Sanofi to pay $11.8M to settle Medicare kickback claims

Sanofi has agreed to pay the U.S. $11.85 million to resolve claims it used a patient assistance charity to funnel illegal payments to patients to use its multiple sclerosis drug, Lemtrada. 

According to the U.S. Justice Department, patient assistance charity The Assistance Fund ran a program to provide copayments for Medicare patients prescribed Lemtrada, which costs about $100,000 per year. 

The fund allegedly raised its maximum grant payment to $20,000 to accommodate Lemtrada patients. 

In 2015 and 2016, Sanofi allegedly worked with a third-party contractor to find Medicare patients who had been prescribed Lemtrada but hadn't received it yet because they couldn't afford the copays. Then Sanofi would instruct the contractor to quickly refer as many Lemtrada patients as possible to the fund. 

Sanofi would pay the fund to cover Lemtrada for patients, so Lemtrada patients received a disproportionately large share of the Medicare copay grants, and patients taking multiple sclerosis drugs other than Lemtrada received a disproportionately small share of the Medicare copay grants, according to the Justice Department.

The Justice Department said this violated the Anti-Kickback Statute, which prohibits pharmaceutical companies from offering or paying any remuneration to entice Medicare or other federal programs to buy their drugs. 

"They rigged the system so those taking its drug, Lemtrada, gained an unfair advantage over patients using other medications," the Justice Department wrote. 

The settlement doesn't include an admission of guilt by Sanofi. 

Read the full news release here

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