Magazine article Drug Topics

Playing Rx Monopoly?

Magazine article Drug Topics

Playing Rx Monopoly?

Article excerpt

West Virginia alleges PCS, Rite Aid employ "unfair and deceptive practices'

West Virginia has filed a suit against PCS Health Systems Inc., PCS Mail Services, and Rite Aid Corp. Frances Hughes, managing deputy attorney general, said the state believes PCS and its parent company, Rite Aid, have a monopoly on prescriptions written for state employees by virtue of PCS' administration of pharmacy benefits for the Public Employees Insurance Agency (PEIA).

For its part, Rite Aid "believes that the suit is without merit, and we'll defend it vigorously," spokeswoman Allison Costello said.

Technically, all pharmacies in the state belong to the network PCS set up for PEIA. Monopoly charges have been made because PCS is allegedly "setting the reimbursement, particularly for multisource drugs, at a level that doesn't even meet the pharmacy's actual acquisition cost," Hughes said. The state has also alleged that PCS is denying access to available generics in order to collect a higher co-pay from patients, which would also violate state regulations. Also among the complaints are unreasonable co-pays for patients, and violations of state statutes and the West Virginia Pharmacy Practice Act.

West Virginia Pharmacists Association (WVPA) executive director Richard Stevens told Drug Topics the tactics are designed to shift patients to PCS mail order or Rite Aid retail locations. "Given that Rite Aid owns PCS mail order, Rite Aid wins either way," he said. According to the suit, PEIA pays for approximately 2.2 million prescription drug claims per year, at a cost of about $60 million.

In some cases, PCS is steering patients to specific Rite Aid locations and offering financial incentives to keep their business there, Stevens alleged. In one example he related, a manic depressive patient waited two weeks for PCS mail-order Rxs to arrive. When she called PCS to ask about the order's status, she was directed to go to a Rite Aid store in Petersburg, W Va., where she could pick up a 90-day supply of her four medications.

on July 23, Rite Aid sent an e-mail message to pharmacists with procedures to follow when patients are referred by PCS. The message informs pharmacists that in such an event, a PCS pharmacist would call the store to transfer the Rx, and that PCS "will enter a Management Access Override for this patient to allow up to a 90day supply with NO co-pay. …

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