Appeals Court Won’t Revive Collusion Case Against MS Drugmakers

A federal appeals court has declined to revive a whistleblower lawsuit alleging that a dozen drugmakers and pharmacy benefit managers (PBMs) colluded to defraud Medicare by driving up the price of multiple sclerosis (MS) drugs.

John Borzilleri, a healthcare investment fund manager, originally filed suit in U.S. District Court for the District of Rhode Island in 2014. The complaint alleged that pharma companies Bayer, Biogen, Merck KGaA, Novartis, Pfizer, Teva Pharmaceuticals and PBMs Aetna, Cigna, CVS Health, Express Script, Humana and UnitedHealth Group participated in the scheme.

In 2018, the Justice Department declined to pursue the matter because it couldn’t substantiate Borzilleri’s allegations. And in a Jan. 21 ruling the U.S. Court of Appeals for the First Circuit upheld a lower court’s ruling dismissing the complaint.