BCBS Vermont suing Teva Pharmaceuticals over MS drug marketing

Photo: Jeff Lagasse/Healthcare Finance News

Blue Cross and Blue Shield of Vermont, along with the Vermont Health Plan, has filed a lawsuit against Teva Pharmaceuticals, claiming the company has used unsound marketing practices to promote and sell Copaxone, a drug used to treat multiple sclerosis.

Specifically, BCBS is accusing the pharmaceutical company of offering coupons to consumers to prevent them from switching to a generic, lower-cost version of the drug. Though consumers were able to access the drug affordably, BCBS was left to pick up the difference between Capoxone and a generic alternative, according to the suit.

Between 2002 and 2019, Teva made $34 billion from Copaxone, the lawsuit stated. The company began selling the drug in 1997 for about $770, but raised the price to $1,000 in 2003 and again to almost $6,000 by 2017.

What this means, alleges BCBS, is that Teva exploited the "fundamental disconnect" between the entities that pay for prescription medications – such as employers and insurers who pay claims incurred by health plan members – and the people and entities that determine which products are actually purchased, such as doctors, benefit managers, pharmacists and health plan members.

WHAT'S THE IMPACT

Among the other accusations levied against the pharmaceutical company is that it artificially prolonged Copaxone's patent exclusivity, and blocked lower-cost generics from entering the market.

BCBS claimed in the suit that Teva "manipulated the prescribing decisions of doctors, the product selection decisions of pharmacists, the drug prioritization and formulary decisions of pharmacy benefit managers, and the purchasing decisions of health plan members." 

The insurer also accused Teva of evading drug substitution laws that would have mandated the use of generic equivalents by changing Copaxone's prescribed dosage.

Teva, "in collusion with pharmacy benefit managers, then resorted to anticompetitive, unfair, and deceptive tactics to coerce and otherwise induce patients and doctors to switch to the new dosage, over which Teva improperly claimed and for some time received extended patent exclusivity," the lawsuit alleged.

Teva did not respond to a request for comment.

THE LARGER TREND

In 2019, insurer Humana filed a lawsuit accusing Teva and 36 other pharmaceutical companies of price fixing in the generic market. Humana alleged a conspiracy to drive up the cost of generic drugs, in some cases by 1,000% or more.

Among the defendants, Humana singled out Teva as spearheading what it called the "overarching conspiracy" to leverage a "culture of cronyism in the generic drug industry."

Teva selected a core group of "high quality" conspirators and targeted drugs in which Teva and these companies overlapped for price increases, understanding that they would lead and follow each other's price increases, and did so frequently and successfully, Humana claimed.

This was part of an even larger overarching conspiracy and understanding of how the generic manufacturers fix prices and allocate markets to suppress competition, Humana said.

The case, in the Eastern District of Pennsylvania, is ongoing.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com