Aventis Pays More Than $190 Million to Settle Drug Pricing Fraud Matters

    WASHINGTON, Sept. 10 /PRNewswire-USNewswire/ -- Aventis Pharmaceuticals
 Inc. has paid the United States and a number of states, as well as the
 District of Columbia, over $190 million to resolve allegations that the
 company caused false claims to be filed with Medicare and other federal
 health programs as a result of the company's alleged fraudulent pricing and
 marketing of drugs, the Justice Department announced today. Aventis is now
 known as sanofi-aventis U.S. Inc. and sanofi-aventis U.S. LLC.
 
     Aventis, one of the world's largest pharmaceutical manufacturers, has
 agreed to settle False Claims Act allegations concerning its pricing and
 marketing of Anzemet, an antiemetic drug used primarily in conjunction with
 oncology and radiation treatment to prevent nausea and vomiting. The
 government alleged that the pharmaceutical company engaged in a scheme to
 set and maintain fraudulent and inflated prices for Anzemet knowing that
 federal health care programs established reimbursement rates based on those
 prices.
 
     The United States alleged that Aventis used the difference between the
 inflated prices that it reported, which were used by federal programs to
 set reimbursement rates for health care providers, and the actual prices
 for the drugs charged to its customers in order to market, promote and sell
 Anzemet to existing and potential customers.
 
     The difference between the reimbursement rate of the federal health
 care programs and the actual price paid by health care providers is
 commonly known as the "spread." The larger the spread on a drug, the larger
 the profit or return on investment for the provider. Because reimbursement
 from federal programs was based on the fraudulent, inflated prices, the
 United States contended that Aventis caused false and fraudulent claims to
 be submitted to federal health care programs.
 
     "Marketing drugs to doctors based on potential profits undermines
 confidence in the integrity of our health care system because it treats
 beneficiaries like commodities instead of patients," said Assistant
 Attorney General Peter D. Keisler. "The Justice Department will continue to
 hold drug companies accountable for fraudulent pricing schemes designed to
 give windfalls to drug companies and doctors at the expense of federal
 health care programs for the poor and the elderly."
 
     The investigation commenced after the filing of a False Claims Act suit
 by Ven-A-Care of the Florida Keys Inc., a home-infusion company. The Act
 allows for private persons to file a qui tam or whistleblower suit on
 behalf of the government. If the government is successful in resolving or
 litigating its claims, the whistleblower may receive a share of the
 recovery. As part of this settlement, the Ven-A-Care whistleblowers will
 receive approximately $32 million as their share of the settlement.
 
     "Again, a corporation has been caught fraudulently inflating the cost
 of a drug used primarily to reduce the side effects of cancer treatments
 without regard to the increased costs borne by government health care
 programs or elderly and indigent patients," said U.S. Attorney R. Alexander
 Acosta of the Southern District of Florida. "Corporations cannot continue
 to mislead the government into paying vastly exaggerated prices by
 exploiting a health care system based on trust and fair play."
 
     As part of a condition for continuing to work with providers who do
 business with the Medicare and Medicaid programs, Aventis agreed to enter
 into a Corporate Integrity Agreement with the Office of Inspector General
 of the Department of Health and Human Services that, among other things,
 will require the company to report accurate average sales prices and
 average manufacturer's prices for its drugs covered by Medicare and other
 federal health care programs.
 
     "Fraudulent drug pricing and marketing schemes divert scarce Medicare
 and Medicaid resources away from patient care," said Daniel R. Levinson,
 HHS Inspector General. "One of OIG's top priorities is to root out
 pharmaceutical fraud and hold companies liable for their actions."
 
     "One of the essential elements in administering federal health programs
 is the need to protect taxpayers and the millions of elderly and low-income
 Americans who depend on these programs," said Kerry Weems, Acting
 Administrator for the Centers of Medicare and Medicaid Services. "This
 settlement reinforces our commitment to protect the integrity of Medicare
 and Medicaid."
 
     Of the more than $190 million settlement, the federal recovery is
 $179,787,726, and the states' and District of Columbia's recovery for their
 share of Medicaid is $10,645,600.
 
     The investigation was conducted by the Civil Division of the Department
 of Justice, the U.S. Attorney's Offices for the Southern District of
 Florida and the District of Massachusetts, the Office of Inspector General
 for the Department of Health and Human Services, the Office of Program
 Integrity of TRICARE Management Activity, and the National Association of
 Medicaid Fraud Control Units.
 
     http://www.USDOJ.gov
 
 
 
 

SOURCE U.S. Department of Justice