(888) 330-7295

Pfizer versus Johnson & Johnson?

Pfizer versus Johnson & Johnson?

In a recent turn of events, pharmaceutical company Pfizer filed a lawsuit against Johnson & Johnson over anticompetitive pricing allegations. Long story short, Pfizer has a biosimilar that competes with a Johnson & Johnson drug. Pfizer claims that J&J has made “’exclusionary contracts’ for Remicade with health insurers, hospitals and clinics effectively prevented them from offering Pfizer’s lower-priced copy so they could retain rebates and other J&J perks.”

“If such tactics are widespread, and I suspect they are, the Pfizer case will be the beginning of a wave of cases, challenging a behavior that helps drug companies erect competition-free zones, long after a drug’s patent has expired,” said Robin Feldman, director of the Institute for Innovation Law at the University of California Hastings.

The idea is that if these contracts are in place they prevent employer groups, employees, even the government from having the option to pick the lower priced drug. What is worse is this lawsuit concerns only two competing drugs. Now imagine there are hundreds of high cost drugs out there that could quite possibly currently be steered away from the cheaper version through similar contracts in what seems like an effort to keep a bigger slice of the pie.

Does this sound all to familiar with some other companies in the pharmaceutical industry?

Check this out, Mylan hit with racketeering suit over big price hikes of EpiPen.

Self-Insured ERISA Health Plans Sued

Over 100 CIGNA Administered Self-insured ERISA Health Plans Sued for Embezzlement-Health Plan Litigation Tsunami

This article highlights some major concerns in the Healthcare Industry. Let’s break it down. Alleged embezzlement by the major insurance company highlighted in the article from 100’s of self-insured companies. These are major companies including: JP Morgan Chase, Macy’s, etc., employing hundreds of thousands of people, that have been allegedly embezzled from. From an underwriting perspective, the allegedly embezzled claims that went through these plans ultimately lead to higher rates on premiums for the companies, as well as higher premiums for employees.

“Most troubling are accusations that the Plans, even after being alerted to these potentially illegal practices and despite formal complaints being lodged with the DOL, astonishingly continued to delegate and authorize Cigna, to investigate its own alleged wrongdoing!”

Why is that important? From an employee perspective now, look at the value of an annual raise. In industries with low margins, a good employee raise might be a small percentage of their annual salary. The value of the raise is immediately shot out of the window if the premiums and cost of healthcare are more than the actual raise. That is why it is so important to make sure the second biggest expense behind payroll, for most companies, is managed correctly and with good integrity.

Check out ClaimDOC’s blog for more healthcare industry news!