Omnicare: The Drugmaker’s Pitch in the Pharmacy’s Name

Omnicare agreed to pay $28.125 million in the Omnicare Depakote fraud case over allegations that it accepted kickbacks from Abbott Laboratories to recommend Depakote to nursing-home residents. The alleged sales channel ran through the pharmacists reviewing residents’ medications. Grants, rebates and educational materials connected the drugmaker’s commercial interests to advice that physicians received from the pharmacy.

How Consultant Pharmacists Could Steer Depakote Prescriptions

Omnicare supplied drugs and employed pharmacists who recommended them to nursing-home physicians. That combination gave the pharmacy a place in the prescribing decision as well as the sale. The whistleblower’s complaint alleged that Omnicare directed its pharmacists to recommend more of a manufacturer’s drugs after entering a payment arrangement with that manufacturer. Physicians could write new prescriptions or authorize switches from drugs their patients already took.

The complaint described monthly drug-regimen reviews as part of the consultant pharmacist’s work. It alleged that Abbott paid Omnicare and PharMerica to turn chart reviews into opportunities to convert residents to Depakote. Physician authorization letters and forms could then permit the pharmacy to make those switches. A routine review of the resident’s medicines became, in the alleged scheme, a recurring opportunity to sell a particular drug.

The government’s allegations covered grants, educational funding, rebates linked to use, management meetings and other benefits. The target included Depakote use for agitation and aggression associated with dementia. The whistleblower alleged that the promotion generated false claims to government health care programs, including Medicare and Medicaid. In that alleged arrangement, manufacturer payments helped determine which medicines residents with dementia received, while public programs paid for the prescriptions.

ReView Put the Sales Message Into Clinical Materials

The Justice Department alleged that ReView was a payment vehicle for increasing Depakote use. According to the government’s complaint, Omnicare solicited substantial contributions to the program from Abbott and other pharmaceutical manufacturers, and its internal documents called ReView its “one extra script per patient” program. The whistleblower’s account shows how the program’s educational materials could reach a prescribing decision.

According to the complaint, Abbott funded a CD for Omnicare consultant pharmacists through an educational grant. It included a pocket guide, presentations about Depakote use for dementia-related agitation and aggression, material for families, and draft letters from Omnicare asking treating physicians to change prescriptions. The whistleblower alleged that Abbott controlled the content. The package supplied both the clinical pitch and a letter asking the physician to act on it.

The complaint also alleged that Abbott-funded treatment guidelines promoted Depakote products as first-line treatments for dementia patients even though the FDA had not approved that use. Pocket versions carried the pharmacies’ identities:

That is what made the pharmacy logo useful in the alleged scheme. A drugmaker’s sales message arrived under the name of the pharmacy advising the nursing home about its residents’ medicines.

Less Paperwork as a Selling Point

The sales pitch extended to the nursing station. The whistleblower alleged that Abbott promoted Depakote as requiring less documentation than traditional antipsychotics, including less work recording residents’ behaviors and maintaining flow records. The alleged advantage was fewer forms for the staff as well as more prescriptions for the manufacturer. Training presentations and nursing paperwork therefore mattered alongside rebate contracts.

Amgen’s Aranesp and the Same Prescription Switches

A separate whistleblower complaint involving Amgen’s Aranesp described a similar use of the pharmacy’s influence. It alleged that nursing homes complained about repeated requests to switch residents between Procrit and Aranesp because of the rebates manufacturers offered Omnicare. It also alleged that monthly medication reviews became a mechanism for switching drugs. In both complaints, the question was what commercial arrangement sat behind the recommendation to change a resident’s treatment.

Who Settled the Omnicare Depakote Case?

Omnicare Inc. was the settling pharmacy in the Justice Department’s October 17, 2016 announcement. Abbott was the manufacturer and had resolved its own Depakote case separately in 2012. CVS Health acquired Omnicare in 2015, approximately six years after Omnicare ended the conduct that gave rise to the settlement.

Two former Abbott employees brought the whistleblower cases in the Western District of Virginia. One had worked in long-term-care sales and training, selling Depakote products. That role gave the complaint its view inside the sales presentations and promotional materials. The government joined the cases and brought its own complaint against Omnicare.

PharMerica reached its separate Depakote settlement in 2015, agreeing to pay $9.25 million over allegations that it received rebates, educational grants and financial support to recommend the drug. Its consultant pharmacists’ monthly medication reviews supplied the channel for influence.

How Much Is a Whistleblower Claim Worth?

The Omnicare settlement announcement included a $3 million whistleblower reward from the approximately $20.3 million federal share of the recovery.

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

What Evidence Is Needed to Prove Fraud?

In the Omnicare Depakote case, the evidence connects the manufacturer’s payments, the pharmacy’s recommendations, the resulting prescriptions and the government healthcare claims. We examine those connections with the insider who knows how the arrangement worked.

ReView materials and draft physician letters show the requested change in treatment. Chart reviews and prescription-switch authorizations show how the pharmacy could carry it out. Grant records, rebate contracts and meeting payments explain the financial relationship behind the promotion. The complaint alleged that Omnicare caused reimbursement claims to go to Medicare and Medicaid after delivering drugs to residents.

The payment path also matters. The complaint describes prescription drugs as part of the bundled payment for covered Medicare Part A nursing-home care. CMS’s billing manual explains payment to outside suppliers through the facility’s contracts. The facility’s pharmacy contract can therefore be part of the money trail, alongside the manufacturer’s agreement with the pharmacy.

A 2018 teaching article in the Journal of Forensic & Investigative Accounting cites a fraud-examiners’ survey finding that fraud was most often detected through tips from employees, vendors and customers. Here, someone who knows the contracts and someone who knows the medication reviews may see different parts of the same arrangement. The useful inside knowledge is how those parts connect.

You Know Why the Prescription Changed

If you saw manufacturer payments shape pharmacy recommendations, tell our whistleblower experts what drove the drug switches. We build the case with you and bring in pharmaceutical kickback whistleblower lawyers who understand consultant-pharmacy arrangements. We stay beside you as the clinical decisions and commercial payments become a case for recovering public money.