California insurance regulator sues AbbVie alleging Humira kickbacks

Like other drugs in its class, Humira is used for a wide-range of chronic inflammatory conditions, carrying 10 separate indications on its Food and Drug Administration-approved label. "AbbVie operates in compliance with the many state and federal laws that govern interactions with healthcare providers and patients", the company replied in a statement cited by Reuters' Ankur Banerjee and Tamara Mathias. This amounted to health insurers dishing out about $1.2 billion to pay for the fraudulent claims, which would make it the largest health insurance fraud case in the California Insurance Department history, according to the complaint.

In fact, the "Ambassadors" were Humira advocates hired to do one thing: "keep patients on a risky drug at any cost", California Insurance Commissioner Dave Jones said in a statement. According to the suit, Suarez became aware of the nationwide reach of AbbVie's nurse network because his success as an Ambassador led him to a role as a trainer of other staff. It's likely patients were prescribed Humira because of the kickbacks provided by AbbVie and not because it was the best medication to treat them, California Insurance Commissioner Dave Jones said on a conference call announcing the lawsuit.

According to the lawsuit, AbbVie footed the bill for physicians' meals, drinks and travel, all in an effort to induce them to write more Humira prescriptions.

The pharmaceutical industry's most powerful lobbying group is opening its war chest to try to sway a policy fight with no clear connection to medicine or health care, spending a half-million dollars here to oppose a California ballot measure that would expand rent control protections across the state.

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The state's lawsuit is based on allegations by a registered nurse who worked for AbbVie. These nurses trained patients on administering their subcutaneous injections and provided patient care, paperwork help, and other services, all of which alleviated burdens on prescribers' practices in exchange for selecting Humira from a range of available treatments. "The kickback scheme also included nurses whom the company sent to the homes of patients taking the drug, the lawsuit says", reports the AP's Thanawala.

"While Suarez initially took the job as an Ambassador to help care for patients with challenging diagnoses, says the suit, he later "...felt that the focus of the Ambassador program was getting and keeping patients on Humira to maintain and increase AbbVie's profits". Instead, the nurses employed through the program were allegedly instructed to keep patients on Humira and refer questions and concerns to AbbVie, not physicians. "These private nurses, paid by AbbVie, attenuate the direct relationship between the patient and their healthcare provider in troubling ways".

Shares of AbbVie were down 2 percent to $93.05 in afternoon trading.

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