(WNY News Now)BUFFALO, N.Y.—Pfizer Inc., the pharmaceutical behemoth, has agreed to pay $59.7 million to Biohaven Pharmaceutical Holding Company Ltd., its subsidiary, to settle claims that Biohaven offered inappropriate payments to healthcare providers in violation of the False Claims Act. These payments, which were made before to Biohaven’s acquisition by Pfizer in 2022, are said to have affected the prescription of Nurtec ODT, Biohaven’s migraine treatment.
According to U.S. Attorney Trini E. Ross for the Western District of New York, patients should be aware that their doctor is writing prescriptions based on their medical expertise rather than financial inducements from pharmaceutical firms. This settlement demonstrates our resolve to hold lawbreakers accountable, irrespective of their position or reputation.
According to Brett A. Shumate, Acting Assistant Attorney General of the Justice Department’s Civil Division, “the government has shown its commitment to ensuring that drug companies do not use kickbacks to influence physician prescribing through this settlement and others.” The agency will employ all available means to stop pharmaceutical companies from compromising the impartiality of medical professionals’ treatment choices.
Offering or providing anything of value to encourage the referral of goods or services covered by Medicare, Medicaid, TRICARE, and other government health care programs is prohibited by the anti-kickback act. The purpose of the act is to prevent improper financial incentives from impairing the judgment of medical providers.
The settlement, which was made public today, settles claims that Biohaven violated the anti-kickback statute by paying medical professionals improper compensation, including speaker honoraria and meals at upscale restaurants, between March 1, 2020, and September 30, 2022, in order to persuade them to prescribe the migraine drug Nurtec ODT. According to the United States, Biohaven chose specific medical professionals to join the Nurtec speaker bureau and paid them to speak in order to persuade them to prescribe Nurtec ODT in exchange for speaker honoraria and meals. The government also claimed that some prescribers who attended several programs on the same subject did not gain any educational benefit from attending them again, and that some Biohaven speaker programs were attended by people who did not need to learn anything, like the speakers’ spouses, friends, family, or coworkers from their own medical practice. According to the United States, this behavior continued until Pfizer bought Biohaven in October 2022 and stopped the Nurtec speaker programs.
According to Deputy Inspector General Christian J. Schrank of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), violations of the anti-kickback statute, like those claimed in this settlement, can have a detrimental effect on taxpayer-funded health care and unduly influence prescribers. If companies and providers try to circumvent laws designed to safeguard the integrity of federal health care programs, HHS-OIG will continue to work with law enforcement partners to hold them accountable.
According to Special Agent in Charge Patrick J. Hegarty of the DCIS Northeast Field Office, the Department of Defense Office of Inspector General’s Defense Criminal Investigative Service (DCIS) places a high premium on looking into schemes that compromise the integrity of TRICARE, the healthcare system for military personnel and their families. Our commitment to pursuing companies that try to taint the TRICARE system in collaboration with our partner agencies and the Department of Justice is demonstrated by today’s statement.
Patrica Frattasio, a former sales representative at Biohaven, filed claims under the qui tam or whistleblower provisions of the False Claims Act, which were resolved as part of the civil settlement. A private party may bring a claim on behalf of the US under those laws, and they will be entitled to a share of any money recovered. U.S. ex rel. Patricia Frattasio v. Biohaven Pharmaceutical Holding Company Ltd., No. 6:21-CV-06539 (W.D.N.Y.) is the caption for the qui tam case. About $9.5 million of the settlement represents a recovery for State Medicaid programs, while about $50.2 million represents the federal component of the reimbursement. Ms. Frattasio’s portion of the government recovery in this case will be about $8.4 million.
The U.S. Attorney’s Office for the Western District of New York, the Commercial Litigation Branch Fraud Section, and the Justice Department’s Civil Division worked together to achieve the resolution in this case.
The case was handled by Assistant U.S. Attorney David M. Coriell for the Western District of New York and Trial Attorney Jessica Sarkis of the Justice Department’s Civil Division.
The government’s focus on preventing health care fraud is demonstrated by the investigation and conclusion of this case. The False Claims Act is one of the most effective instruments in this endeavor. The Department of Health and Human Services can receive tips and complaints about possible fraud, waste, abuse, and mismanagement from any source by calling 800-HHS-TIPS (800-447-8477).
Liability has not been established; the claims settled by the settlement are merely assertions.