Ultragenyx, a pharmaceutical company, has agreed to pay $6 million for allegations of paying kickbacks that contributed to increased claims for its drug, Crysvita. The company is accused of submitting false claims to Medicare and Medicaid by offering free genetic tests to encourage prescriptions of its drug.
The Department of Justice revealed in a press release that Ultragenyx also instituted a separate fee to obtain test result information, which was used in marketing efforts and influenced the prescription of its drug. Furthermore, it led health care providers to coordinate the distribution of Crysvita. Crysvita is an FDA-approved medication utilized for treating X-linked hypophosphatemia (XLH) in patients aged six months or older, including adults. XLH is a rare inherited disorder that results in low phosphate levels in the blood, leading to weakened bone strength.
Acting U.S. Attorney Joshua S. Levy for the District of Massachusetts stated, "Kickbacks, in whatever form, have no business in our federal healthcare system." He added that they are always vigilant against financial kickbacks that can unduly influence medical decisions, compromise patient care and lead to wastage in federal healthcare programs. Levy stressed their commitment to identifying improper financial kickbacks as medical practices evolve. As part of the settlement agreement, Ultragenyx acknowledged and accepted responsibility for certain facts underpinning the settlement.
The press release further disclosed that Ultragenyx collaborated with a genetic testing laboratory on a sponsorship program to conduct genetic tests for XLH—a genetic mutation necessary for insurance coverage. The laboratory provided test results to Ultragenyx which were utilized for marketing prescriptions and boosting sales. The United States alleges that Ultragenyx facilitated false claims to Medicare and Medicaid by paying kickbacks to beneficiaries and the laboratory for report results—this increased referrals of potential Crysvita patients to Ultragenyx's sales force. The company's sales force subsequently followed up with healthcare providers regarding these test results.
