Justice Department Joins Two Whistleblower Lawsuits Against Medco Health Solutions
The Justice Department yesterday joined two whistleblower lawsuits against pharmacy benefit manager Medco Health Solutions, a subsidiary of Merck, the Philadelphia Inquirer reports. The lawsuits, which were unsealed yesterday, allege that Medco improperly destroyed patient prescriptions and often switched patients to Merck medications, which were more expensive in some cases (Loyd, Philadelphia Inquirer, 6/24). Pharmacists George Hunt and Walter Gaucher, who had worked in a Medco mail-order facility in Las Vegas, filed one of the lawsuits in 1999, and Dr. Joseph Piacentile, identified only as a New Jersey physician, filed the second suit in 2000 (Freudenheim, New York Times, 6/24). According to the lawsuits, filed in federal court in Philadelphia, Medco:
- Defrauded government agencies by "switching patients from one drug to another drug without their consent or knowledge, at an increased expense" to health insurance programs such as Medicaid and Medicare;
- Destroyed prescriptions on days with high mail order volume to avoid delays that could have led to contractual performance penalties (Philadelphia Inquirer, 6/24);
- Mailed patients less than the number of pills ordered but charged them for the amount ordered (Duhigg, Washington Post, 6/24);
- Misled physicians that they could help the company "meet its control objectives" through a switch to Merck medications (Philadelphia Inquirer, 6/24);
- Prompted physicians to switch their prescriptions because of undisclosed payments to Medco from pharmaceutical companies; and
- Hired employees who "seldom have college degrees and have no prior training in pharmacy services other than limited on-the-job training" to call physicians to discuss potential adverse interactions between medications; many of the employees lied about calls made to physicians because they could not meet their quota of 20 to 25 calls per hour.