Pharmaceutical Kickbacks

Right now the pharmaceutical industry is in the middle of its biggest challenge in history. Whistleblowers have exposed and continue to expose fraudulent practices ranging from pricing issues to sales and marketing practices at a rate never anticipated by either the pharmaceutical industry or the Department of Justice. Settlements and jury verdicts have been headline grabbing and large, attracting the attention of pharma, regulators, Congress and taxpayers. The qui tam pharmaceutical fraud cases settled since 2000 alone have amounted to over 3.5 billion dollars, representing various patterns of fraud. We expect to see some new patterns as time goes by, especially with the new Medicare prescription drug benefit. Pharmaceutical fraud is still abundant and this blog is intended to keep readers up to date with all pharmaceutical fraud related news and to provide commentary when warranted. This blog also contains an array of laws and regulations concerning the Federal Food, Drug and Cosmetic Act set out in an easy to read format.

The Hefty Medicare Price Tag for the Off-Label Prescriptions

by Nolan and Auerbach on June 27, 2011

Recently,  the US Department of Health & Human Services Office of Inspector General found that, in the six-month period from January through June 2007, an astounding 51 percent of Medicare claims for atypical antipsychotics were off-label. This amounted to over $116 million in Medicare funds.

Further focusing on the off-label use of antipsychotics in nursing homes, the OIG determined that 83 percent of Medicare claims for atypical antipsychotics for these residents were associated with off-label use; 88 percent were associated with the condition specified in the FDA boxed warning.

So why are so many nursing homes turning a blind eye to the antipsychotics’ black box warnings? What is pumping this water uphill? Could it be companies marketing off-label? This OIG report comes on the heels of Congressional scrutiny and a chorus of legal actions from State Attorney Generals, accusing the drugmakers of improperly marketing antipsychotics.

Some off-label marketing schemes regularly influence the prescribing habits of physicians. While the coffers of pharma companies fill with tainted funds, patient safety and government healthcare programs suffer.

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

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