Accredo Health Group, a specialty pharmacy run by Express Scripts, has agreed to a $60 million settlement to resolve allegations by the United States Department of Justice (DOJ) that the company participated in a kickback scheme with Novartis to induce specialty pharmacies to boost prescriptions for certain drugs. Approximately $45 million will paid to the United States and approximately $15 million will be paid to a group of states to settle the states’ claims based on the same alleged conduct. The DOJ claimed that Novartis improperly offered patient referrals to Accredo Health Group in exchange for recommending patient refills of Exjade, a Novartis drug indicated to reduce excess iron in a patient’s blood following transfusion. As part of the arrangement, Accredo allegedly counseled patients on the benefits of Exjade, failing to mention potential serious side effects of the drug. The DOJ claims this scheme caused claims to be submitted in violation of the federal False Claims Act and the federal Anti-Kickback Statute. The lawsuit stemmed from a whistleblower case brought by a former Novartis account manager who continues to pursue separate whistleblower claims against Novartis and other companies.
Frier Levitt provides legal counsel on federal and state fraud and abuse laws including the Anti-Kickback Statute and False Claims Act. Frier Levitt also defends specialty pharmacies facing unfair PBM audits and network termination. Contact us today to speak to an attorney.
