Lawsuit Claims CVS Overcharged Insured Customers for Drugs

A new lawsuit alleges CVS charges insured customers more for generic drugs. The lawsuit is seeking class-action status.

Plaintiff Megan Schultz accused the pharmacy chain of a “fraudulent scheme” that required her to pay $165.68 for a prescription that without insurance would only have cost $92 – and said the company failed to tell her she would pay less if she did not use her insurance.

The suit does not identify the specific prescriptions involved, but lists common prescription products such as Lexapro, Viagra, and amoxicillin as “affected drugs.” At least 16 other lawsuits have been filed accusing pharmacies of similar practices.

The complaint lays blame largely on the minimal regulation of pharmacy benefit managers who negotiate insurance payments to pharmacies. The suit alleges CVS has a financial incentive to offer pharmacy benefit managers a portion of sales.

Because arrangements between pharmacies and PBMs are confidential, the consumer has no way to know whether the amount the two parties negotiate is more than the price of the drug without insurance. The arrangement, therefore, allows the pharmacy to overcharge customers without their knowledge and funnel the balance back to the PBMs, the suit claims.