Shortly after President Donald Trump was inaugurated, the Department of Justice announced that gigantic pharmaceutical company Pfizer would be paying nearly $60 million to the government to settle claims that its wholly owned subsidiary, Biohaven, had defrauded Medicare and similar programs.
Announcing the settlement, the Department of Justice announced, “Pharmaceutical company Pfizer Inc. (Pfizer), on behalf of its wholly-owned subsidiary Biohaven Pharmaceutical Holding Company Ltd. (Biohaven), has agreed to pay $59,746,277 to resolve allegations that, prior to Pfizer’s acquisition of the company, Biohaven knowingly caused the submission of false claims to Medicare and other federal health care programs by paying kickbacks to health care providers to induce prescriptions of Biohaven’s drug Nurtec ODT.”
Continuing, the DOJ noted that in violating the anti-kickback statute, the Pfizer subsidiary had created the perception that medical providers were compromised by thinking about finances rather than what was best for patients. It said, “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 health care programs. The statute is intended to ensure that medical providers’ judgments are not compromised by improper financial incentives.”
The DOJ then described in more depth the detail of the fraudulent conduct and kickback corruption, saying, “The settlement announced today 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 health care professionals to induce them to prescribe the migraine medication Nurtec ODT in violation of the anti-kickback statute.”
Continuing, it noted, “The United States alleged that Biohaven selected certain health care 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 Nurtec ODT.”
It further said, “The government 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 this conduct persisted until October 2022, when Pfizer acquired Biohaven and terminated the Nurtec speaker programs.”
Acting Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division was quoted in the statement a saying, “Through this settlement and others, the government has demonstrated its commitment to ensuring that drug companies do not use kickbacks to influence physician prescribing. The department will use every tool at its disposal to prevent pharmaceutical manufacturers from undermining the objectivity of treatment decisions by health care providers.”
Also chiming in was U.S. Attorney Trini E. Ross for the Western District of New York, who said, “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. This settlement reflects our commitment to hold those who violate the laws accountable, regardless of their status or prestige.”
Commenting on the seriousness of the corruption, HHS Deputy Inspector General Christian Schrank said, “Violations of the anti-kickback statute, such as those alleged in this settlement, can unduly influence prescribers and negatively impact taxpayer-funded health care. HHS-OIG will continue to collaborate with law enforcement partners to ensure that providers and corporations are held accountable if they attempt to bypass laws meant to protect the integrity of federal health care programs.”
