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Another way CVS works with drug makers is receiving payments from them for marketing activities, including for sending letters to patients promoting a pharmaceutical firm’s drugs based on drug histories in CVS’s computers. This practice has landed CVS in legal trouble before, but it apparently continues.

In August 2007, a Massachusetts court ruled that CVS and a drug company had committed unfair and deceptive business practices in a program where CVS sent letters to its customers promoting the drug maker’s products.  The drug manufacturer, Merck, had been paying CVS a fee of $2 per letter to send the letters to patients with a certain medical profile. CVS hired an outside marketing firm, Elensys, to send the letters and – without patients’ permission – provided Elensys with a database of patients including their names, addresses and birthdates, and the letters they were to receive. 

A person with diabetes who received one of the letters sued, claiming in part that CVS had engaged in deceptive business practices by failing to disclose fully its arrangement with Merck.  The court ruled that CVS had deceived the customer by providing medical advice – recommending drugs – without revealing that it was “making a net profit each time it provides that medical advice.”  Even before the case was decided, hundreds of consumer complaints ultimately forced CVS to stop sending the letters to patients.  

However, CVS apparently continues to take money from drug companies, including Merck, to send letters to patients’ doctors promoting particular drugs. A doctor received the letter below in June 2008. CVS Caremark sent the letter to promote Merck’s diabetes medication, Januvia.  The letter was accompanied by several “chart inserts” that identified the doctor’s diabetes patients by name, patient identification number, and date of birth, and suggested that they might be candidates for a Januvia prescription.  According to G. Caleb Alexander, a University of Chicago associate professor of medicine, Januvia is five to 11 times more expensive than other diabetes therapies such as metformin and glipizide.

CVS’s aggressive use of intimate information for marketing purposes raises additional concerns because of CVS’s repeated failures to keep that information private and secure. A review of CVS’s record shows that the company has repeatedly exposed private information – both paper records and online data— to possible theft or public exposure.