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Top 10 Health Fraud False Claims Settlements of 2010

January 2, 2011

9 out of 10 of the largest healthcare fraud settlements in 2010 were paid by pharmaceutical companies. 7 out of 10 involved allegations of illegal kickbacks to physicians. 5 out of 10 involved off-label marketing of drugs.  The total amount recovered through the top ten federal False Claims Act healthcare settlements in 2010 was over $4 billion. Below in descending order are the settling defendants alleged to have committed the biggest federal healthcare frauds of 2010:

#1

The Company: GlaxoSmithKline. The Settlement: $750 Million ($600M False Claims Act settlement + $150 in criminal fines and forfeitures). The Allegations: Selling contaminated drugs to Medicaid and other government health programs.

#2

The Company: Allergan. The Settlement: $600 Million ($375M False Claims Act settlement + $225M criminal fines). The Allegations: Illegally marketing Botox for unapproved uses and paying kickbacks to prescribing physicians.

#3

The Company: AstraZeneca. The Settlement: $520 million. The Allegations: Illegally marketing antipsychotic Seroquel for insomnia and paying kickbacks to prescribing physicians.

#4

The Company: Novartis Pharmaceuticals. The Settlement: $422.5 million. The Allegations: Illegally marketing Trileptal and other drugs for off-label uses and paying kickbacks to prescribing physicians.

#5

The Company: Forest Pharmaceuticals. The Settlement: $313+ million. The Allegations: Paying kickbacks to prescribing physicians.

#6 (a tie)

The Company: Roxane Laboratories.  The Settlement: $280 million. The Allegations: Fraudulently inflating drug prices, reporting false pricing, and causing false claims to be submitted to CMS through Average Wholesale Pricing (“AWP”) scheme (also known as “Ain’t What’s Paid”).  The alleged purpose of such schemes is to market the spread and provide a hidden kickback to pharmacies who by the defendant’s drugs.

The Company: Dey, Inc. The Settlement: $280 million.  The Allegations: Near identical AWP false price reporting scheme.

#7

The Company: Elan Corporation.  The Settlement: $214.5 million ($11M to be paid by Japanese drug maker Eisai, Inc.). The Allegations: Illegally marketing epilepsy drug Zonegran for off-label treatment of a variety of illnesses, including migraines and mood swings.

#8

The Company: Abbott Laboratories, Inc. The Settlement: 126.5 million.  The Allegations: AWP false price reporting scheme à la Roxane and Dey.

#9

The Company: The Health Alliance of Greater Cincinnati. The Settlement: $108 million. The Allegations: Paying kickbacks to physicians for referring cardiac patients to hospitals.

#10

The Company: Kos Pharmaceuticals. The Settlement: $41 million. The Allegations: Illegally off-label marketing Advicor and paying kickbacks to prescribing physicians.


To report Medicare Fraud, contact Frohsin & Barger.

One Comment
  1. donna lawless permalink

    I read this for an assignment and found that seroquel use for insomnia was illegally marketed and now I am really upset as my son is in the Army and that is what they gave him for insomnia. He quit taking it because I told him it was not intended for that purpose and he should take something else. I don’t know if they are getting a kick back but I know I will get to the bottom of this enlightening information.

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