Drugmaker AbbVie will pay $24 million to settle fraud lawsuit

California Insurance Commissioner Ricardo Lara announced that the Department of Insurance reached a $24 million settlement with pharmaceutical giant AbbVie that will require it to change its marketing practices for its immunology drug Humira.

Once a blockbuster sales driver for the company, Humira faced stiff competition from similar drugs on the international market. In the second quarter of 2020, foreign sales of the drug dropped by nearly 20 percent, and U.S. sales did not increase enough to cover that steep drop. Humira is used to treat symptoms of arthritis, Crohn’s disease, ulcerative colitis, plaque psoriasis and ankylosing spondylitis.

The settlement resolves a lawsuit filed in Alameda Superior Court that the state of California brought against AbbVie, alleging that it had violated the Insurance Frauds Prevention Act by failing to disclose critical information to patients and health care providers.

“AbbVie’s prior practices in marketing Humira egregiously put profits ahead of transparency in patient care and violated California law,” Lara said. “This settlement delivers important reforms to AbbVie’s business practices and a substantial monetary recovery that will be used to continue to combat insurance fraud.”

In a statement emailed to the Bee, AbbVie leaders said that their nurse ambassador program had enjoyed high levels of support and engagement and that the negotiated settlement would not require significant changes to it.

“Patient support programs, such as AbbVie’s Humira Complete Nurse Ambassador program, are important for helping patients access and adhere to the life-changing treatments their doctors have prescribed,” the statement said. “Although federal courts have considered the issues raised in this proceeding and have dismissed parallel cases, this resolution allows us to proceed with our important programs and focus our efforts on enhancing the lives of the patients we serve.”

The state of California will receive $15 million of the $24 million settlement, and a former AbbVie nurse who reported the practices to the Insurance Department will get the remainder.

AbbVie had employed registered nurses as ambassadors to talk with patients about Humira, but did not disclose that they were employees of the big pharma company, the lawsuit alleged, and the company also unlawfully provided valuable professional goods and services to doctors at no cost to induce them to prescribe Humira.

AbbVie, based near Chicago, denied any wrongdoing. But, as part of the settlement, the company agreed to the monetary payment and to reform its marketing practices in California. Among the changes:

Nurse ambassadors now must disclose they work for AbbVie, and the company will instruct them not to have patient-specific discussions with providers.

The company’s sales representatives no longer will invite prescribing health care providers to offsite business meals.

Patients must be given copies of the Humira medication guide approved by the U.S. Food and Drug Administration.

AbbVie employees can no longer describe ambassadors as extensions of the physicians’ offices and cannot provide their contact information to physicians. They also cannot actively participant in conversations that patients have with their insurance companies.

The company also faces a lawsuit in the Northern District of Illinois that alleges violations of the Federal False Claims Act and various state false claims acts, but the state of California is not a party to that legal action.

TNS