Health Care and Pharmaceutical Fraud
The American health care industry is one of the most notable industries in relation to Qui Tam lawsuits. Individuals who make claims against the pharmaceutical industry have brought about major consequences for companies involved in pharmaceutical fraud, which not only benefits the government, but also tax payers and health insurance policy holders. Everyone has an interest in stopping fraud in the health care industry.
At an alarmingly increasing rate, pharmaceutical companies are pushing their sales representatives to sell a given drug or medical device at almost any cost. Some of the sales tactics pharmaceutical representatives employ, however, are entirely illegal under federal law. For instance, sales personnel are known to offer “kickbacks,” or under the table benefits, to doctors who prescribe a drug to their patients. This is called an inducement, and it is entirely illegal.
Prescribing drugs for patients may seem like a doctor’s everyday task, but when the doctors are provided with financial and recreational benefits in exchange for their business, their judgement as a medical professional is jeopardized and their main goal is to benefit the pharmaceutical company’s bottom line, not to benefit the patient.
Another form of fraudulent pharmaceutical activity is ” off-label use.” The Federal Food Drug and Cosmetic Act (FDCA) provides guidelines for new drugs and prohibits them from being marketed to consumers until they are approved by the FDA for their specific intended use. Once a drug is approved by the FDA, it is only approved for the specific use that is to be noted on the label, and any other prescribed uses are illegal.
If, in the future, the company decides it wants to market the drug for other intended uses, it is required by law to apply for a “New Drug Application” to gain FDA approval for the newly mentioned uses. Many companies find this time consuming and unimportant. Any other recommended uses of the drug that are not approved by the FDA is considered off-label marketing.
Off-label marketing is a tactic enacted by pharmaceutical representatives and even physicians to sell a product to a consumer and to push the product to as many patients as possible. Many physicians are given rewards for increasing the sale of a drug and are rewarded through things such as professional sporting event tickets, lavish vacations, bonuses and other financial benefits.
Physicians are often given phony scientific studies by sales personnel for the drug and other falsely accredited documents as proof that the drug is safe for other uses that are not technically approved by the FDA. It is rare for an actual involved doctor or other medical professional to come forward and blow the whistle on these individuals once the fraudulent activity becomes known, for fear of jeopardizing his or her occupation.
Improved whistle blower statutes help put a stop to this type of conduct. As more cases are brought to light by whistle blowers, not only are the misconducts of pharmaceutical companies and health professionals being put under a spotlight, but the protections available for others to come forward against their employers are becoming even stronger. The government has found that the best information to prove the violations of companies in question comes from insiders, especially those who have participated in the illegal conduct. These individuals who decide to come clean may be rewarded under the False Claims Act.
If you have witnessed pharmaceutical fraud or health care fraud, it is important that you discuss this with someone who understands Qui Tam law. Remember, the first person who reveals fraud in a Qui Tam lawsuit is the one who obtains the reward – so it’s also important that you act quickly and confidentially. Our Qui Tam lawyers at Kershaw, Cook & Talley can explain your rights and answer your questions with complete confidentiality.
Call us toll free at 888-997-5170 for a free and confidential case evaluation, or fill out the form found on this page and throughout our site.