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Big Pharma Pfizer has agreed to a hefty $59.7 million settlement to resolve allegations of a kickback scandal that has defrauded Medicare and other federal healthcare programs.
The scandal revolves around Biohaven Pharmaceutical, a company acquired by Pfizer in October 2022, which engaged in unethical practices to push prescriptions of its migraine medication, Nurtec ODT, also known as Rimegepant.
Credit: Nurtec
Whistleblower Patricia Frattasio, a former sales representative at Biohaven, played a crucial role in bringing these malpractices to light, leading to a qui tam lawsuit under the False Claims Act in 2021.
The U.S. Department of Justice disclosed that from March 2020 through September 2022, Biohaven manipulated the healthcare system by offering kickbacks—including speaker honoraria and lavish meals at upscale restaurants—to healthcare professionals.
Allegations include that Biohaven paid some healthcare providers over $100,000 to boost prescriptions of their migraine medication, Nurtec ODT, resulting in fraudulent claims to federal programs like Medicare and Medicaid.
This egregious scheme involved not just ordinary incentives, but also repeated, unnecessary educational programs that offered no real benefit to attendees, turning these events into mere facades for bribery.
This practice, aimed at increasing Nurtec ODT prescriptions, breached anti-kickback statutes designed to keep medical decisions free from financial influence.
Under the terms of the settlement, Biohaven does not admit liability but has agreed to pay the United States and participating Medicaid states a total of $59,746,277.54.
This amount includes interest and restitution, addressing claims submitted to Medicare, Medicaid, TRICARE, and the Veterans Health Administration from March 2020 through September 2022.
“Approximately $50.2 million of the settlement constitutes the federal portion of the recovery and approximately $9.5 million constitutes a recovery for State Medicaid programs. Ms. Frattasio will receive approximately $8.4 million as her share of the federal recovery in this case,” according to the press release from the DOJ.
“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.
You can read the settlement agreement below:
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