A group of EpiPen purchasers have sued their pharmacy benefit managers, known as PBMs, in federal court in Minneapolis. In a lawsuit filed by Berman DeValerio, the EpiPen purchasers claim the PBMs—Express Scripts, CVS Health, and Prime Therapeutics—bear responsibility for the massive increase in the amounts EpiPen purchasers paid out-of-pocket for EpiPen. A copy of the Complaint is available here. The EpiPen purchasers allege that instead of pushing for lower prices from Mylan, the drug company that markets and sells EpiPen, the PBMs demanded rebates from Mylan—and kept a significant amount of those rebates for themselves.

As reported by The Wall Street Journal, the price of an EpiPen two-pack has continuously increased from $93.88 in 2007 to $608.61 in 2016. The Plaintiff EpiPen purchasers allege that instead of negotiating for lower or stable prices for all health insurance plan members, the Defendant PBMs negotiated for increasingly larger rebates for themselves, driving up the price of EpiPen. Furthermore, rather than passing these rebates on to EpiPen purchasers in the form of lower or stable prices, Plaintiffs allege that Defendants kept significant amounts, resulting in massive revenue increases for themselves.

Plaintiffs further allege that Defendant PBMs’ alleged conduct has caused EpiPen deductible payments—the price paid by EpiPen purchasers with annual health insurance deductibles—to increase by nearly 1600%, and EpiPen coinsurance payments—the percentage of the EpiPen price paid by EpiPen purchasers with coinsurance—to increase by more than 1,500%. In seeking highly profitable rebates for EpiPen at the expense of plan members, the Plaintiff EpiPen purchasers allege that the Defendant PBMs breached their fiduciary duties under ERISA.

The case is brought on behalf of a proposed class of all persons in the United States and its territories who are participants in, or beneficiaries of, health insurance plans governed by ERISA who, pursuant to the terms of their health insurance plans, paid any portion of the purchase price for EpiPen or EpiPen Jr. between June 2, 2011 and the present. ERISA governs most employer-sponsored health insurance plans.

For more information about this action, you may contact Steven Groopman at (617) 542-8300 or visit www.bermandevalerio.com.

Berman DeValerio is a national law firm with offices in Boston, Massachusetts; San Francisco, California; and Palm Beach Gardens, Florida. Since its founding in 1982, Berman DeValerio has devoted its practice to complex litigation, on behalf of individuals, consumers, and its institutional clients.

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