I doubt a mountain of complaints would mean anything to legal authorities ... insurers have no duty to cover it for off label use.
I am not communicating, nor advocating communicating, with "legal authorities." Neither am I arguing, nor advocating arguing, the existence of any "duty."
As others have posted, and despite cynical views to the contrary, some insurers/PBMs' formulary committees do have some interest in new scientific information relating to drugs they cover. Until there is a label change, the more they hear persuasive, new information, the more likely they may be to put Vascepa at a tier higher than "non-preferred Brand," which in the case of my CVS Caremark Silverscripts plan, is Tier 4 and where Vascepa currently is designated for 2019. As other posts on this mb indicate, some PBMs/insurers, in fact, have already given Vascepa a higher tier.
Those (hopefully few) insurers/PBMs who are misinforming patients and prescribing physicians that a "lower cost, clinically equivalent" alternative medication (to Vascepa) exists and warrants dispensing Lovaza when Vascepa has been prescribed, also need to be addressed. Complaints and their disposition are required to be documented for review by the federal government (at least those re medicare part D plans). After relevant, scientific information has been supplied to the PBM/insurer and is in the complaint file, it could become hazardous for them to continue such misleading practices (or if the problem is because of lack of information, they might voluntarily change).
I respect your right to disagree. My view remains that the more times a PBM/insurer's formulary (or related) people hear from knowledgeable and informed customers with persuasive (e.g., NEJM, Mason AHA presentation, Vascepa HCP webpage, Cardiology Today article) information, the more likely it is that they will, at a minimum, be receptive to overtures from Amarin, and possibly to act on their own.
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