Insurer Suits Take Aim at ‘Pay for Delay,’ Copay Assistance

In recently filed lawsuits, major health insurers accuse pharmaceutical companies of engaging in behavior that illegally boosted sales of their products. However, the alleged schemes are very different both in terms of how they work and whether policymakers are likely to step in and definitively end the practices, experts tell AIS Health.

Two of the lawsuits concern “pay-for-delay” deals, in which drug manufacturers sidestep competition for their branded products by offering patent settlements that effectively pay generic manufacturers not to bring their products to market. Humana Inc. and Centene Corp., in separate lawsuits filed in New Jersey’s District Court on Sept. 22, accuse Merck & Co., Inc. of using such a tactic when conspiring with generic manufacturers to delay the market entry of generic substitutes for two blockbuster cholesterol drugs, Vytorin and Zetia.

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