New Jersey Whistleblower Lawyer Blog

If you understand the current interplay between Average Wholesale Price (AWP), ingredient cost, discounts off AWP given by Pharmacy Benefit Managers (PBMs) and other elements that go into drug pricing, please give me a call as the more I learn, it is apparent the less that I know.
However, I do know one thing. Any mother or father who shops in a supermarket would understand the basic cost of salt and sugar. I would bet that if you walked into any supermarket in the country and asked any individual, regardless of their native language, they would come within $3.00 of guessing the price of the appropriate cost of a pound of sugar or a pound of salt.
Imagine how shocked anyone would be to learn what Baxter International was selling “bags” of salt and sugar for to Medicaid according to a lawsuit filed by the State of Louisiana . Now, admittedly, the “bag” of salt and the “bag” of sugar sold to Medicaid were actually in the form of a saline solution and a dextrose solution. The solutions were provided in intravenous drip bags. The drip bags are more difficult to produce than buying salt or sugar off the shelf, however, not terribly difficult.
In a study, the Department of Justice determined that the appropriate AWP for a dextrose solution (sugar) would be around $2.75 a bag. The AWP for a saline solution (salt) was $1.71 per bag. The lawsuit in Louisiana alleges that Baxter International charged $928.51 per bag for saline and dextrose.
It is truly amazing that these simple solutions of readily available products can be subject to such an overcharge. However, it is the current state of our health care system.
The lawsuit was brought against many defendants for overcharges to the Louisiana health care system. We cannot be sure as to whether or not New Jersey has brought any such action or participated in the settlement of national claims.
It might be interesting to look and see how the State of New Jersey’s participation in these lawsuits may have resulted in a recovery of monies that could offset the current budget deficit.

If you are aware of overcharges made to the State or Federal Government, you may be entitled to a reward as a “relator”. Contact a qualified New Jersey Whistleblower lawyer to discuss your information.

Related Web Sources:
$928 for a Bag of Salt: How Drugmakers Rip Off Taxpayers (By Jim Edwards)

A number of recent cases have shown that the drug companies are prepared to pay millions, and sometimes, billions of dollars to settle cases involving prescribing drugs for unapproved uses. These “Qui Tam” matters are brought by individuals who have learned information that is not otherwise available to the Federal Government. New Jersey has a similar “Whistleblower Law” technically referred to as the “False Claims Act”.

Of interest in the recent cases with settlements is the fact that there has been no real action taken against the doctors who may be the worst offenders in prescribing the drugs. According to ProPublica, statistics show that 15 drug and medical device companies have paid $6.5 billion since 2008 to settle accusations of either marketing fraud or payment of kickbacks. In the various suits, approximately 75 doctors were named as being involved but none of the doctors were sanctioned in any way.

Drug maker Eli Lilly pleaded guilty to illegally marketing an anti-psychotic drug “Zyprexa”. Eli Lilly paid $1.4 billion in criminal penalties and settlements in the various civil lawsuits. Interestingly, one doctor, Psychiatrist George Jerusalem prescribed more than $1 million a year worth of Zyprexa. Dr. Jerusalem was a consulting psychiatrist to more than 100 nursing homes and was treating between 3,000 and 5,000 residents. Among other allegations, it was alleged that Eli Lilly had paid Dr. Jerusalem in excess of $50,000.00 in “consulting fees”.

Continue reading " Making the Doctor Connection in Off- Label Drug Prescriptons " »