In recent months, Roche has demanded large payments from pharmacies that dispense Roche’s Accu-Check blood-glucose test strips (also called vials by Roche). Roche alleges that pharmacies have submitted reimbursement claims for Roche’s retail version of Accu-Check blood-glucose test strips but were involved in a “scheme” whereby it obtains and sells discounted vials of Roche durable medical equipment (DME) Accu-Check test strips. In its letter to pharmacies, Roche threatens to sue if the pharmacy does not immediately agree to remit payment to Roche for these allegedly “wrongfully” gained profits.
Two Roche units, Roche Diagnostics Corp. and Roche Diabetes Care, are already litigating claims against several pharmacies and medical supply companies. In its suit, Roche alleges that pharmacies and medical supply companies purchase blood glucose test strips at the lower DME price and take advantage of the price differences between test strips sold to people covered by DME plans and those covered by pharmacy benefits plans. Since test strips paid for by pharmacy plans have a significantly higher list price and insurance reimbursement rates, Roche accused pharmacies and medical supply companies of intentionally mis-billing DME products to wrongfully illicit profits, costing Roche an alleged $89 million in wrongful rebates and legitimate sales.
Roche’s current lawsuit in the District Court for the Southern District of Indiana is still pending and based on the recent issuance of letters to pharmacies demanding payment, Roche may be seeking to amend its list of defendants. On September 18, 2017, the District Court for the Southern District of Indiana dismissed Roche’s action against Pharmacy John Does 1-50 and provided that if, through discovery, the plaintiffs are able to learn the name of the unknown defendants, Roche may seek leave to add a claim against those individuals. As such, Roche appears to be eliciting information from pharmacies not only to demand payment, but also to potentially add pharmacies to its list of defendants.
Roche makes these allegations with nearly no factual support for its claims and demands payment or proof of purchase information from suspect pharmacies. Frier Levitt recommends discussing the matter with knowledgeable attorneys before providing any information to Roche.
If you or your pharmacy has been contacted by either Roche Diagnostics Corp. or Roche Diabetes Care, Inc., it is important that you act swiftly to ensure that your legal rights are protected. Contact Frier Levitt today to speak with an attorney.
See also: PHARMACY ALERT: Roche Begins Issuing Demand Letters Seeking Repayment for Test Strips Claims
