materially omitted from their pitch to physicians that in many instances the switches cansed
substantial health risks to the elderly population. As a direct and proximate result of these
material misrepresentations and omissions, the prescribing physicians were induced to execute
PALs. Accordingly, the Defendant Manufacturers got what they paid for - a huge boost in
market share due to thousands of switches to the drugs that were often more expensive for
payors, creating a ready pool of additional revenues the Defendant Manufacturers used to fund
the kickbacks to Omnicare.
The end result of the PAL scheme dramatically increased the number of claims
submitted to the government for the higher priced, "preferred" medications, which led to
Manufacturers' increased revenues, and the correspondingly-increased cost to the government
healthcare programs, were the direct, intended, and foreseeable result of the unlawful kickbacks
to Omnicare and the business plans that the Defendant Manufacturers developed in concert with
Omnicare to maximize the number of switches.
switches to the Defendant Manufacturers' preferred medications purely for financial gain and
without medical justification - the prescribing physicians would not have executed the PALs.
The prescribing physicians reasonably and justifiably relied upon the consulting
pharmacists' misrepresentations. The law and ethical rules impose upon pharmacists the duty to
disclose all material facts relating to drug switching in order for physicians to make fully
informed decisions and to recommend drug switching based solely upon their independent
medical judgment that the switch would be in the particular patient's best interest.