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Drug Suppliers Face the Music in Illinois

Some major health care companies have been questioned by a state prosecutor taking aim at Medicaid fraud.

This month, both Merck (MRK - Get Report) and Cardinal Health (CAH - Get Report) revealed that they have fielded subpoenas from Illinois Attorney General Lisa Madigan. Merck said the prosecutor asked for information "related to repackaging of prescription drugs."

Then Cardinal issued a similar announcement, saying Illinois had begun "examining whether the company presented or caused to be presented false claims for payments to the Illinois Medicaid program related to repackaged pharmaceuticals."

Drug manufacturers such as Merck sell much of their supplies to three major distributors, including Cardinal, that operate drug repackaging arms. Those repackaging units break down bulk supplies and sell the drugs to pharmacies in more manageable quantities.

Now, Madigan seems to be questioning the big players in the drug supply chain.

Cardinal has portrayed its own repackaging unit, National PharmPak, as the largest operation of its kind. Competitors AmerisourceBergen (ABC - Get Report) and McKesson (MCK - Get Report) run giant repackaging units as well. During its investor day last year, AmerisourceBergen said the company's American Health Packaging division has "exceptional relationships" with 14 of the 17 largest brand-name drug manufacturers. Similarly, McKesson has said in the past that its own Rx-Pak division handles more than 175 different brand-name drugs.

"We do not believe Cardinal is the target of the investigation at this point," J.P. Morgan analyst Lisa Gill wrote after the company disclosed the investigation earlier this month. "We believe the subpoena serves a fact-finding purpose, and we expect others in the pharmaceutical channel to receive similar subpoenas."

In the meantime, Merck and Cardinal have said very little about their own subpoenas. Merck spokeswoman Amy Rose simply confirmed that the company had "received a subpoena, responded to it and is cooperating with the investigation." Cardinal didn't return phone messages from seeking further elaboration on Tuesday. Neither AmerisourceBergen nor McKesson said whether they have been questioned by Madigan.

Track Record

Madigan has caused a stir by pursuing some other big health care companies already.

Back in January, the Chicago Tribune reported, Madigan subpoenaed Caremark (CMX) -- a giant pharmacy benefit manager -- for allegedly reselling drugs that had been returned through the mail. Illinois has since replaced Caremark, which has denied any wrongdoing, with a competing PBM.
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