California Sues Abbvie Over ‘Illegal’ Kickbacks

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California has filed a lawsut against AbbVie alleging that it gave illegal kickbacks to health care providers to prescribe Humira (adalimumab), indicated for multiple inflammatory diseases. The whistleblower-based suit, which was filed under the Insurance Frauds Prevention Act, alleges that private insurers have paid out $1.2 billion in Humira-related pharmacy claims.

 

According to the complaint, AbbVie allegedly engaged in classic kickback efforts (cash, meals, drinks, gifts, trips, and patient referrals) and “more sophisticated ones — free and valuable professional goods and services to physicians to induce and reward Humira prescriptions,” the state says. “These professional goods and services included free insurance processing and prior authorizations, gifts of medical practice management hardware and software, and even marketing assistance, all of which save physicians valuable staff time and resources.”


The state says that the most dubious part of Abbott’s alleged scheme was that it inserted its own personnel directly into patient homes. “When doctors prescribe Humira, AbbVie sends its registered nurses — which AbbVie calls ‘ambassadors’ — into patients’ homes, representing them to be an extension of the doctor’s office. The system AbbVie established takes advantage of the ambassadors’ nursing background and direct access to patients to serve the biopharma giant’s financial interest in getting patients to take Humira by downplaying its risks. Ambassadors are trained to send patient complaints directly to AbbVie and not the patients’ treating physicians. Ambassadors also provide unbalanced information, as they are trained to tout the drug while at the same time also instructed on methods to avoid directly answering patient questions about risks of the medication, including those pertaining to Humira’s serious and important side effects.”

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