Express Scripts will pay $60 million to end allegations by The Department of Justice that it participated in a kickback scheme with Novartis that caused federal health care programs to pay for a medicine based on false claims.
The U.S. Department of Justice alleged that Novartis offered patient referrals to Accredo Health Group, which is a specialty pharmacy run by Express Scripts, in exchange for bolstering refills of Exjade, a drug used for reducing excess iron in patients who undergo blood transfusions, says the documents filed in federal court in New York.
As a result of the arrangement, Medicare, Medicaid and other programs were defrauded, according to the documents.
The litigation that originated with David Kester, a former Novartis sales manager who in 2011 filed a whistleblower case claiming the drug maker used different plans – including rebates – to induce specialty pharmacies to boost prescriptions for various drugs. Among them was the Myfortic immunosuppressant treatment.
Last year, another specialty pharmacy, BioScrip, paid $15 million to settle allegations as part of the same litigation.
Jeffrey Newman represents whistleblowers