prescribed for a long period of time, switching a patient from another manufacturer's ACE
inhibitor to Monopril in exchange for ongoing kickbacks was a significant economic incentive
While Bristol Myers and Omnicare may have attempted to disguise their bribes as
"rebates" or "discounts," Omnicare communicated the unvamished truth to the employees
implementing the switches. Manufacturers were paying a bounty for each switch.
Bristol Myers' representatives often visited Omnicare locations for the purpose of
promoting the switches. Bristol Myers developed special materials targeted solely to Omnicare
pharmacists and physicians in Omnicare-serviced nursing homes to "educate" these audiences on
the importance of the switching program and on how to switch patients from other ACE
inhibitors to Monopril.
Bristol Myers' marketing personnel met with Omnicare pharmacists before the
mass switching to Monopril, to educate pharmacists on how to make the switches. Relator
Lisitza was at such a meeting. Bristol Myers' marketing staff and Omnicare senior management
told Omnicare's front line phannacists and supervisors that the switches were good for the
patients and good for the payors. They claimed that the switches would be beneficial to patients
in Omnicare-serviced long-term care facilities, and would save the payors money - government
entities as well as private insurers.
Bristol Myers also made marketing and pharmacy technical agents available to
Omnicare pharnlacists who needed subsequent technical assistance to switch patients from other
ACE inhibitors to Monopril.