A recently filed federal lawsuit claims that the largest drugstore chain, Walgreens, and a generic drug manufacturer, Par Pharmaceuticals Cos., overcharged insurance companies, union health and welfare funds, and self-insured employers for generic versions of Prozac, Zantac, and generic versions of other common prescription medications manufactured by Par by providing and billing for higher-priced capsules of the drugs rather than the tablets prescribed by physicians. The alleged overcharging occurred between April, 1999 and December, 2006, and allegedly resulted in millions of dollars in over-payments and unjustified profits for Walgreens and Par.
Walgreens had paid $35 million in 2008 to settle federal and states claims that it was overcharging Medicaid programs for a generic version of Zantac and a generic version of Prozac.
Source (United Food and Commercial Workers Unions and Employers Midwest Health Benefits Fund vs. Walgreen Co., U.S. District Court for the Northern District of Illinois, Case No. 12-CV-00204).
The ever-increasing cost to American taxpayers for health care, including prescription medications, is taking its toll on our economy. Various economic commentators cite different reasons for the high costs of health care in the U.S.: the overuse of high-cost medical care systems such as hospital emergency rooms by the uninsured for care that should be provided by less-costly health clinics or other outpatient providers; the high cost and overuse of specialized care and costly medical testing; the high cost of medical malpractice insurance premiums; the cost of medical malpractice settlements and verdicts, etc. But perhaps the most troubling source of increasing medical care costs is medical fraud.
Medical fraud comes in many forms: doctors and other medical providers billing for services and medical equipment not provided; billing for more costly procedures than were provided; performing procedures not medically necessary, etc. Medicare is assigned with the task of investigating possible Medicare fraud claims and referring claims of fraud found to be valid for civil or criminal prosecution.
The cost of prescription drugs represents a large portion of health care costs in the U.S. Chronic medical conditions may require long-term use of expensive prescription medications. Acute medical conditions may also require the use of expensive prescription medications. The typical argument in favor of generic drugs is that they are just as effective as the name-brand drugs but are less costly to produce and cost the consumer much less than the name-brand drugs. The promise of savings by using generic versions of drugs is one reason why Medicare, Medicaid, and health insurance companies prefer that the generic versions be substituted for the prescribed name-brand drugs, if appropriate.
The massive amounts spent on prescription medications in the U.S. makes it ripe for fraud and abuse. Millions of dollars in unjustified profits can be earned if the system for reimbursement is used inappropriately. One must question how much cases of prescription medication fraud and prescription medication misuse or abuse are costing Americans who can little afford the costs. Anyone found to have committed intentional overcharging for prescription drugs should be penalized to the fullest extent of the applicable laws.
If you or a loved one have been harmed by a drug, you may be entitled to compensation for your injuries and losses.
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