Texas suit claims Lilly bribed providers to prescribe drugs

Eli Lilly has been accused of giving illegal inducements to encourage medical providers in Texas to prescribe its medicines in a new lawsuit backed by state Attorney General Ken Paxton.

The complaint (PDF) claims Lilly provided a 'free nurse' programme, delivering patient care services at no charge to providers, in return for prescribing a long list of its "most profitable" medicines, including tirzepatide-based medicines Mounjaro for diabetes and Zepbound for weight loss.

The scheme focused on the follow-up care, either in person or remotely, that is necessary to deliver medical care, but which can fall outside of what providers can bill government-sponsored health programmes like Medicare or Medicaid.

One example cited in the suit is the provision of one-on-one injection training for patients and caregivers, while it also alleges that Lilly's recently introduced direct-to-consumer (DTC) sales channel, LillyDirect, is "yet another tool Lilly uses to funnel patients to certain of the covered drugs."

It further alleges that the drugmaker arranged for remuneration to induce recommendations and prescriptions for its medicines through in-kind reimbursement support services. It claims these could reduce or even eliminate provider costs on matters such as determining whether a patient's insurance would cover treatment, checking if a drug is on formulary, and appealing denial of coverage decisions.

The suit covers 14 Lilly products for cancer, diabetes, eczema and other inflammatory diseases, osteoporosis, and weight loss. According to Paxton, millions of dollars in claims to Texas Medicaid were 'tainted' by the arrangements.

"Big Pharma compromised medical decision-making by engaging in an illegal kickback scheme," he said. "Eli Lilly fraudulently sought to maximise profits at taxpayer expense and put corporate greed over people's health. I will not stand by while corporations unlawfully manipulate our healthcare system to line their own pockets"

Last year, Paxton sued Lilly and other major manufacturers of insulin, as well as pharmacy benefit managers (PBMs), accusing them of artificially inflating prices in violation of the Texas Deceptive Trade Practices Act.

Commenting on the latest action, Lilly said that the organisation represented by the state of Texas in the complaint – the Health Choice Alliance, according to court documents – has a history of bringing this type of legal action against pharma companies and has repeatedly been unsuccessful.

The company insisted it will "vigorously defend" itself against the allegations.