Drug sales reps have a front-row seat to illegal marketing schemes. The role of drug marketing is to promote drugs for FDA-approved uses, but pharmaceutical companies have a track record of paying illegal kickbacks and inducing prescriptions for off-label uses of their products.
Pharmaceutical Integrity Coalition is currently investigating numerous drugmakers for this type of violations and we want to hear from whistleblowers, who can remain confidential sources.
Under the False Claims Act (FCA), drug sales representatives with knowledge about misconduct by pharmaceutical companies can bring claims against them on behalf of the government and receive cash awards.
When physicians inappropriately prescribe drugs to Medicare and Medicaid beneficiaries, our taxpayer dollars end up paying for them. When these prescriptions are connected to illegal marketing, any claims for government reimbursement constitute false claims.
FCA (False Claims Act) whistleblowers can receive up to 30 percent of any recoveries resulting from their whistleblower report and legal claim.
Sometimes there is marginal evidence that a drug developed to treat one condition may be useful in treating another. In this scenario, without sufficient safety information and clinical trials the FDA will not approve the drug for the prospective off-label uses. Until the FDA approves the drug as a treatment for a second condition, sales reps cannot tell doctors to prescribe it for that use.
Although these regulations are very clear, some drug companies will push their drugs for off-label use simply to increase sales.
Another common fraud scheme is the use of kickbacks in pharmaceutical marketing. In the past, kickbacks were very straightforward. A kickback was literally a sales rep telling a physician, "If you prescribe our drug to your patients, we'll give you a $500 incentive payment.” That is not the case anymore. Today, kickbacks can be disguised as research grants, speaking fees, medical directorships, paid trips to conferences, and more.
For instance, if a drugmaker wants a well-known cardiologist to speak at an event, they could perhaps pay her $2,000. But if they pay the cardiologist $20,000 and make it clear that they are only paying that cardiologist a huge amount of money because she is prescribing a lot of the company’s drugs, or the specialist will only keep getting these payments for speaking engagements if she prescribes drugs, that $20,000 payment constitutes a kickback.
Illegal kickback schemes and off-label promotion are two types of misconduct commonly exposed with the help of pharmaceutical sales reps. If these whistleblowers have information that no one else has reported, and they report it through a lawyer by filing an FCA lawsuit, they can be eligible for large cash awards.
To qualify for a whistleblower reward, you must have inside information and direct, first-hand knowledge. Pharmaceutical company employees, sales reps in particular, are usually in an ideal position to expose misconduct.
With the help of whistleblowers, the government has recovered billions of dollars from pharmaceutical companies in connection with False Claims Act and Anti-Kickback Statute violations. And there are many more billions waiting to be recovered.
Pharmaceutical fraud is rampant in our country, and the government relies on whistleblower tips to expose it. For their efforts, tipsters are rewarded with a substantial share of the taxpayer funds recovered.
Common Types of Pharmaceutical Fraud
- Off-Label Marketing: Drugmakers promote drugs for off-label uses, violating federal law.
- Illegal Kickbacks: Bonus payments to doctors/hospitals, luxury vacations, lavish meals, tickets to sports’ games and other events, speaking fees, conference-related travel, consulting fees, research grants, free drug samples for illegal sales, etc. . .
- Inflating Drug Prices for Medicare and Medicaid
- Offering Better Pricing to Private Buyers
- Pharmaceutical Benefits Manager Fraud: Illegal discount agreements, kickbacks paid to insurance companies, and contractual responsibility violations.
Who Blows The Whistle on Pharma?
- Sales representatives
- Sales managers
- Compliance officers
- Pharmaceutical company employees
- Hospital employees
- Doctor’s office staff
How Big Pharma Induces Sales Reps to Mislead the Public
The opioid crisis bears testimony to how Big Pharma’s downplaying of drug risks can impact society. By overstating the benefits and concealing the risks of Oxycontin, Purdue Pharma has greatly contributed to a public health crisis that has taken thousands of lives.
A former Purdue sales rep recently recalled, “I remember hearing rumors early on that the bonuses for the Purdue sales reps were just incredible. Some of them were making $50,000 or $60,000 a quarter in incentive bonuses.”
According to Physicians for Responsible Opioid Prescribing, “What you find in the private practice of medicine in America, is if you’re generating positive numbers, a lot of the questions don’t get asked.”
Sex and Guns to Sell Opioids - Insys Pays $225 Million
A group of recently unsealed whistleblower suits filed by Insys employees revealed that sales reps took prescribing doctors out to strip clubs, shooting ranges, and lavish meals. Between 2012 and 2018, a single Florida doctor who benefitted from this special treatment wrote a disproportionate number of prescriptions for Insys’ opioid Subsys, resulting in $3.3 million in Medicare reimbursements.
The complaints against Insys also exposed the company’s peculiar hiring criteria. In 2012, Insys hired an escort manager and former stripper without any relevant education as a sales representative. According to an Insys sales manager, the woman was “sleeping with [a] doctor and getting a lot of prescriptions out of him.” Later, Insys hired another female sales rep “to have sexual relations with doctors in exchange for Subsys prescriptions.” In 2013, an Insys sales manager indicated that the ideal candidate for an open sales rep position would be someone who was “banging a doctor.”
In June 2019, Insys agreed to pay $225 million to resolve allegations that it had bribed doctors to encourage Subsys prescriptions. The settlement led Insys to file for bankruptcy. Other opioid makers, including Purdue, are also facing bankruptcy in connection with their role in the opioid crisis.
Drug Sales Reps Expose Misconduct and Receive Cash Awards
Pharmaceutical companies sell billions of dollars worth of drugs annually. Sometimes a single popular drug brings in a few billion a year in revenue. Medicare and Medicaid often foot the bill for the majority of prescriptions. When a sales rep files a whistleblower lawsuit, hundreds of millions of dollars are often at stake, and this can lead to tens of millions in whistleblower awards.
Endo Sales Rep Whistleblower Receives $33 Million
In 2015, Peggy Ryan, a former Endo Pharmaceutical sales rep, received a $33.6 million whistleblower award. Ryan had filed an FCA lawsuit that exposed Endo’s off-label marketing of its product Lidoderm, a pain patch. Endo paid a total of $171 million to resolve allegations of federal and state FCA violations. The company admitted that it had illegally promoted Lidoderm for non-FDA-approved uses.
The whistleblower stated that “from the onset of her training, her Endo superiors urged her to open the door to off-label dialogues with physicians, distributing off-label studies, and conferring messages like, ‘put the patch where the pain is.'”
In 2019, Bruce Boise, a former Cephalon sales rep, filed a lawsuit citing misconduct involving the drugmaker’s “opioid lollipop,” Actiq. The complaint highlighted Cephalon’s dangerous and illegal off-label marketing of the highly addictive drug.
Boise initially reported the fraud to the FDA. He started wearing a wire and became an informant. Unfortunately, he was promptly found out and fired. When he learned about the False Claims Act, he hired a lawyer and filed a lawsuit. Cephalon eventually settled the case for $425 million, and Boise received an 8-figure whistleblower award. At the time, a spokesperson for the tipster stated, “Bruce Boise, sacrificed a lot to protect patients across this country.”
AstraZeneca Pays $520+ Million to Resolve Allegations Involving Seroquel
Another pharmaceutical sales rep turned whistleblower, Allison Zayas, filed a lawsuit that exposed AstraZeneca’s reluctance to disclose a dangerous drug interaction that took numerous lives. In 2009, Zayas became aware that at least 10 patients who were taking both AstraZeneca’s Seroquel and methadone at New York clinics had died. She informed her employer, who nevertheless continued to market Seroquel aggressively, often to methadone clinics.
The sales rep filed a whistleblower lawsuit in 2010, claiming the company had withheld critical information from the FDA, failed to alert patients about dangerous drug interactions, and knowingly marketed the drug for patients on methadone.
AstraZeneca settled the case for an undisclosed amount. The company had previously paid $520 million to resolve off-label marketing allegations involving Seroquel.
Warner Chilcott Pays $125 Million Over Illegal Marketing
In 2015, Warner Chilcott and several executives pleaded guilty to illegal marketing charges, and the company agreed to pay $125 million to settle FCA allegations. The case was initiated by two former Warner Chilcott sales representatives who refused to engage in misconduct. The settlement made the tipsters eligible for a $22.9 million award.
Warner Chilcott’s Illegal Marketing
- Kickbacks paid to doctors (lavish dinners, inflated speaking fees, etc.)
- Manipulating prior authorizations to facilitate reimbursements by Medicare, Medicaid, and private insurers
- Off-label marketing, unproven claims
- Drugs cited in the lawsuit: Actonel, Asacol, Atelvia, Doryx, Enablex, Estrace, and Loestrin
Warner Chilcott’s misconduct involved Medicare and Medicaid fraud.
Avanir Whistleblowers Receive $17 Million Award
Kevin Manieri, an Avanir sales director, and two other whistleblowers filed Medicare fraud lawsuits against the drugmaker. The complaints alleged that the company had paid kickbacks to doctors to induce Nuedexta prescriptions. A doctor from Cleveland, Ohio, and three other individuals were indicted in connection with the fraud allegations.
Nuedexta was legally marketed by California-based Avanir for pseudobulbar affect (PBA), a rare disease. Allegedly, the company decided to promote the drug for off-label uses by paying kickbacks to doctors. The illegal payments were disguised as speaking fees. A high-prescribing Cleveland doctor received a staggering $56,000 in Avanir fees.
For their role in the recovery of taxpayer funds, Manieri and two Georgia-based whistleblowers received a collective reward surpassing $17 million.
Pfizer Settlement - Sales Rep and Doctor Share $59 Million Award
In 2016, Pfizer agreed to pay $785 million to resolve Medicaid fraud allegations involving its drug Protonix. The case was initiated by AstraZeneca sales representative Lauren Kieff and Dr. William LaCorte, a serial whistleblower. For their actions in exposing the fraud, Kieff and LaCorte were awarded $59 million.
The whistleblowers became aware of fraudulent pricing involving the drug at a New Orleans hospital. Protonix is marketed by Wyeth, a Pfizer subsidiary, which was the defendant in the case before Pfizer acquired it in 2009.
According to the whistleblower complaint, Protonix was offered at a discount to several buyers, while Medicaid was paying full price. This violates the FCA’s “best price” rule for companies that provide products and services to the government. Prosecutors estimated that the practice resulted in the loss of at least $2 billion taxpayer dollars.
Forest Sales Rep Receives $7.8 Million Award
In 2016, Forest Laboratories and Forest Pharmaceuticals agreed to pay $38 million to settle a fraud lawsuit filed by a sales rep from Germantown.
The sales representative was Kurt Kroening, who claimed Forest was paying illegal kickbacks to induce prescriptions of its hypertension drug Bystolic, its fibromyalgia medication Savella, and its Alzheimer’s drug Namenda. For his role in bringing misconduct to light, Kroening was awarded $7.8 million.
While he worked as a sales representative for Forest, the Wisconsin resident witnessed how the drugmaker monitored the number of prescriptions doctors wrote, incentivizing high prescribers with lavish meals, all-expenses-paid trips, and sham speaking fees. “Kickback schemes [like Forest’s] undermine the integrity of medical decisions and increase the costs of health care for everyone,” a spokesperson for the DOJ commented.
U.S. Worldmeds Pays $17.5 Over Kickbacks - Whistleblower Gets $3.2 Million
As sales reps and doctors are incentivized to ignore medical necessity and focus on maximizing drug reimbursements, aggressive drug marketing often evolves into Medicare fraud. That is exactly what happened at U.S. Worldmeds, which settled a whistleblower case in April 2019.
The drugmaker agreed to pay $17.5 million to resolve False Claims Act allegations involving illegal kickbacks. The financial incentives included paying trips to the Kentucky Derby for two high-prescribing physicians. Two whistleblowers shared a $3.2 million share of the settlement.
Pharmaceutical Fraud is Ongoing - Report Illegal Schemes Today
Pharmaceutical Integrity Coalition urges drug company sales representatives and sales managers, physicians, and others with evidence of illegal marketing schemes to come forward. Inappropriate marketing involving kickbacks and disproportionate bonuses tied to prescription rates usually result in Medicare fraud and False Claims Act violations.
Whistleblowers in Medicare/Medicaid fraud cases often receive multimillion-dollar awards.
Our current investigations reveal that off-label marketing and kickback schemes are ongoing at various pharmaceutical companies in the U.S. These illegal schemes have cost government programs billions of dollars.
Pharmaceutical Integrity Coalition believes fraudulent schemes are in progress in several jurisdictions, including New York, Miami, Dallas, Los Angeles, Seattle, Detroit, Saint Louis, Boston, Houston, Chicago, Atlanta, and elsewhere.
Even if the drug company is located outside the United States, whistleblowers can still receive a reward as long as the illegal marketing practices are taking place in the U.S.
If you are a prescribing doctor, drug sales rep, hospital employee, or compliance officer in any state, and you have documented proof of illegal drug marketing, contact us anytime for a complimentary consultation and a thorough evaluation of your case.
Our consumer advocates, pharmaceutical fraud specialists, and litigators can help you package your information to build a bulletproof case. We work with top whistleblower attorneys who have a track record of recovering billions of taxpayer dollars in False Claims Act cases.
Why Pharma Sales Reps Need to File a Whistleblower Lawsuit – Pitfalls to Avoid
Sales reps who wish to become whistleblowers sometimes make the mistake of contacting the federal government or using a fraud hotline to report misconduct.
This is a huge mistake. Government officials do not have the time or resources to investigate all claims, and they focus their attention on well-documented lawsuits filed by experienced whistleblower attorneys.
The federal False Claims Act gets about 700 cases filed a year in the entire country. That's not a big number for a population of several hundred million. On the other hand, the Medicare fraud hotline literally gets tens of thousands of calls and online forms per year. The FDA gets thousands and thousands of calls.
Calling a hotline or filling out an online form does not get you a reward. The only way to get the reward is to go through the formal process of filing a lawsuit.
Contacting the press is also a mistake. Whistleblower awards go to people who provide original information about fraud, so sharing your information can reduce your chances of obtaining a reward. On the other hand, False Claims Act lawsuits are kept under seal while the government investigates. If the information is leaked, fraudsters will know they are being investigated, and this will give them a chance to stop misconduct and destroy evidence.
The only way to maximize your chances of holding fraudsters accountable, recovering taxpayer funds, protecting patients, and obtaining an award is to file a False Claims Act lawsuit with the help of a seasoned whistleblower attorney.
Drug sales reps who try to report misconduct internally seldom fare well. Fraud is ingrained in the culture of many pharmaceutical companies, and the only way to deter drugmakers from breaking the law is to make them pay back millions of dollars through settlements and verdicts.
Pharmaceutical Integrity Coalition has a network of successful pharma whistleblower attorneys in New York, Missouri, Michigan, Indiana, Illinois, Wisconsin, Minnesota, Nebraska, Kansas, Colorado, Utah, New Mexico, Arizona, Nevada, California, Texas, Massachusetts, Maryland, Louisiana, North Carolina, Oklahoma, Oregon, Washington, Florida, Virginia, Ohio, Pennsylvania, Georgia, Alaska, Alabama, and beyond.
We urge pharmaceutical sales representatives and other would-be whistleblowers to contact Pharmaceutical Integrity Coalition for a free and confidential legal case assessment.
Government Fights Pharmaceutical Fraud with The Help of Insiders
Since 2009, the government has recovered nearly $20 billion from companies and individuals who defrauded federal and state healthcare programs like Medicare, Medicaid, and TRICARE. Whistleblowers in these cases have received hundreds of millions of dollars as a reward for their role in uncovering fraud and recovering taxpayer funds.
The False Claims Act allows insiders with proof of fraud against the federal and state governments to sue pharmaceutical companies on the government's behalf. These lawsuits are filed under seal, and they remain so until the government decides whether to intervene or not. Even if the government declines, plaintiffs can proceed with their cases. Only an experienced whistleblower attorney with sufficient resources can continue with an FCA case if the government declines.
There is a statute of limitations to file FCA lawsuits against pharmaceutical companies. As a rule, you have six years to file a whistleblower complaint, but there can be certain extensions. Pharmaceutical Integrity Coalition staff can help you determine whether your claim is still valid. If you suspect misconduct by a pharmaceutical company, you need to act fast to ensure you are the first to file and the statute of limitations has not run out. If another whistleblower files a lawsuit with the same information, only the first to file can receive an award.
Do You Have Evidence Of Pharmaceutical Fraud? Act Now – Strict Time Limits
Pharmaceutical Integrity Coalition can help you file a successful whistleblower lawsuit and receive a substantial cash award. Contact us for a confidential case assessment. Act fast, the clock is ticking. There is a deadline to file your complaint under the False Claims Act’s statute of limitations.
Whistleblower attorneys play a critical role in helping insiders navigate complex scenarios and adverse situations.
If you have information about fraud by drugmakers or other healthcare industry players, we want to hear from you. Contact Pharmaceutical Integrity Coalition to secure legal counsel and discuss your chances of success. Our teams have helped numerous sales reps and other pharma insiders obtain awards amounting to tens of millions of dollars.
What’s in it for us? Our goal is simple – We restore integrity, safety and public confidence to the pharmaceutical industry. We never charge a fee for our service.