Bayer, Glaxo
Settle Medicaid Fraud Cases
Drugmakers Agree to Pay for
Withholding Discounts from Insurance Program
By Denise Lavoie
Associated Press
Thursday, April 17, 2003; Page A07
BOSTON, April 15 -- Drugmakers Bayer AG and GlaxoSmithKline agreed to pay the
largest Medicaid fraud settlements ever negotiated to resolve allegations that
they overcharged the government health insurance program for poor people, a
federal prosecutor said.
Bayer will pay the government more than $250 million, and Glaxo will pay
almost $88 million for failing to give the Medicaid program the lowest price
charged to any customer, said U.S. Attorney Michael J. Sullivan, whose office in
Boston helped negotiate the agreement.
Bayer said it set aside $257 million last year to cover the cost.
The settlements will be shared by the federal government, the District of
Columbia and all the states except Arizona.
Under the agreement, Bayer will plead guilty to violating the Federal
Prescription Drug Marketing Act, Sullivan's office said. It will pay a criminal
fine of about $5.6 million for alleged overcharges involving Cipro, an
antibiotic, and Adalat, a drug to control blood pressure. Bayer will pay about
$251.6 million in civil penalties.
Glaxo agreed to pay a civil fine for overcharging Medicaid for the
antidepressant Paxil and the nasal allergy spray Flonase. Glaxo was not accused
of a crime.
Sullivan said both companies offered discounts to Kaiser Permanente -- the
nation's largest health maintenance organization -- for their drugs. The drugs
were then relabeled, which allowed the companies to avoid reporting the low
prices given to Kaiser and to avoid paying millions of dollars in rebates to
Medicaid.
Under the law, drug companies are required to report all their prices and to
pay Medicaid a rebate if they charge anyone less than they do the government.
Sullivan would not elaborate on why Bayer was charged with a crime while
Glaxo was not, but he said the conduct engaged in by the two companies was not
identical.
Sullivan said that at a time of state budget deficits and skyrocketing prices
for prescription drugs, withholding funding from Medicaid can have a devastating
impact on efforts to provide drug coverage for the poor.
Glaxo said in a prepared statement that the sole issue in the case was how it
interpreted an "ambiguous aspect" of the law. The company said it agreed to the
civil settlement to avoid the delay and expense of trial.
Peter Lurie, deputy director of Public Citizen's Health Research Group in
Washington, said such settlements could help control drug costs.
"In other countries -- through a variety of different mechanisms -- they
negotiate prices, they establish profit margins, and there's a transparency to
the process that tends to mitigate the possibility of this kind of fraud," Lurie
said. "But in this kind of non-transparent program, there's an invitation to
fraud."
State and federal prosecutors are in the midst of several investigations into
drug manufacturers.
TAP Pharmaceutical Products Inc., Pfizer Corp. and Bristol-Myers Squibb
reached separate agreements to settle multimillion-dollar complaints. Attorneys
general from 47 states are investigating whether Pfizer illegally marketed the
epilepsy drug Neurontin.
The Bayer investigation was prompted by George Couto, a Bayer marketing
executive who became a whistle-blower. In 1999, Couto reported his concerns to
his boss, according to his New York lawyer, Neil V. Getnick. When the company
did nothing about his complaint, Couto, who has since died, took his claims to
the Justice Department, Getnick said.
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