The US fined Swiss drugmaker Novartis AG US$390 million for granting kickbacks to pharmacies that recommended the company’s drugs, according to an agreement announced on Friday.
In a settlement deal, the company admitted that it gave specialty pharmacies exceptional rebates and patient referrals in exchange for recommending Exjade, which treats excess iron in blood, and Myfortic, an anti-rejection drug used by kidney transplant recipients.
The civil settlement is substantially smaller than the US$3.3 billion fine the US government originally sought in the case.
To boost sales of Exjade, Novartis leveraged its control over patient referrals to pressure pharmacies to hire or assign nurses to call Exjade patients and encourage them to order refills of the drug.
Sales of the drug had suffered up to that point due to side effects that were worse than expected, the government said.
These nurses understated the “serious, potentially life-threatening risks of taking Exjade,” such as kidney and liver failure, the US Justice Department said.
With Myfortic, Novartis offered lucrative rebates to five specialty pharmacies in exchange for urging doctors to switch patients from other drugs to the drug.
Consumers at pharmacies should receive treatments “free from the taint of corporate kickbacks,” US Attorney Preet Bharara said in a statement.
“Novartis turned pharmacies that should have been disinterested health care providers into a biased sales force for the drugmaker,” Bharara said.
“Pharmaceutical companies and their relationships with health care providers — whether they are doctors, pharmacists or nurses — must comply with the Anti-Kickback Statute. If they don’t, we would bring all appropriate law enforcement tools to bear,” he said.
In related news, the US Food and Drug Administration on Friday approved a third drug to treat multiple myeloma, a type of blood cancer. The approved pill, called Ninlaro, is made by Japan’s Takeda Pharmaceutical Co.
The FDA approved two other multiple myeloma treatments this year, one from Johnson & Johnson and the other from Novartis.
The US National Cancer Institute estimates that about 27,000 people are to be diagnosed with multiple myeloma this year and more than 11,200 people would die of the disease.
The FDA said Ninlaro can slow the progression of the disease when other treatments fail. Patients taking Ninlaro lived a median of nearly six months longer without the disease worsening than those taking other regimens, the FDA said.
Side effects of Ninlaro include diarrhea, constipation, low blood platelet count, as well as numbness and pain from nerve damage.
Additional reporting by AP
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