Government Joins Whistle Blower Fraud-Suit against Drug Giant Wyeth

  by Deb Cupples |  And people wonder why this nation's health care costs have skyrocketed? 

Given how many fraud cases the Justice Department has pursued against health-care industry companies of all sorts (hospitals, drug companies, labs, pharmacies...), there is simply no excuse for Congress and the Executive Branch to fail to recognize the contribution of greed to health-care costs run amok -- or to fail to enact laws and policies to reduce those costs.

The Justice Department reported:

"The United States and 16 states have joined in two whistleblower suits filed in the District of Massachusetts against the drug manufacturer, Wyeth, alleging that the company knowingly failed to give the government the same discounts it provided to private purchasers of its drugs, as required by laws governing the Medicaid program. As a result, Wyeth allegedly avoided paying hundreds of millions in rebates due to state Medicaid programs for its drugs, Protonix Oral and Protonix IV. These drugs belong to a class of drugs known as proton pump inhibitors (PPI), which are used to suppress stomach acid.

"Under the Medicaid Drug Rebate Program, drug manufacturers of brand name drugs (i.e. non-generic drugs) are required to report to the government the prices they charge their customers, including the "best price" offered for their drugs. They also are required to pay rebates to the state Medicaid programs that are calculated on any discounted prices that are offered.... 

"Between 2000 and 2006, Wyeth offered steep discounts to thousands of hospitals nationwide for Protonix Oral and Protonix IV under a pricing arrangement known as the "Protonix Performance Agreement." This pricing arrangement required that the hospitals purchase both drugs together under a so-called "bundled" arrangement and it offered them a steep discount for doing so. Wyeth did this in part to gain access to the far more lucrative retail outpatient market, intending that patients who used the intravenous version of Protonix in the hospital would later purchase Protonix Oral once they were discharged from the hospital. (DoJ, paragraph breaks added.)

I must interject: yes, that's six years of questionable conduct.  Does anyone see a systematic pattern emerging?  The Justice Department continued:

"Under the Protonix Performance Agreement, hospitals that placed both products on their formularies and attained certain market share requirements were entitled to up to a 94% discount off the list price of Protonix Oral and up to 80% off the list price of Protonix IV. Although Wyeth was required under the Medicaid Drug Rebate Program to determine the effective prices paid by hospitals under this arrangement, and to pass along the benefit of the lowest prices to the state Medicaid programs, Wyeth allegedly failed to do so and therefore avoided paying hundreds of millions of dollars to Medicaid in quarterly rebates. (DoJ, paragraph breaks added.)

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Comments

[EMR]

Indeed fraud case against health care industry is increasing in numbers in the present days. We get to know about such cases from the newspapers and internet.

[maria]

Who do i talk to, about a clinic that give medicine, by so call nurses with out ever seen a doctor. this medicine give me a horrible pain on my chest, it feels like a heart attack, 5 deferent kind of medicine a day. I feel like IM going to die after i take them. I had to stop taking them, I need your help.
thank you
maria