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conspiracy with Bristol Myers included the following:

Making false statements to physicians as to the represented to the physicians that the switch to Omnicare, the patient, and Medicaid money, when

reason for the switching. "preferred" medications this was not the case.

Omnicare would save

Failing to disclose kickbacks and other .financial interests to physicians. Omnicare did not disclose to physicians when soliciting PALs that it was receiving kickbacks from Defendant Manufacturers such as Bristol Myers for switching certain types of medications to "preferred" medications.

Falsely representing that the "preferred" medications were scientifically and medically preferable to other available alternatives. Omnicare also published what they purported to be the results of clinical trials and other studies suggesting that "preferred"

respective medication represented a further

cause

them

medications were now the

classes.

These

purported

medical "drugs of choice" within their scientific results were fraudulent, and

effort

on

OlTIl1icare's

part

to

justify

switching

all

"non-preferred"

medication

to

prescriptions to "preferred" medications so that Omnicare could maximize the amount kickbacks it was receiving. In this way, Omnicare made prescription recommendations

of to

the physicians that were intended to affect their prescribing behavior, to prescribe Monopril, and later other "preferred" medications.

i. e.,

  • Forcing their pharmacist staffto solicit PAL letters based on fraudulent information and to apply fraudulently-obtained PAL letters wherever possible. Omnicare monitored the progress of their consultant and dispensing pharmacists and used the solicitation of PALs as a part of their measured job performance.

  • Monitoring physicians who refused to sign PALs, or who requested that some patients not be switched. These physicians were given a "hard sell" by Bristol Myers and Omnicare consultant pharmacist staff in the hopes that they could be convinced to execute PALs for all their patients on ACE inhibitors.

77.

Bristol Myers paid kiekbacks to Omnicare on the basis of specific sales and

performance

goals

set

forth

in

the

Market

Share

Agreement.

The

amount

of

a

kickback

increased on a sliding scale proportionate with Omnicare's successful increase of Monopril's

market share through the PAL-based kickbacks-for-switches program.

78.

With the PAL letters signed, Omnicare staff made system changes to ensure

Omnicare

would

reap

its

reward

from

Bristol

Myers.

Omnicare

reconfigured

its

computer

system so that any physician order for a "nonpreferred" medication would be automatically

21

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