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Lawsuit alleges Biogen schemed with PBMs to preserve Tecfidera market

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A lawsuit filed against Biogen last week alleges the company participated in a kickback scheme with pharmacy benefit managers to promote its blockbuster multiple sclerosis drug Tecfidera instead of generic versions.

The lawsuit, filed by a health plan called Local No. 1 Health Fund in the Northern District of Illinois, says that when Biogen developed its next-gen version of Tecfidera, called Vumerity, it claimed that the drug was “new and improved,” even though medically it didn’t work better than Tecfidera. The lawsuit added that Biogen’s plan was to get doctors to prescribe Vumerity before generic versions of Tecfidera became available.

But the timing of the “market switch” didn’t work in Biogen’s favor, leading the company to enter into “unlawful restraints of trade” with Caremark Rx (now CVS Caremark), OptumRx and Express Scripts, the lawsuit reads.

“Biogen paid the PBMs to manipulate the placement of generic Tecfidera on their formularies — the lists that identify which drugs are covered and establish the applicable patient copayments and coinsurance,” according to the lawsuit. “Biogen paid each of the three PBMs (and others) to refrain from advantaging generic Tecfidera over branded Tecfidera and Vumerity on their formularies. Biogen labeled these payments as ‘rebates’ or ‘fees’. In reality they were kickbacks to the PBMs for helping to insulate Tecfidera and Vumerity from lower-priced generic competition.”

The health fund is asking the court for damages and attorneys’ costs.

A representative for Biogen told Endpoints News the company does not comment on pending litigation.

While Biogen’s fight to prevent Tecfidera competition failed in the US, it partially succeeded in Europe last year. The European Commission decided to extend regulatory market protection of Tecfidera until Feb. 2, 2025.

The drug has long been a major revenue generator for Biogen, but sales have dwindled since generics were able to enter the market in the US. The drug brought in $4.4 billion in revenue in 2019, but revenues have since dropped to $1.4 billion in 2022 and just over $1 billion in 2023.


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