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antipsychotics to Abilify.

178.

Bristol

Myers

also

worked

with

Omnicare

to

illegally

solicit

PALs

from

physicians authorizing blanket switches to Abilify. Bristol Myers' actions in furtherance of this

conspiracy included:

  • Makingfalse statements to Omnicare front line pharmacy personnel as to the reasonfor the switching. Bristol Myers made false representations to Omnicare phannacy staff, through materials prepared uniquely for Omnicare staff, through "kickoff' and other meetings designed to maximize the wholesale switching, and through making themselves available for technical consultations. These false representations included:

    • o

      That the switch to Ability was financially advantageous to the government and private insurers, when this was almost never the case.

    • o

      That Abilify was clinically the most appropriate antipsychotic, when frequently this, too, was not the case.

  • Making false statements to physicians as to the reasons for the switching. Bristol Myers made its marketing personnel available at Omnicare-serviced nursing homes to work with Omnicare consultant pharmacists to convince physicians to sign PALs authorizing wholesale switches.

  • Failing to disclose kickbacks and other financial interests to physicians in helping Omnicare solicit PALs. Bristol Myers did not disclose to physicians that it was providing kickbacks to Omnicare for switching certain types of medications to "preferred" medications.

  • Requiring Omnicare to develop computerized electronic capability to accurately track levels ofparticipation in the illegal PAL solicitation program by site and by prescribing clinician

  • Rewarding Omnicare for the proportion of patients switched to AbilitY vIa illegal switching payments based in part on the success of the switching scheme.

179.

Bristol Myers knew, intended, or reasonably should have lmown and foreseen that

the Market Share Agreement would induce Omnicare to engage in unauthorized medication

substitution, replacing the independent medical judgment of a patient's physician or psychiatrist

with that of Omnicare pharmacists, consulting pharmacists, and other Omnicare employees, by

changing physicians' orders for specific atypical antipsychotics to Abilify.

49

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