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CVS faces a new lawsuit over its pharmacy networks for HIV/AIDS patients. Photo: RJ Sangosti / The Denver Post via Getty Images

Several HIV/AIDS patients have sued CVS Health, alleging the pharmacy giant flouted federal and state insurance laws by forcing patients into two options: fill their prescriptions at CVS locations or through CVS' mail order, or face thousands of dollars in out-of-pocket costs.

The big picture: It's another lawsuit that raises questions about how people with Aetna health insurance, especially those with expensive chronic conditions, would be treated if CVS got approval to acquire Aetna for $69 billion.

The class-action lawsuit, filed anonymously by patients due to the sensitivity of their conditions, also goes after employers like Amtrak that fund prescription drug plans for their employees and chose to use CVS. The suit boils down to a few key allegations:

  • Patients with a CVS drug plan previously had gone to other local, in-network specialty pharmacies to pick up their HIV/AIDS medications.
  • Patients were shocked to find out their old pharmacy was out-of-network, and they were on the hook for their medications, which could easily cost more than $2,000 a month.
  • CVS changed its pharmacy benefits a few years ago by requiring HIV/AIDS patients to either pick their drugs up at a CVS store or get them delivered to their homes, the suit claims.
  • One plaintiff who is not home several days a week said he found his 90-day mail-ordered supply of drugs "baking in the afternoon sun."
  • Patients also weren't comfortable picking up their drugs because many CVS stores lack private areas to ask questions.
  • The plaintiffs said they also weren't able to opt out of CVS' options.

The major question: Other lawsuits have alleged that CVS uses anticompetitive muscle to force business partners to use certain vendors. Would Aetna customers with conditions like HIV be forced to use CVS and cut ties with their old pharmacies at the risk of paying lots of money for prescriptions out of their pockets?

CVS' response: "We have not been served with this complaint and have not had an opportunity to thoroughly review the allegations. However, (CVS') highest priority is assuring patient access to clinically appropriate drugs while managing overall health care costs for our clients. To that end, we offer our clients multiple clinical tools and pharmacy network options targeted at achieving both of these goals."

Go deeper

Tracking the pandemic's unequal impact

Expand chart
Data: Morning Consult/Axios; Chart: Will Chase/Axios

The pandemic was bound to hit the most economically vulnerable among us the hardest. New polling data from Morning Consult, out this morning, shows the degree to which those difficulties were more concentrated among people of color.

Catch up quick: The Morning Consult/Axios Inequality Index has tracked the economic experience of adults in three wage groups since May 2020. We began publishing the findings in May of this year, and six months in, we’re slicing the data a little differently — and looking at inequality between ethnicities.

2 hours ago - Health

WHO says Omicron poses "very high" risk

World Health Organization Director-General Tedros Adhanom Ghebreyesus speaking in Geneva in October. Photo: Fabrice Coffrini/AFP via Getty Images

The World Health Organization said Monday in a new risk assessment that it believes the COVID-19 Omicron variant poses a "very high" risk to the globe because it may be more transmissible than other strains of the virus.

Why it matters: Though the WHO acknowledged there are still many uncertainties associated with the variant, the agency said it believes the likelihood of potential further spread of Omicron around the world is "high."

Battle for the soul of a new web

Illustration: Aïda Amer/Axios

A well-funded and intensely motivated chunk of tech's hive mind is finding common cause in a vast new project: rebuilding the web on a foundation of cryptocurrency and blockchain tech. They call it "Web3."

The big picture: Developers, investors and early adopters imagine a future in which the technologies that enable Bitcoin and Ethereum will break up the concentrated power today's tech giants wield and usher in a golden age of individual empowerment and entrepreneurial freedom.