Phillips & Cohen has been very successful in pharmaceutical fraud whistleblower cases against many pharma companies.
Companies engaged in pharmaceutical fraud may be liable under the False Claims Act for Medicare and Medicaid fraud in any case where the government loses money directly or indirectly. The False Claims Act’s “qui tam” whistleblower provision gives private citizens (such as pharmaceutical whistleblowers) the power to sue companies on behalf of the government.
Examples of pharmaceutical fraud reported by whistleblowers include:
- paying kickbacks and inducements to physicians, hospitals and pharmacists to prescribe or otherwise favor their drugs;
- engaging in off-label marketing;
- misreporting the “best price,” the “federal ceiling price” or other benchmark prices that pharmaceutical companies report to the Medicare and Medicaid programs;
- overcharging for “340B” program drugs;
- manufacturing or diverting substandard or tainted drugs.
- providing false data to the Food and Drug Administration or withholding negative data from the FDA about the efficacy of a pharmaceutical drug or medical device in clinical research trials to get FDA approval to sell and market the pharmaceutical drug or medical device.
- manufacturing, selling or distributing adulterated drugs — meaning those processes didn’t meet required standards to ensure safety, quality, purity and correct strength of the drug.
- patient assistance foundations conspiring with drug manufacturers from whom they accept donations, then using that money to steer patients to buy the donors’ drugs.
Pharmacy benefits management companies also have come under increasing scrutiny as a result of qui tam lawsuits.
Phillips & Cohen has brought “qui tam” whistleblower cases alleging pharmaceutical fraud in a variety of ways, including off-label marketing, kickback schemes and other Medicare and Medicaid fraud practices.
Those pharmaceutical whistleblower cases – such as our record-setting cases against GlaxoSmithKline and Pfizer Inc. — have stopped illegal and improper marketing and sales practices that were harmful to patients’ health and possibly their lives. Pharma companies paid huge sums to settle those cases, and our clients received hefty whistleblower rewards for exposing and helping to stop those harmful practices.
Phillips & Cohen’s top pharmaceutical fraud whistleblower cases:
- GlaxoSmithKline paid $3 billion to settle a number of qui tam cases, including an off-label marketing case brought by Phillips & Cohen that resulted in the government recovering more than $1.5 billion out of the total settlement. It was the largest healthcare fraud settlement ever.
- Pfizer paid $1.8 billion to settle a qui tam case and a related criminal fine involving the off-label marketing of Bextra, a prescription painkiller. Pfizer settled other whistleblower cases at the same time, pushing the total settlement to $2.3 billion.The Pfizer settlement set a record at the time as the largest healthcare fraud settlement and now is second only to the Glaxo settlement.
- TAP Pharmaceuticals paid $875 million to settle a qui tam case we brought, a separate qui tam lawsuit and a related criminal charge involving illegal kickbacks to doctors.
- Cephalon Inc paid $425 million to settle a criminal charge and qui tam lawsuits filed by Phillips & Cohen and two other whistleblowers involving the off-label marketing of Actiq, Gabitril and Provigil.
We also have had successful qui tam whistleblower cases against other pharma companies such as Omnicare Inc., Alpharma Inc., Jazz Pharmaceuticals Inc. and Ortho-McNeil-Janssen Pharmaceuticals Inc.