AbbVie hit with lawsuit over alleged $1.2B kickback scheme

AbbVie was sued by the California Department of Insurance for allegedly orchestrating a wide-ranging kickback scheme to illegally boost prescriptions of its best-selling arthritis drug Humira, according to a STAT news report. 

The lawsuit, filed in Alameda County Superior Court Sept. 18, accuses AbbVie of illegally offering cash, meals, trips, drinks and patient referrals to physicians to encourage them to write more prescriptions.

The complaint also alleges that the drugmaker engaged in a more malicious practice: using an elaborate network of nurse ambassadors to ensure the prescriptions were regularly refilled. Registered nurses hired by AbbVie to visit patients at home and help with administering the drug were instead used to boost refills and downplay potential risks of the drug, the suit alleges.

About 274,000 claims for Humira prescriptions were submitted to insurers from 2013 to 2018. This amounted to health insurers dishing out about $1.2 billion to pay for the fraudulent claims, which would make it the largest health insurance fraud case in the California Insurance Department history, according to the complaint.

"AbbVie spent millions convincing patients and healthcare professionals that AbbVie Ambassadors were patient advocates. In fact, the 'Ambassadors' were Humira advocates hired to do one thing: Keep patients on a dangerous drug at any cost," said California Insurance Commissioner Dave Jones.  "In this case, patient care was traded for $1.2 billion in ill-gotten gains."

The allegations were brought to the insurance department by Lazaro Suarez, who worked as an AbbVie nurse ambassador in Florida.  

Humira is a blockbuster drug for AbbVie that treats rheumatoid arthritis. It generated $12.3 billion in sales in the U.S. last year.

After news of the lawsuit broke Sept. 18, AbbVie shares fell almost 3 percent.

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