Thousands of Mainers get their prescriptions through CVS Caremark's chain of pharmacies -- the largest in the country. The company also manages a drug benefit for health plans and large employers. But buyer beware, say consumer advocates who are calling on regulators to crack down on CVS for allegedly breaking consumer protection laws.

"There's a built-in, major conflict of interest that is not benefiting consumers." Sharon Treat is a Democratic state representative from Hallowell and Executive Director of the National Legislative Association on Prescription Drug Prices.  She's referring to the conflicts of interests she and other legislators in the group see in the 2007 merger between CVS and Caremark, which essentially had the drugstore giant buying a leading pharmacy benefit manager.

The group wants the Federal Trade Commission to investigate alleged anti-competitive practices such as one involving a CVS Caremark prescription program. "And in this program, the company informs consumers that if they want to continue to fill prescriptions at their current co-pay, they have to switch their prescription to mail order or to a CVS store, and if they don't use a CVS store, then they have to pay an increased co-pay," Treat says.  "You know, this is not something benefiting the consumer, it's something benefiting CVS."

The group says that CVS Caremark also steers consumers toward more expensive and less effective drugs in exchange for payments from drug companies. 

Mike DeAngelis, spokesman for the Woonsocket, Rhode Island-based company, disputes the allegations in a written statement.  In it he  says, "Our integrated pharmacy and PBM operations provide greater choice and more convenience for patients, improve health outcomes, and lower overall health care costs for plan sponsors and participants."
 
The demand for a review from the FTC, which has yet to respond to the legislative group and did not return calls for this story, comes as advocates accuse CVS stores of overcharging their customers.

"An overcharge will happen when the scanner charges more than the lowest price than represented to the customer in the store," says Edgar Dworksy, the founder of ConsumerWorld.org, and a former assistant attorney general in Massachusetts.  A consortium of labor unions there recently used reports from state inspections to show what it describes as pricing violations at CVS.

Though Dworsky says he is not affiliated with the labor group, he says he is disturbed by the findings that show CVS overcharged customers about five times more often than other leading drugstore chains in the state. "So it may be in the circular that says the item is on sale for 99 cents, or there may be a shelf sign that says the item is 99 cents, or there may be a sticker on the product that says the item is 99 cents.  And when they folks did the survey, if they were charged more than one of those prices, that's an overcharge," he says.

CVS spokesman DeAngelis responded to the overcharging allegations in a statement, saying that keeping prices updated can be labor-intensive and lead to errors but he says CVS strives to achieve 100%  accuracy and move quickly to rectify any unintentional discrepancy.