Increasingly, federal investigators have been turning their attention to manufacturing deficiencies at some of the world’s largest drug makers. According to one industry report, the number of FDA inspection reports has skyrocketed to an all-time high. This focused attention comes on the heels of a recent report from the US General Accountability Office, which found that the FDA failed to adequately inspect a number of manufacturing facilities around the globe.

The added governmental exposure has shed the light on a number of problems, likely encouraging a weekly parade of drug recalls from pharmaceutical companies. For some companies, they have led the parade of FDA warnings and recalls on a number of occasions. For example, Johnson & Johnson has repeatedly tangled with the FDA, most recently when it was warned by the FDA about problems at its Cordis stent facility. Last year, this same company temporarily closed a large Pennsylvania facility and recalled an estimated 136 million bottles of liquid children’s Tylenol and other pediatric products, after quality controls failed.

However, the real driving force behind this surge of pharmaceutical mea culpas probably has less to do with federal investigators and more to do with pharmaceutical industry’s concerns about potential False Claims Act qui tam actions. The simple fact is that drug makers are now on notice that employees can bring successful whistleblower suits involving current Good Manufacturing Practices (cGMP) violations.

The extended reach of whistleblowers was made crystal clear last year, when the U.S. Department of Justice joined in a whistleblower action against GlaxoSmithKline, exposing systemic manufacturing deficiencies at the company’s Puerto Rico facility. Ultimately, the company settled the action for $750 million, and the whistleblower was handsomely rewarded to the tune of $96 million.

In a very real sense, the GlaxoSmithKline settlement has encouraged other potential whistleblowers to step forward and uncover other instances of cGMP violations. More importantly, because the False Claims Act provides incentives and protections for these whistleblowers, drug companies cannot simply disregard their concerns. The lasting impact is that, whether through recalls or False Claims Act settlements, drug companies are forced to fess up to fraud and unsafe manufacturing practices.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, P.A.

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Drug ‘Xenaderm’ Under Fraud Microscope

by admin on April 22, 2011

The Department of Justice (DOJ) has intervened in a Nolan & Auerbach, P.A. qui tam suit against Xenaderm maker, DFB Pharmaceuticals, alleging the marketing company Healthpoint (owned by DFB) knowingly promoted and sold the drug under the premise that it could be billed to Medicare and Medicaid. Xenaderm, a drug used for burns and wounds in the removal of dead tissue, was found in a 1972 DESI review to be ineffective.

That allegedly didn’t stop Healthpoint from continuing to manufacture and market Xenaderm. The DOJ claims the total cost to Medicaid from this fraud exceeds $90 million.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, P.A.

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In recent years, a number of drug companies have settled False Claims Act cases, alleging that the companies off-label marketed their products to children. Oftentimes, the offending marketing materials did not specifically mention the use of the products in the pediatric population. However, the companies still ran afoul of the FCA, for their marketing efforts aggressively targeted pediatric specialists.

These successful actions dispelled the misconception that off-label marketing only occurs when marketing materials explicitly promote an unapproved use.

When a drug company details pediatricians or it corrals pediatricians into a room to tout the benefits of its drugs, it is implicitly stating that its products are approved for the doctors’ patient population. If, however, the products have not been approved for use in children and the company fails to share this information with the audience, there is likely a violation of the False Claims Act. In other words, half truths are considered “false” when it comes to off-label marketing.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, P.A.

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Uncovering Pharmaceutical Manufacturing Problems

by Nolan and Auerbach on March 30, 2011

Increasingly, federal investigators have been turning their attention to manufacturing deficiencies at some of the world’s largest drug makers. According to one industry report, the number of FDA inspection reports has skyrocketed to an all-time high. This focused attention comes on the heels of a recent report from the US General Accountability Office, which found that the FDA failed to adequately inspect a number of manufacturing facilities around the globe.

The added governmental exposure has shed the light on a number of problems, likely encouraging a weekly parade of drug recalls from pharmaceutical companies. For some companies, they have led the parade of FDA warnings and recalls on a number of occasions. For example, Johnson & Johnson has repeatedly tangled with the FDA, most recently when it was warned by the FDA about problems at its Cordis stent facility. Last year, this same company temporarily closed a large Pennsylvania facility and recalled an estimated 136 million bottles of liquid children’s Tylenol and other pediatric products, after quality controls failed.

However, the real driving force behind this surge of pharmaceutical mea culpas probably has less to do with federal investigators and more to do with pharmaceutical industry’s concerns about potential False Claims Act qui tam actions. The simple fact is that drug makers are now on notice that employees can bring successful whistleblower suits involving current Good Manufacturing Practices (cGMP) violations.

The extended reach of whistleblowers was made crystal clear last year, when the U.S. Department of Justice joined in a whistleblower action against GlaxoSmithKline, exposing systemic manufacturing deficiencies at the company’s Puerto Rico facility. Ultimately, the company settled the action for $750 million, and the whistleblower was handsomely rewarded to the tune of $96 million.

In a very real sense, the GlaxoSmithKline settlement has encouraged other potential whistleblowers to step forward and uncover other instances of cGMP violations. More importantly, because the False Claims Act provides incentives and protections for these whistleblowers, drug companies cannot simply disregard their concerns. The lasting impact is that, whether through recalls or False Claims Act settlements, drug companies are forced to fess up to unsafe manufacturing practices.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, P.A.

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CNBC Runs Whistleblower Series

by Nolan and Auerbach on February 9, 2011

Throughout the week, CNBC is doing a special series on whistleblowers, and much of it concerns the False Claims Act. This morning, Recognizing that there is a huge “cottage industry” out there, CNBC ‘s Eamon Javers reported that pharmaceutical companies have changed their practices as a result of pharmaceutical fraud whistleblower lawsuits. An overview and the schedule is at CNBC.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, P.A.

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Recently, the U.S. Justice Department announced settlements with three pharmaceutical companies for a total of $421 million to settle allegations they reported “false and inflated prices” for pharmaceutical products knowing that government health care programs would use those reported prices to set payment rates. According to the Justice Department, the actual sales prices for the products were “far less” than what the companies reported. In this trio of False Claims Act qui tam settlements, Abbott Laboratories Inc. agreed to pay $126.5 million, Roxane Laboratories Inc. (n/k/a Boehringer Ingelheim Roxane Inc.) agreed to pay $280 million, and B. Braun Medical Inc., a subsidiary of Germany-based B. Braun Melsungen AG, agreed to pay $14.7 million. As part of these settlements, the whistleblowers will receive approximately $88.4 million.

In this pharmaceutical fraud scheme known as “marketing the spread,” the drug companies fraudulently created a large incentive for providers to prescribe their drugs. This “spread” is the difference between the resulting inflated government payments and the actual price paid by health care providers for a drug.  The larger the “spread” on a particular drug, the larger the profit for the provider or pharmacist. In turn, because payment from the Medicare and Medicaid programs was based on the false inflated prices, the government alleged that the defendants caused false claims to be submitted to government health care programs, and as a result, the government paid millions of claims for far greater amounts than it would have if the defendant companies had reported truthful prices.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, P.A.

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Kos Pharmaceuticals, a subsidiary of Abbott Laboratories, has agreed to pay $41 million to quiet criminal and civil allegations that it violated the federal anti-kickback laws, when it allegedly bribed doctors, medical groups and managed care organizations to prescribe or recommend two of the company’s drugs, Advicor and Niaspan. In addition, the drug-maker settled allegations that it promoted the cholesterol-lowering drug Advicor for off-label uses.

The price tag to settle the civil allegations was $38 million. The criminal settlement required Kos Pharmaceuticals to ink a $3 million check, to enter into a deferred prosecution agreement, and to agree to the filing of a criminal information charging the company with one count of conspiracy to violate the anti-kickback statute.

Noticeably, the doctors who accepted the bribes were not held accountable. “As long as dishonest doctors are willing to be bought, drug companies will be able to bribe their way into America’s medicine cabinets,” said Nolan & Auerbach partner Jeb White. “We need to recognize that it takes two to tango in the underworld of pharmaceutical kickback schemes.”

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, PA.

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Long-term care pharmacy Remedi Seniorcare, Inc. has agreed to pay $1,279,575 to settled a qui tam action, raising allegations that it illegally distributed misbranded and adulterated drugs in interstate commerce.  This was a unique and important whistleblower case, alleging that, instead of disposing unused medications, the pharmacy unlawfully recycled, repackaged, and redistributed thousands of drugs to Medicare and Medicaid beneficiaries. This was the sixth settlement this year for the national whistleblower law firm of Nolan & Auerbach, P.A, whose False Claims Act qui tam cases have recovered more than $1.3 billion for the US Treasury.

The whistleblower alleged that every day, Remedi would typically pick up twenty or more tote bags of unused medicine from long-term care facilities, ostensibly destined for disposal. However, instead of properly disposing the medication, the pharmacy would allegedly recycle the drugs, by removing pills and tablets from their packaging in unsterile environments, sorting the drugs into unsanitary bins, and inserting the medicine into new packaging. According to the whistleblower, the sorting process regularly comingled drugs with different expiration dates, lot numbers, and potency. These alleged practices caused federal and state government health care programs to pay for adulterated drugs.

To ramp up these operations, the pharmacy supposedly hired outside “efficiency experts,” who made recommendations on how the pharmacy could further streamline its recycling scheme. By repackaging everything from blisterpacks to bulk syringes, the pharmacy was able to pocket funds that would have been spent on new medications.

The Food and Drug Administration is the agency responsible for protecting the health and safety of the American public by ensuring, among other things, that pharmaceuticals designed for use in humans are safe and effective for their intended uses and are labeled accurately and in compliance with the law. The federal law imposes numerous requires on the distribution of prescription drugs, including that the drugs are not misbranded or adulterated.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, PA.

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FOLLOW THE MONEY: New Database Details Pharma Payments to Doctors

by Nolan and Auerbach on December 23, 2010

According to a new database compiled and published by ProPublica, a non-profit investigative journalism group, drug companies shelled out more than $250 million to some 17,000 doctors and nurses across the country in 2009 and 2010. While some of these payments may be legitimate, the aggregate amount certainly raises eyebrows, especially since several drug companies have recently admitted to sidestepping the Anti-Kickback Act by disguising bribes as “consulting fees” or “speakers’ honoraria.”

Applied to the pharmaceutical world, the Anti-Kickback Act, 42 U.S.C. § 1320a-7b(b), makes it illegal for a drug company to bride a doctor to prescribe its drugs. The Anti-Kickback Act is designed to, inter alia, ensure that patient care is not improperly influenced by inappropriate compensation from the pharmaceutical industry.

There are a variety of rules and exceptions that come into play when assessing whether a drug company’s payments to a doctor violates the Anti-Kickback Act. However, at the end of the day, the question boils down to whether the drug company was looking to improperly influence the doctor’s prescribing habits. If the company was looking to bribe its way into the medicine cabinets of Medicare and Medicaid patients, the payments were likely illegal kickbacks, under the federal Anti-Kickback Act.

To encourage insiders to step forward and report these shadowy payments, the US Congress recently clarified, in the federal health care reform legislation, that violations of the federal Ant-Kickback Act are per se violations of the federal False Claims Act. In turn, if a person has detailed information about a drug company bribing doctors to prescribe its drugs, that person might receive a substantial whistleblower reward.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, PA.

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Whistleblowers Needed to Expose Drug Manufacturing Deficiencies

by Nolan and Auerbach on December 21, 2010

Recently, we discussed GlaxoSmithKline’s False Claims Act settlement, in which the drug maker shelled out $750 million to quiet allegations about manufacturing deficiencies at its Puerto Rico. Based on a recently released FDA inspection report, it looks like another drug company’s Puerto Rican plant is having trouble following current Good Manufacturing Practices (cGMP).

In this report, the FDA rattles off a laundry list of violations at the plant owned by McNeil Consumer Healthcare, a unit of Johnson & Johnson: distribution of drugs that failed quality requirements, a failure to identify product defects during routine testing, failure to detect incorrect expiration dates on drug labels, failure to adequately investigate product problems, failure to follow laboratory controls and inadequate training of lab staff.

Some of these mirror concerns raised in a January 2010 FDA warning letter that was sent McNeil about this same Puerto Rico plant.  McNeil has also seen this scenario play out before at a different plant.  After quality controls failed at its Fort Washington, Pa. plant, the company temporarily closed the plant and recalled an estimated 136 million bottles of liquid children’s Tylenol and other pediatric products.

This latest brush up with the FDA stems from inspections that date from late September through early November. The 10-page report concluded that there was no assurance at the Puerto Rico plant “that the current laboratory controls are adequate to assure that drug products conform to appropriate standards of identity, strength, quality and purity.” The report also states, “The established procedures and controls for cleaning and maintenance may not be sufficient to prevent mix-ups and/or contamination during the manufacturing and packaging process as evidenced by the mix-up deviations and incidents involving manufacturing and packaging operations.”

Somebody had the courage to blow the whistle on GlaxoSmithKline’s manufacturing deficiencies. Hopefully a brave McNeil employee can similarly provide the inside information the government needs to further shine a light on the problems at this wayward Puerto Rico facility.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, PA.

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