A federal investigation into how pharmaceutical companies provide free services to patients and physicians is underway. Amgen Inc., Bayer AG, and Eli Lilly & Co. are all involved with whistleblower lawsuits claiming that services, such as complimentary reimbursement and nursing assistance, are used to drive up sales.
Although the companies claim that these methods help patients and physicians, investigators believe that these free services have replaced old practices of rewarding doctors who prescribe with expensive dinners and vacations. In other words, the services are being regarded as illegal kickbacks. A recent Wall Street Journal study reported that drugmakers like Biogen, Gilead Sciences, Inc., and Sanofi SA may also be acting illegally.
Prescriptions for Humira
In September 2018, a California State Insurance Commissioner sued AbbVie Inc., the makers of arthritis drug, Humira, for giving kickbacks described above to encourage doctors to prescribe Humira to patients. AbbVie Inc. claims that the lawsuit has no merit, because they only offer the services after the drug has been prescribed.
The lawsuit asserts that AbbVie Inc. has sent nurses to visit patients to train them on how to inject Humira and sent company representatives to medical offices to help with getting reimbursement for the high-priced drug. He said that these nurses were trained to convince patients to stay on the drug, while minimizing the issue of its possible side effects.
Other Illegal Practices
Aside from free nursing and paperwork assistance, lawmakers are looking into other practices that drugmakers may be employing to increase sales. When drug companies make donations to third-party charities that cover Medicare prescription co-pays, sales go up. One company that was accused of this was United Therapeutics Corp., which paid a $210 million settlement without admitting liability.
In 2017, Sanofi, SA was investigated by the U.S. attorney’s office for the Southern District of New York for their diabetes educator program. It has since been discontinued. Gilead Sciences, Inc. was also probed about their education programs, reimbursement support, and interactions with specialty pharmacies for their drugs, Harvoni and Sovaldi.
Although it may appear that drugmakers are offering helpful services, one attorney feels that the process undermines medical decision making. Critics agree, pointing out that the practices can push physicians to choose one drug over another. It can also boost prescriptions of higher-cost drugs on patients who cannot afford them.
The Anti-Kickback Statue
There is a federal statute that makes kickbacks and payments used to encourage government-reimbursed medical care and drug prescriptions illegal. The Anti-Kickback Statute (AKS) prohibits receiving something of value for encouraging patient referrals, items, or services that are payable by federal health care programs. Violating the statute can incur criminal penalties, such as fines and jail time.
Although medical practitioners may be frequently targeted by drug companies to accept kickbacks, it is safer to avoid accepting them. A physician that gets into these types of dealings could be putting their medical careers and patients at risk.
Philadelphia Health Care Lawyers at Sidney L. Gold & Associates, P.C. Represent Physicians Involved with Drugmaker Kickbacks
If you are a doctor that needs legal support in a kickback case, we can help. Contact our team of Philadelphia health care lawyers at Sidney L. Gold & Associates, P.C. Fill out our online form or call us at 215-569-1999 for a free consultation. With an office located in Philadelphia, we serve clients from the surrounding areas, including Bucks County, Chester County, Delaware County, and Montgomery County.