In a case that highlights the government’s crackdown on pharmaceutical misconduct, Biohaven Pharmaceutical Holding Company Ltd., a subsidiary of Pfizer Inc., has agreed to pay $59.7 million to settle allegations of illegal kickbacks.
The settlement addresses claims that, before Pfizer’s acquisition, Biohaven paid improper incentives to health care providers to promote prescriptions of its migraine medication, Nurtec ODT.
From March 2020 to September 2022, Biohaven allegedly offered speaker honoraria and lavish meals at upscale restaurants to physicians, aiming to encourage them to prescribe Nurtec ODT.
Federal authorities contend that these actions violated the anti-kickback statute, which prohibits offering financial rewards to influence decisions involving Medicare, Medicaid, TRICARE, and other federally funded health care programs.
Federal Government Sends a Clear Message
Acting Assistant Attorney General Brett A. Shumate emphasized that the settlement reaffirms the government’s commitment to ensuring objectivity in health care decisions.
“Drug companies cannot be allowed to manipulate physician prescribing practices with financial incentives,” Shumate stated.
U.S. Attorney Trini E. Ross also underscored the importance of protecting patients, saying, “Doctors should prescribe medication based on their professional judgment, not because of financial rewards from pharmaceutical companies.”
Allegations of Improper Conduct
According to the government, Biohaven created a speaker bureau where select health care providers were offered paid speaking engagements.
These events often included attendees who gained little to no educational value, such as friends, family members, or colleagues from the speakers’ own practices.
Some physicians attended multiple programs on the same topic, raising questions about the educational merit of these events.
The alleged misconduct persisted until October 2022, when Pfizer acquired Biohaven and promptly ended the Nurtec speaker programs.
Whistleblower Played a Key Role
The case was brought to light by Patricia Frattasio, a former sales representative at Biohaven, under the whistleblower provisions of the False Claims Act.
Frattasio’s whistleblower suit allowed her to recover approximately $8.4 million from the settlement as her share of the federal recovery.
In total, $50.2 million of the settlement will go to the federal government, while $9.5 million will be allocated to state Medicaid programs.
A Coordinated Effort to Fight Health Care Fraud
This settlement was the result of collaboration between the Justice Department’s Civil Division, the U.S. Attorney’s Office for the Western District of New York, and investigative partners, including the Department of Health and Human Services and the Department of Defense.
Special Agent Patrick J. Hegarty of the Defense Criminal Investigative Service emphasized the importance of protecting taxpayer-funded programs like TRICARE.
“We remain committed to pursuing corporations that undermine the integrity of our health care systems,” he said.
Protecting Federal Health Care Programs
Authorities stress that cases like these showcase the government’s dedication to combating health care fraud.
The False Claims Act remains a powerful tool in holding companies accountable, with tips and complaints about potential fraud encouraged through reporting channels like the Department of Health and Human Services hotline.
No Admission of Liability
While the settlement resolves the allegations, it’s important to note that there has been no formal determination of liability against Biohaven.
Nonetheless, this case serves as a strong reminder that financial incentives undermining the integrity of medical decision-making will not be tolerated.
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