omissions nullified the consent set forth in the PALs.
Drug selection is fundamentally a medical judgment.
To be valid, a prescription
preferred medications to fill prescriptions for ACE inhibitors, statins, antibiotics, pain
medications, and atypical antipsychotics, the conspirators made a medical judgment for a large
vulnerable population for financial gain rather than based on appropriate individualized patient
evaluation - unlawfully usurping the role of both the treating physician and the FDA.
All state laws broadly prohibit filling a prescription with any drug other than the
one prescribed, and narrowly restrict the circumstances under which a pharmacist can choose
among different drugs. The switching that occUlTed pursuant to the PAL scheme took place
outside of circumstances in which a pharmacist might have legally made a switch and took place
for purely monetary reasons - so that the Defendant Manufacturers could obtain larger market
share for their pricier drugs. The switches violated state laws, contrary to the certifications
Defendant Manufacturers made as a condition of obtaining payment from the states.
Each and every claim for the switched medications and refills caused to be made
by the Defendant Manufacturers lacked valid physician authorization and therefore constitutes a
THE KICKBACKS-FOR-SWITCHES SCHEME VIOLATED THE ANTI KICKBACK STATUTE, RENDING ALL CLAIMS SUBMITTED TO THE GOVERNMENT FOR DRUGS COVERED BY THE MARKET SHARE AGREEMENTS FALSE CLAIMS
dispensing pharmacies) fit squarely within the AKS's definition of illegal remuneration. In
direct violation of the AKS, Defendant Manufacturers paid substantial sums of money to