Texas sues Sanofi, claiming kickbacks to doctors

Texas Attorney General Ken Paxton has filed a lawsuit against Sanofi, claiming the company bribed doctors to prescribe its medicines, in the state's latest broadside against pharma groups.

The complaint (PDF) names Sanofi subsidiary Sanofi-Aventis US and alleges that the company gave illegal inducements to encourage medical providers in Texas to favour its medicines over those available from rivals.

The claims are similar to those in a lawsuit that Texas filed against Eli Lilly last year, and revolve around the provision of patient care services, at no charge to providers, that the state maintains effectively represent kickback programmes.

As with the Lilly lawsuit, the claim against Sanofi references a 'free nurse' programme, providing patient support at no charge to health systems when a particular medicine is prescribed, as well as 'support services programmes' that help healthcare providers to "bypass the administrative hurdles associated with Medicaid reimbursement."

It contends that both schemes are designed to encourage doctors to choose Sanofi medicines over those of its rivals "to secure years of revenue."

Examples cited in the suit include the provision of one-on-one nursing support for patients prescribed Sanofi's immunology therapy Dupixent (dupilumab), multiple sclerosis drug Aubagio (teriflunomide), and severe asthma treatment Tzield (tezepelumab).

It also takes issue with free reimbursement support services that, it claims, in some instances, eliminate the cost to healthcare providers of prescribing some medicines – particularly expensive drugs that need prior authorisation from Medicaid and other payers before they can be prescribed.

Getting reimbursement for these medications can be time-consuming and costly, with providers having to demonstrate whether a patient's insurance would cover treatment, check if a drug is on formulary, and, in some cases, appeal denial of coverage decisions.

"The quality of Texans' healthcare should never be determined by big pharma bribery," said Paxton in a statement.

"Sanofi is in clear violation of Texas law that prohibits the exact type of kickback scheme that the company is actively engaging in," he added. "The people of Texas deserve to know that the drugs they're being prescribed are being given to them to best address their medical needs."

The suit is seeking an injunction on the programmes, as well as monetary relief of more than $1 million, including civil penalties.

Last year, Texas also sued Sanofi and Bristol Myers Squibb, claiming they had failed to disclose that their antiplatelet drug Plavix (clopidogrel) was less effective for some patients, including those with Black, East Asian, and Pacific Islander heritage.

Sanofi said that the two programmes "are structured to comply with applicable federal and state laws and are intended to support patients, not to influence prescribing decisions," adding that it is "zealously defending this litigation."