CVS Health Inc's (NYSE:CVS) subsidiary, Aetna Inc., has filed a lawsuit against more than 20 generic drug manufacturers. The lawsuit alleges a coordinated scheme to fix prices, allocate markets, and stifle competition.

The result was a significant overcharge for essential medications.

Defendants include Teva Pharmaceutical Industries Ltd (NYSE:TEVA), Amneal Pharmaceuticals Inc. (NASDAQ:AMRX), Dr. Reddy's Laboratories Inc. (NYSE:RDY), Novartis AG (NYSE:NVS), Pfizer Inc. (NYSE:PFE), Viatris, Inc. (NASDAQ:VTRS), among others.

The lawsuit accuses the defendants of orchestrating one of the largest price-fixing conspiracies in U.S. history, causing inflated drug prices and widespread harm to consumers, insurers, and the healthcare system.

The lawsuit claims that these pharmaceutical companies colluded to artificially raise generic drug prices by as much as 2,762%.

Examples include clomipramine (2,600% increase), nadolol (+2,762%), and oxybutynin chloride (up to 1,500%).

Aetna alleges this conspiracy exploited market conditions, fostered cronyism, and suppressed competition, while depriving third-party payers like Aetna of expected cost savings.

According to the complaint, the defendants utilized secretive methods to implement their price-fixing strategies. These included in-person meetings, private phone calls, and strategic coordination during trade association events. Evidence of collusion was deliberately minimized, with written communications often destroyed to evade detection.

Central to the allegations is the so-called "fair share" system, which allocated market share and dictated price increases among competitors. This strategy, referred to as the "rules of engagement," ensured that generic drugmakers avoided undercutting one another, thereby maintaining inflated prices. In some cases, competitors allegedly submitted cover bids to maintain an artificial equilibrium in the market.

The lawsuit highlights Teva Pharmaceuticals as an example of this practice, alleging the company collaborated with select "high-quality" competitors to lead and follow each other's price hikes.

This agreement reportedly extended to various drugs, enabling the companies to dominate the market and secure extraordinary profits.

Aetna contends that the defendants' actions have severely impacted the U.S. healthcare system, driving up costs for insurers, consumers, and government programs like Medicare Part D.

The insurer is seeking treble damages and injunctive relief under state antitrust and unfair competition laws to recover losses and prevent future anticompetitive practices.