Pfizer pays close to $60 million to resolve kickback allegations
Pfizer subsidiary Biohaven allegedly gave physicians speaker honoraria and meals at high-end restaurants to induce them to prescribe Nurtec.
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Photo: Willie B Thomas/Getty Images
Pfizer, on behalf of its wholly-owned subsidiary Biohaven Pharmaceutical Holding Company, has agreed to pay close to $60 million to resolve kickback allegations involving payment to providers.
Prior to Pfizer's acquisition of the company, Biohaven knowingly caused the submission of false claims to Medicare and other federal healthcare programs by paying providers to induce them to write prescriptions of Biohaven's drug Nurtec ODT, according to the Department of Justice.
Nurtec ODT is used to treat and prevent migraines in adults.
The claims resolved are allegations only, and there has been no determination of liability, the DOJ said.
The DOJ contends the alleged payment to providers persisted until October 2022, when Pfizer acquired Biohaven.
WHY THIS MATTERS
The allegations were brought by whistleblower Patricia Frattasio, a former Biohaven sales representative, who will receive approximately $8.4 million as her share of the $59,746,277 federal recovery of the case, according to the DOJ.
Approximately $50.2 million of the settlement is the federal portion of the recovery, and about $9.5 million constitutes a recovery for state Medicaid programs.
The settlement announced Friday resolves allegations that from March 1, 2020, through Sept. 30, 2022, Biohaven paid improper remuneration, including in the form of speaker honoraria and meals at high-end restaurants, to healthcare professionals in order to induce them to prescribe the migraine medication Nurtec ODT in violation of the anti-kickback statute.
The United States alleged that Biohaven selected certain healthcare providers to be part of the Nurtec speaker bureau and provided them paid speaking opportunities with the intent that the speaker honoraria and meals would induce them to prescribe the drug, the DOJ said.
The DOJ further alleged that certain prescribers who attended multiple programs on the same topic received no educational benefit from attending repeat programs, and that certain Biohaven speaker programs were attended by individuals with no educational need to attend, such as the speakers' spouses, family members, or friends or colleagues from the speakers' own medical practice.
The United States contends that the conduct persisted until October 2022, when Pfizer bought Biohaven and terminated the Nurtec speaker programs.
THE LARGER TREND
The anti‑kickback statute prohibits offering or paying anything of value to induce the referral of items or services covered by Medicare, Medicaid, TRICARE, and other federal healthcare programs. The statute is intended to ensure that medical providers' judgments are not compromised by improper financial incentives.
The resolution obtained in this matter was the result of a coordinated effort between the Justice Department's Civil Division, Commercial Litigation Branch Fraud Section and the U.S. Attorney's Office for the Western District of New York.
ON THE RECORD
"Patients deserve to know that their doctor is prescribing medications based on their doctor's medical judgment, and not as a result of financial incentives from pharmaceutical companies," said U.S. Attorney Trini E. Ross for the Western District of New York. "This settlement reflects our commitment to hold those who violate the laws accountable, regardless of their status or prestige."
Email the writer: SMorse@himss.org