Pfizer Settles Anti-Kickback Violation Claims for Nearly $60 Million

Pfizer, Inc., on behalf of its wholly owned subsidiary Biohaven Pharmaceuticals, Inc. has paid almost $60 million dollars to settle claims that the pharmaceutical giant engaged in a kickback scheme from 2020 through 2022. Biohaven was charged with knowingly causing false claims to be submitted to Medicare and other health care programs, as well as doling out luxury gifts and money in exchange for health care providers prescribing their drug to patients.¹

The drug, Nurtec ODT, a CGRP receptor antagonist, which is used to prevent and treat migraine headaches, netted Pfizer $928 million in sales in 2023.² Pfizer recently announced that sales increased 39% in 2024 due to strong demand in the U.S. and a launch in international markets.³ Pfizer bought Biohaven for $11.6 billion in 2022 allegedly in large part due to the drug, Nurtec.⁴

Biohaven Violated Anti-Kickback Statutes

A whistleblower lawsuit first brought the anti-kickback claims against the Pfizer subsidiary in a 2021 lawsuit The allegations included high speaker pay-outs, allowing attendance at multiple speaker programs that provided no educational benefit and included attendance by friends and spouses of speakers, and expensive meals at high-end restaurants.⁵

Events were held at entertainment venues or fancy restaurants that were not conducive to educational lectures and speakers were allegedly paid pursuant to the number of prescriptions they wrote rather than their expertise, and those payments were grossly underreported to the CMS Open Payment System in excess of $250,000 dollars.⁶

Settlement Was a Joint Effort Between Federal and State Agencies

The settlement was a joint effort put together by the U.S. Department of Justice, the U.S. Attorney’s Office for the Western District of New York and other federal agencies. The large pay-out will be divided among several states and the federal government.⁷ The federal government will receive about $50.2 million. About $9.5 million will go to state Medicaid programs. Whistleblower Patricia Frattasio, a former Biohaven sales representative, will collect $8.4 million under this settlement.⁸

Trini Ross, U.S. Attorney General for the Western District of New York pointed out:

Patients deserve to know that their doctor is prescribing medications based on their doctor’s medical judgment, and not as a result of financial incentives from pharmaceutical companies.⁹

Acting Attorney General, Brett A. Shumate explained:

Through this settlement and others, the government has demonstrated its commitment to ensuring that drug companies do not use kickbacks to influence physician prescribing.¹⁰

While the drug giant has agreed to pay nearly $60 million dollars, it will do so without admitting any wrongdoing. The settlement relates to alleged conduct at Biohaven before Pfizer’s acquisition of the company in October 2022 and does not include any admission of liability or wrongdoing,” a spokesperson for Pfizer said.^{11 12}

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