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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, May 25 2018

Full Issue

Pfizer Settles With U.S. Over Practice Of Using Charity To Pay Kickbacks To Medicare Patients

“Pfizer used a third party to saddle Medicare with extra costs,” U.S. Attorney Andrew Lelling said in a statement. “Pfizer knew that the third-party foundation was using Pfizer’s money to cover the co-pays of patients taking Pfizer drugs, thus generating more revenue for Pfizer and masking the effect of Pfizer’s price increases.”

Reuters: Pfizer To Pay $23.85 Million To Settle U.S. Co-Payment Kickback Probe

Pfizer Inc agreed to pay $23.85 million to resolve U.S. charges that it used a purportedly independent charity to pay illegal kickbacks to Medicare patients, covering their out-of-pocket costs for its prescription drugs. The U.S. Department of Justice said on Thursday that the civil settlement resolves allegations that Pfizer improperly used the Patient Access Network Foundation as a conduit to cover co-payment obligations of patients taking three Pfizer drugs. (Stempel, 5/24)

Stat: Pfizer To Pay Nearly $24M For Illegally Using A Charity To Pay Kickbacks

Specifically, the Department of Justice alleged that Pfizer used the Patient Access Network Foundation as a conduit to cover co-pay costs for Medicare patients taking three of its drugs, according to the settlement agreement. These drugs were Sutent and Inlyta, which both treat renal cell carcinoma, and Tikosyn, which treats arrhythmia in patients with atrial fibrillation or atrial flutter. The feds contended that, from 2012 through 2016, Pfizer used a specialty pharmacy called Advanced Care Scripts to shift some patients to the charity, which then covered co-pay costs, rather than giving Sutent and Inlyta directly to Medicare patients who met financial qualifications for its existing free drug program. And Pfizer allegedly made donations to PAN so co-pay costs would be covered. (Silverman, 5/24)

Bloomberg: Pfizer Used Charity To Mask Heart Drug Price Hikes, U.S. Says

For drugmakers, the charities have been a way to help patients with out-of-pocket costs imposed by insurers and government programs. Without them, drugmakers argue, patients might skip doses or avoid treatment altogether because of the expense. Over the last two years, the government has been issuing subpoenas and investigating the relationships between drug companies and the charities, which are supposed to operate independently from their industry donors. Medicare bars direct subsidies of products by drugmakers as kickbacks. (Langreth, 5/24)

Boston Globe: Pfizer To Pay Nearly $24 Million To Settle Kickback Charges

The company also signed a five-year corporate integrity agreement with the inspector general of the Department of Health and Human Services. Drug companies are barred from subsidizing copayments for patients enrolled in Medicare, but may donate to independent nonprofits that provide such assistance. (Saltzman, 5/24)

Kaiser Health News: Pfizer Settles Kickback Case Related To Copay Assistance For $24M

Pfizer spokeswoman Sally Beatty stressed that the company takes compliance “very seriously.” The company continues to donate to charities that offer assistance with copays. “The Company believes all individuals deserve access to medicines prescribed by their physicians,” she said in a statement provided to Kaiser Health News. “Pfizer continues to believe these programs help patients lead healthier lives.” (Lupkin, 5/24)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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