Pfizer Settles Biohaven Kickback Case for $59.7 Million

Pfizer Settles Biohaven Kickback Case for $59.7 Million

Introduction

Mississippi has joined 37 other states and Puerto Rico in settling allegations that Biohaven Pharmaceutical Holding Company Ltd., a subsidiary of Pfizer Inc., engaged in illegal kickback practices. The settlement resolves claims that Biohaven provided improper payments and incentives to healthcare providers to promote its migraine medication, Nurtec ODT.

Pfizer to Pay Nearly $60 Million

As part of the agreement, Pfizer will pay $59,746,277.54, plus interest, on behalf of Biohaven. The allegations state that Biohaven knowingly submitted or caused the submission of false claims to Medicaid and other federal healthcare programs by offering kickbacks in the form of cash, lavish meals, and honoraria payments to healthcare providers in exchange for prescribing Nurtec ODT.

Protecting Medicaid Integrity

The Mississippi Attorney General emphasized the importance of ensuring Medicaid funds are used appropriately. "Taxpayers who fund Medicaid should be able to count on the program’s soundness, and its beneficiaries should receive honest and fair medical advice from their healthcare providers," the Attorney General stated. The settlement aims to uphold the integrity of Medicaid and protect Mississippi residents from unethical medical practices.

Violations of the Anti-Kickback Statute

The settlement resolves allegations that from March 1, 2020, to September 30, 2022, Biohaven violated the Anti-Kickback Statute (AKS), 42 U.S.C. § 1320a-7b(b), by compensating providers for participating in speaker programs designed to boost Nurtec ODT prescriptions among Medicaid and other federal healthcare beneficiaries.

Excessive Payments and Lavish Perks

Some providers received tens of thousands of dollars—up to $100,000—for their participation in these programs. Many of these events were attended by individuals with no medical or educational interest, including speakers’ spouses, family members, and friends. Additionally, some providers attended multiple programs covering the same topic, receiving expensive meals and drinks with no educational benefit.

Mississippi’s Share of the Settlement

As part of the settlement, Mississippi will receive $162,204.59 in restitution and other recoveries. The case was initiated by whistleblower Patricia Frattasio, a former Biohaven employee. The investigation was conducted in partnership with the U.S. Department of Justice and the U.S. Attorney’s Office for the Western District of New York.

Funding for Medicaid Fraud Investigations

The Mississippi Attorney General’s Office Medicaid Fraud Unit is primarily funded through a grant from the U.S. Department of Health and Human Services. For the 2025 federal fiscal year, the unit will receive $4,001,713.00, covering 75% of its funding, with the remaining 25%, or $1,333,904.00, provided by the State of Mississippi.