Pfizer Settles False Claims Case for $23 Million
Pfizer will pay $23.85 million to resolve claims that it used a foundation to pay copays of Medicare patients taking three company drugs. A Justice Department news release on the settlement identifies the Pfizer drugs as Sutent and Inlyta, which both treat renal carcinoma, and Tikosyn, which treats arrhythmia in patients with atrial fibrillation or flutter.
The department says that under the anti-kickback law, drug companies can’t offer, directly or indirectly, any remuneration, including paying patients’ copay obligations, to induce Medicare patients to buy the company’s drugs.
The government alleged that, in order to generate revenue, and instead of giving Sutent and Inlyta to Medicare patients who met the financial requirements for Pfizer’s existing free drug program, the company used a third-party specialty pharmacy to transition certain patients to the foundation, which covered their Medicare copays. Pfizer allegedly made donations to the foundation to enable it to cover the copay costs and received confirmation from the foundation, through the specialty pharmacy, that the foundation funded the copays.
For Tikosyn, the department says that Pfizer raised the wholesale acquisition cost by over 40% in the last three months of 2015, knowing the increase would also increase Medicare beneficiaries’ copay obligations and potentially prevent some patients from affording the drug. Pfizer allegedly worked with the foundation to create and finance a fund for Medicare patients suffering from the condition treated by Tikosyn, coordinated the opening of the fund with the implementation of its drug price increase, and referred patients to the fund.
Pfizer also has entered into a corporate integrity agreement with the HHS inspector general.