments as "clawbacks."

"CVS, motivated by profit, deliberately entered into these contracts, dedicating itself to the secret scheme that kept customers in the dark about the true price [of drugs]," the lawsuit reads.

CVS officials denied Ms. Schultz's claims and said the co-pays are set by PBMs. "The allegations against us made in this proposed class action suit are built on a false premise and are completely without merit," CVS spokesman Michael DeAngelis told Bloomberg Tuesday via email.

The lawsuit represents one of at least 16 filed nationwide against PBMs, insurers or pharmacy chains regarding clawbacks.

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