The following is a list of the 21 largest civil settlements, reached between the United States Department of Justice and pharmaceutical companies from 2001 to 2017, ordered by the size of the total civil settlement. Some of these matters also resolved criminal fines and penalties, listed in parentheses, but these amounts are not considered when ranking these settlements as some of the settlements listed did not have a criminal component. Thus, this article provides the most accurate list of the largest civil-only portion of settlements between pharmaceutical companies and the Department of Justice. Because this article focuses on civil portions of settlements, some of the larger total settlements do not make the list. For example, Purdue Pharmaceuticals entered an agreement with the United States, pleading guilty to felony misbranding of OxyContin with intent to defraud and mislead under sections 33 1(a) and 333(a)(2) of the FD&C Act and agreed to pay more than $600 million, but only $160 million was allocated to resolve civil claims under the False Claims Act, while the remainder was allocated to resolve criminal claims and private claims. [1]
Legal claims against the pharmaceutical industry have varied widely over the past two decades, including Medicare and Medicaid fraud driven by off-label promotion, and inadequate manufacturing practices. [2] [3] With respect to off-label promotion, specifically, a federal court recognized that bills submitted to Medicare or Medicaid driven by off-label promotion as a violation of the False Claims Act for the first time in Franklin v. Parke-Davis, leading to a $430 million settlement. [4] The civil portion of this settlement was $190 million, and it is the last settlement included in the below table.
Year | Rank (by total) | Rank (by civil component) | Product(s) | Company | Total Settlement (with any criminal and other components) | Settlement (civil component only) | Violation(s) | Laws allegedly violated (if applicable) |
---|---|---|---|---|---|---|---|---|
2012 | 1 | 1 | Avandia, Wellbutrin, Paxil, Advair, Lamictal, Zofran, Imitrex, Lotronex, Flovent, Valtrex; | GlaxoSmithKline [5] | $3,000,000,000 | $2B civil | Criminal: Off-label promotion, failure to disclose safety data. Civil: paying kickbacks to physicians, making false and misleading statements concerning the safety of Avandia, reporting false best prices and underpaying rebates owed under the Medicaid Drug Rebate Program | False Claims Act/FDCA |
2013 | 3 | 2 | Risperdal/Invega/ Nesiritide | Johnson & Johnson [6] | $2,200,000,000 | $1.72 billion civil ($2.2 billion with criminal component) | Off-label promotion/kickbacks | False Claims Act/FDCA |
2009 | 2 | 3 | Bextra/Geodon/ Zyvox/Lyrica | Pfizer [7] | $2,300,000,000 | $1 billion civil ($2.3 billion with criminal component) | Off-label promotion/kickbacks | False Claims Act/FDCA |
2012 | 4 | 4 (tie) | Depakote | Abbott Laboratories [8] | $1,500,000,000 | $800 million civil ($1.5 billion with criminal component) | Off-label promotion | False Claims Act/FDCA |
2009 | 5 | 4 (tie) | Zyprexa | Eli Lilly [9] | $1,450,000,000 | $800 million civil ($1.45 billion with criminal component) | Off-label promotion | False Claims Act/FDCA |
2008 | 10 | 5 | Zocor/Vioxx/Pepsid | Merck [10] | $650,000,000 | $650 million civil (no criminal component) | Medicare fraud/kickbacks | False Claims Act/ Medicaid Rebate Statute |
2012 | 9 | 6 | Aranesp | Amgen [11] | $672,000,000 | $612 million civil ($762 million with criminal component) | Off-label promotion/kickbacks | False Claims Act/FDCA |
2010 | 7 | 7 | Kytril/Bactroban/ Paxil CR/Avandamet | GlaxoSmithKline [12] | $750,000,000 | $600 million civil ($750 million with criminal component) | Poor manufacturing practices | False Claims Act/FDCA |
2005 | 8 | 8 | Serostim | Serono [13] | $704,000,000 | $567 million civil ($704 million with criminal component) | Off-label promotion/ kickbacks/monopoly practices | False Claims Act |
2001 | 6 | 9 | Lupron | TAP Pharmaceutical Products [14] | $875,000,000 | $559 million civil ($875 million with criminal component) | Medicare fraud/kickbacks | False Claims Act/ Prescription Drug Marketing Act |
2010 | 13 | 10 | Seroquel | AstraZeneca [15] | $520,000,000 | $520 million (civil only) | Off-label promotion/kickbacks | False Claims Act |
2007 | 12 | 11 | Abilify/Serzone | Bristol-Myers Squibb [16] | $540,000,000 | $515 million ($25 million in civil disgorgement) | Off-label promotion/ kickbacks/Medicare fraud | False Claims Act/FDCA |
2016 | 14 (tie) | 12 | EpiPen (epinephrine) | Mylan [17] | $465,000,000 | $465 million (civil only) | Misclassification under the Medicaid Drug Rebate Program | False Claims Act |
2010 | 14 (tie) | 13 | Trileptal | Novartis [18] | $465,000,000 | $390 million ($465 million with co-defendant settlements) | Off-label promotion/kickbacks | False Claims Act/FDCA |
2008 | 17 | 14 | Actiq/Gabitril/Provigil | Cephalon [19] | $425,000,000 | $375 million civil ($425 million with criminal component) | Off-label promotion [20] | False Claims Act/FDCA |
2004 | 19 | 15 | Claritin | Schering-Plough [21] | $345,000,000 | $290 million civil ($345 million with criminal component) | Medicare fraud/kickbacks | False Claims Act/ Anti-Kickback Statute |
2017 | 20 | 16 | Thalomid/ Revlimid | Celgene Corporation [22] [23] | $280,000,000 | $280 million (civil only; non-intervened) | Off-label promotion/ kickbacks/Medicare fraud | False Claims Act/FDCA |
2003 | 18 | 17 | Zoladex | AstraZeneca [24] | $355,000,000 | $266 million ($355 million with criminal component) | Medicare fraud | Prescription Drug Marketing Act |
2006 | 15 | 18 | Temodar/ Intron A/K-Dur/ Claritin RediTabs | Schering-Plough [25] | $435,000,000 | $255 million civil ($435 million with criminal component) | Off-label promotion/ kickbacks/Medicare fraud | False Claims Act/FDCA |
2010 | 11 | 19 | Botox | Allergan [26] | $600,000,000 | $225 million civil ($600 million with criminal component) | Off-label promotion | False Claims Act/FDCA |
2004 | 16 | 20 | Neurontin | Pfizer [27] | $430,000,000 | $190 million civil ($430 million with criminal component) | Off-label promotion | False Claims Act/FDCA |
The False Claims Act (FCA) is an American federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal government's primary litigation tool in combating fraud against the government. The law includes a qui tam provision that allows people who are not affiliated with the government, called "relators" under the law, to file actions on behalf of the government. This is informally called "whistleblowing", especially when the relator is employed by the organization accused in the suit. Persons filing actions under the Act stand to receive a portion of any recovered damages.
GSK plc is a British multinational pharmaceutical and biotechnology company with global headquarters in London. Established in 2000 by a merger of Glaxo Wellcome and SmithKline Beecham, GSK is the tenth largest pharmaceutical company and #294 on the 2022 Fortune Global 500, ranked behind other pharmaceutical companies China Resources, Sinopharm, Johnson & Johnson, Pfizer, Roche, AbbVie, Novartis, Bayer, and Merck Sharp & Dohme.
Valdecoxib is a nonsteroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, and painful menstruation and menstrual symptoms. It is a selective cyclooxygenase-2 inhibitor. It was patented in 1995.
Fluticasone/salmeterol, sold under the brand name Advair among others, is a fixed-dose combination medication containing fluticasone propionate and salmeterol. It is used in the management of asthma and chronic obstructive pulmonary disease (COPD). It is used by inhaling the medication into the lungs.
Pharmaceutical marketing is a branch of marketing science and practice focused on the communication, differential positioning and commercialization of pharmaceutical products, like specialist drugs, biotech drugs and over-the-counter drugs. By extension, this definition is sometimes also used for marketing practices applied to nutraceuticals and medical devices.
In common law, a writ of qui tam is a writ through which private individuals who assist a prosecution can receive for themselves all or part of the damages or financial penalties recovered by the government as a result of the prosecution. Its name is an abbreviation of the Latin phrase qui tam pro domino rege quam pro se ipso in hac parte sequitur, meaning "[he] who sues in this matter for the king as well as for himself."
Off-label use is the use of pharmaceutical drugs for an unapproved indication or in an unapproved age group, dosage, or route of administration. Both prescription drugs and over-the-counter drugs (OTCs) can be used in off-label ways, although most studies of off-label use focus on prescription drugs.
TAP Pharmaceuticals was formed in 1977 as a joint venture between the two global pharmaceutical companies, Abbott Laboratories and Takeda Pharmaceutical Co. and was dissolved in 2008; its two most lucrative products were proton-pump inhibitor lansoprazole (Prevacid) and the prostate cancer drug, leuprorelin (Lupron). The intention of the joint venture was to get products that Takeda had discovered developed, approved, and marketed in the US and Canada.
In the United States, Medicare fraud is the claiming of Medicare health care reimbursement to which the claimant is not entitled. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately.
The ethics involved within pharmaceutical sales is built from the organizational ethics, which is a matter of system compliance, accountability and culture. Organizational ethics are used when developing the marketing and sales strategy to both the public and the healthcare profession of the strategy. Organizational ethics are best demonstrated through acts of fairness, compassion, integrity, honor, and responsibility.
David Franklin is an American microbiologist and former fellow of Harvard Medical School who while employed by Parke-Davis filed the 1996 whistleblower lawsuit exposing their illegal promotion of Neurontin (gabapentin) for off-label uses. Franklin's suit, filed on behalf of the citizens of the United States under the qui tam provisions of US federal and state law, uncovered illegal pharmaceutical industry practices and created new legal precedent that resulted in a cascade of criminal convictions and civil and criminal penalties against Pfizer and several other pharmaceutical companies totalling more than $7 billion. Civil cases also followed Franklin v. Parke-Davis. Insurance companies, led by Kaiser Permanente, sued Pfizer for fraud and violation of the federal Racketeer Influenced and Corrupt Organizations Act; the Kaiser case settled in April 2014 after Pfizer's appeal at the US Supreme Court was rejected. Franklin v. Pfizer also spawned more than a thousand wrongful death (suicide) suits associated with use of Neurontin. Numerous books have addressed the social, economic and healthcare implications of Dr. Franklin's stance and actions. The settlement was the first off-label promotion settlement under the False Claims Act.
ISTA Pharmaceuticals, Inc, was a US-based pharmaceutical company that specialized in ophthalmic pharmaceutical products and discovers, develops, and markets therapies for inflammation, ocular pain, glaucoma, allergy, and dry eye. ISTA was acquired by Bausch & Lomb, an eye care company, on March 26, 2012. Under the deal, Bausch & Lomb have agreed to pay $9.10 per share for ISTA, bringing the total value of the acquisition to $500 million. In 2012, Valeant Pharmaceuticals withdrew its $360 million offer.
Pharmaceutical fraud involves activities that result in false claims to insurers or programs such as Medicare in the United States or equivalent state programs for financial gain to a pharmaceutical company. There are several different schemes used to defraud the health care system which are particular to the pharmaceutical industry. These include: Good Manufacturing Practice (GMP) Violations, Off Label Marketing, Best Price Fraud, CME Fraud, Medicaid Price Reporting, and Manufactured Compound Drugs. Examples of fraud cases include the GlaxoSmithKline $3 billion settlement, Pfizer $2.3 billion settlement, and Merck $650 million settlement. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).
Franklin v. Parke-Davis is a lawsuit filed in 1996 against Parke-Davis, a division of Warner-Lambert Company, and eventually against Pfizer under the qui tam provisions of the False Claims Act. The suit was commenced by David Franklin, a microbiologist hired in the spring of 1996 in a sales capacity at Parke-Davis, a pharmaceutical subsidiary of Warner-Lambert. In denying the defendants' motion for summary judgment, the court for the first time recognized off-label promotion of drugs could cause Medicaid to pay for prescriptions that were not reimbursable, triggering False Claims Act liability. The case was also significant in exposing the degree to which publication bias impacts the randomized controlled studies conducted by pharmaceutical companies to test the efficacy of their products. Ultimately, the parties reached a settlement agreement of $430 million to resolve all civil claims and criminal charges stemming from the qui tam complaint. At the time of the settlement in May 2004, it represented one of the largest False Claims Act recoveries against a pharmaceutical company in U.S. history, and was the first off-label promotion settlement under the False Claims Act.
Reuben A. Guttman, born 1959 in New York City, is an American attorney and a founding Partner of Guttman, Buschner & Brooks PLLC ("GBB"), a DC-based plaintiffs' firm His practice involves complex litigation and class actions. He has served as counsel in some of the largest recoveries under the False Claims Act. The International Business Times has called Guttman "one of the world's most prominent whistleblower attorneys," and he has been recognized as a Washingtonian Top Lawyer by Washingtonian Magazine.
Indivior is a specialty pharmaceuticals business. It is listed on the London Stock Exchange and is a constituent of the FTSE 250 Index. It is also listed on the NASDAQ Global Select Market.
Founded in 1990, Insys Therapeutics was an American specialty pharmaceutical company based in Chandler, Arizona. Its main product was Subsys, a sublingual liquid form of the drug fentanyl. Fentanyl is an extremely fast-acting and powerful opioid used to relieve peaks of pain in cancer patients.
Marketing of off-label use is advertising the use of drugs for purposes not approved by the regional government. The practice is often illegal and has led to most of the largest pharmaceutical settlements after Franklin v. Parke-Davis, in which a court ruled off-label marketing a violation of the False Claims Act.
{{cite web}}
: CS1 maint: multiple names: authors list (link)