Express Scripts pays $60 million to resolve Novartis kickback arrangement

Express Scripts will pay $60 million to end allegations by The Department of Justice that it participated in a kickback scheme with Novartis that caused federal health care programs to pay for a medicine based on false claims.

The U.S. Department of Justice alleged that Novartis offered patient referrals to Accredo Health Group, which is a specialty pharmacy run by Express Scripts, in exchange for bolstering refills of Exjade, a drug used for reducing excess iron in patients who undergo blood transfusions, says the documents filed in federal court in New York.

As a result of the arrangement, Medicare, Medicaid and other programs were defrauded, according to the documents.

The litigation that originated with David Kester, a former Novartis sales manager who in 2011 filed a whistleblower case claiming the drug maker used different plans “including rebates” to induce specialty pharmacies to boost prescriptions for various drugs. Among them was the Myfortic immunosuppressant treatment.

Last year, another specialty pharmacy, BioScrip, paid $15 million to settle allegations as part of the same litigation.

Jeffrey Newman represents whistleblowers.

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