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BCBS Alleges Teva Schemed to Force MS Drug Price Higher

Blue Cross Blue Shield's logo on a building.

"Lansing, Michigan, USA - March 14, 2012: The Blue Cross Blue Shield location in Lansing, Michigan. Founded in 1929, the Blue Cross Blue Shield Association is a network of insurance organizations that insure almost 100 million Americans."

According to a new lawsuit filed in Vermont federal court on Monday, Teva Pharmaceuticals acted anticompetitively to “induce health insurers and health plans in the United States to 9 pay billions for its excessively priced multiple sclerosis drug.” The suit was filed by Blue Cross Blue Shield of Vermont and The Vermont Health Plan.

The drug at issue, Copaxone, is a brand name for glatiramer acetate, a compound that Teva licensed in 1987 and has sold since 1997, the complaint says. The plaintiffs recount that the monthly cost for the drug when first sold was $769.15; it rose to $1000 by 2003 and by 2017 cost $5,832.

BCBS alleges that Teva’s campaign began with patent litigation abuse, designed to “artificially prolong Copaxone’s patent exclusivity and block lower-cost generics from entering the market.” The plaintiffs also allege that Teva did not lose sales to generics when they did enter the market.

According to the complaint, 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,” causing Copaxone to be prescribed and sold instead of generic competitors.

BCBS claims that Teva first circumvented cost-sharing mechanisms like co-pays often used by health insurers. Teva kept the price to the end user of their drug competitive with generics by providing coupons that reduced their cost-sharing obligations ,while keeping the drug fully priced for payors.

The plaintiffs also accuse Teva of evading drug substition laws that would have required the use of equivalent generics by changing the dosage of Copaxone prescribed.

The putative class is defined as “All entities in the United States and its territories that are at risk, pursuant to a contract, policy, or plan, to pay or reimburse all or part of the cost of prescription drugs prescribed to natural persons covered by such contract policy or plan….” who paid for Copaxone beginning in 2006.

The plaintiffs are seeking class certification, an injunction, and damages, including treble damages. They are represented by Keller Rohrback.

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