Blue Cross Blue Shield of Alabama is one of four Blue Cross groups that filed suit on May 27 against CVS Health for overcharging, sometimes by up to 20 times as much, for generic drugs.
Similar suits were filed by other parties against Rite Aid and Walgreens in 2018.
All the suits hang on the issue of whether drug prices under membership programs fit previous court definitions of “usual and customary” prices, a court-ordered standard that was set in a previous lawsuit against Kmart. Pharmacies were directed by the court to charge normal prices to insurance companies rather than the highly inflated prices that had become customary in the industry.
The Blue Cross groups say they are now finding a wide gap between the prices they are charged for generic drugs compared to a new set of prices offered under membership plans.
Blue Cross of North Carolina, for example, says it was charged $257 for the high blood pressure medicine Nadolol, compared to the $12 price CVS charged its club members.
Pharmacy groups contend that its membership prices are below what the courts have previously defined as customary and normal and are designed to serve customers who cannot afford insurance coverage.