EyePoint Pharmaceuticals: Training Samples by the Hundred

In the EyePoint DEXYCU settlement, EyePoint Pharmaceuticals agreed to pay the United States $4,657,463 to resolve pharmaceutical kickback allegations involving reimbursement protection and excessive free samples for surgery centers. The company’s policy said samples were for training healthcare providers. Its settlement agreement acknowledged deliveries exceeding 100 samples a month to some centers and sales instructions connecting free units to patients’ insurance.

The Department of Justice announced the civil resolution on July 17, 2026. EyePoint also agreed to pay $21,519 to participating states, separately from the federal payment. The case concerned DEXYCU, dexamethasone intraocular suspension, an injectable corticosteroid used to treat eye inflammation after cataract surgery.

EyePoint accepted responsibility for specific facts in the settlement agreement linked by the Department of Justice, including how its Assurance Program worked and how it distributed samples. This pharmaceutical fraud case tells a sharper story than the phrase reimbursement support suggests: the manufacturer supplied products, discounts and money when a center’s insurer would not cover the purchase.

Why Reimbursement Held Back DEXYCU Sales

DEXYCU’s reimbursement problem was a sales problem. EyePoint acknowledged that uncertain commercial insurance payments caused some ambulatory surgery centers to decline to buy the drug.

A surgery center buys medication, administers it during a procedure and seeks reimbursement. The amount it pays for the drug and the amount the insurer pays back determine what that purchase costs the center. For DEXYCU, the government and commercial sides of that calculation could look very different.

The agreement describes a bundled cataract-surgery payment that included drugs administered during the procedure. DEXYCU’s temporary pass-through status allowed separate, additional Medicare reimbursement. A number of commercial insurers, meanwhile, either declined to reimburse DEXYCU or paid very little. A product could therefore bring a separate payment for one patient’s surgery and leave the center absorbing its cost for another.

The whistleblower’s complaint explains why that difference mattered across the practice. It says ophthalmologists preferred to use one drug for postoperative inflammation across their patients, simplifying billing and seeking consistent outcomes. Incomplete coverage could discourage them from choosing DEXYCU even for patients whose insurance would pay.

That is the commercial problem behind reimbursement promises and excess samples. In the alleged arrangement, the manufacturer removed costs on the commercially insured side to win purchases on the government-paid side. The value of the offer reached beyond the patient who received the free dose. Under the complaint’s account, taxpayers funded purchases won with subsidies, while competing suppliers lost business to the free-drug offer.

Two Free Samples With Each Purchase

The whistleblower alleged that EyePoint supplied two free DEXYCU samples for every prescription purchased. The complaint said the free doses subsidized surgeries for patients whose insurers would not reimburse the drug, while encouraging continued purchases for Medicare, Medicaid and TRICARE patients.

The purchased dose and the free doses served different parts of the same account. The center could use the samples in surgeries that otherwise left it paying for the medication. The complaint alleged that this made DEXYCU attractive across the practice and generated more government-reimbursed purchases.

The agreement supplies EyePoint’s own account of its sample distribution. EyePoint acknowledged that internal compliance policies designated samples for training providers to administer DEXYCU. It also acknowledged distributing thousands of samples to the covered surgery centers. Certain sales representatives instructed centers to bill federal healthcare programs for DEXYCU and, on occasion, to use no-cost samples for commercially insured patients.

That puts a concrete question in front of a sales or compliance employee: how did a training supply become part of the customer’s insurance strategy?

What the Sales Visits Revealed

The complaint describes customer conversations and an operating-room whiteboard that connected sample deliveries to actual patients. Its detail came from people trying to sell a competing product into the same surgery centers.

The whistleblower company brought the qui tam case. According to its complaint, its members had sold a competing eye treatment. Their account shows how a competing sales operation can hear the terms a customer has come to expect.

At Barnet Dulaney Perkins, the complaint alleged, surgeons told the whistleblower that a DEXYCU purchase supplied enough medication for both commercial and Medicare patients. In the operating room, the whistleblower saw a whiteboard with DEXYCU marked as a sample next to two patients.

The same purchasing expectation appeared in an email. After the whistleblower approached Box Canyon Surgery Center in Las Vegas about DEXTENZA, the complaint says its nurse administrator wrote:

The customer was asking whether the competing product came with the same insurance subsidy. That puts the alleged inducement into the buyer’s own words.

The complaint also recounted an Ocular Therapeutix employee’s report from the Ohio Valley Eye Institute in Evansville, Indiana. An ophthalmologist there allegedly described the same purchase-and-sample arrangement. The observations reached from the operating room to the sales conversation, and from the Southwest to Indiana.

DEXYCU Assurance Turned Denials Into Compensation

EyePoint’s DEXYCU settlement covered Assurance reimbursement promises alongside its sample program. The company acknowledged that it offered reimbursement or compensation when an insurer denied a DEXYCU claim or paid less than the surgery center’s purchase cost.

The terms changed over time, and the agreement identifies the business documents that carried those changes. The original Assurance Program offered free DEXYCU after a commercial insurer denied reimbursement. EyePoint extended the program to Medicare Advantage plans in July 2019.

An internal email later proposed discounts on future orders for denied units. An April 2020 resource binder offered replacement units for qualifying denials. By October 2020, reimbursement flashcards described paying the difference between a center’s cost and its commercial insurance payment, or reimbursing the purchase cost after a Medicare Advantage denial.

These were different forms of value attached to buying the same drug. A replacement unit replenished inventory. A discount reduced the next purchase bill. A payment covered the reimbursement shortfall. The insurer’s refusal to pay had become the trigger for something the manufacturer supplied.

EyePoint acknowledged paying the covered centers approximately $500,000 in reimbursement, as well as issuing units and discounts, before ending Assurance in the middle of 2022.

What Is a Pharmaceutical Kickback?

A pharmaceutical kickback can be something of value offered to induce purchases paid for by a government health care program. In this case, the alleged value was the purchase risk EyePoint absorbed and the free medication it supplied to win DEXYCU business.

The Department of Health and Human Services’ Office of Inspector General had already addressed that business design in its 2003 Compliance Program Guidance for Pharmaceutical Manufacturers. It identified kickback concerns when reimbursement support came with a promise that removed a purchaser’s normal financial risk. It gave the example of a manufacturer promising that a purchaser would pay for ordered products only if a federal health care program reimbursed it.

The same guidance addressed the monetary value of drug samples, including samples used to treat federal program beneficiaries.

The older free-sample billing cases show a different way the product could become the payment. In the TAP Pharmaceutical Products case, an indictment charged that free Lupron samples were billed to Medicare. The EyePoint complaint described free units subsidizing commercially insured surgeries to induce purchases for government-covered patients.

That distinction matters to the evidence. Under the EyePoint allegation, the benefit and the government claim could concern different doses and different patients. The connection was the center’s purchasing arrangement.

The Civil Resolution and Corporate Integrity Agreement

The settlement agreement describes the government’s alleged kickback period as January 1, 2019 through March 31, 2023. EyePoint also entered a five-year Corporate Integrity Agreement with HHS-OIG, whose official listing dates its start to July 13, 2026.

The agreement records a separate change in the business itself. EyePoint stopped commercializing DEXYCU in the United States at the end of 2022 after the drug lost its pass-through reimbursement status.

What Evidence Is Needed to Prove Fraud?

For this kind of case, we connect the manufacturer’s offer, the center’s financial benefit and the resulting government-paid business. EyePoint’s agreement and the whistleblower’s complaint show how those connections can appear in very different records.

A market-access employee may recognize the Assurance terms, reimbursement flashcards and insurer denials. A sales representative may know how sample quantities were discussed with an account. A surgery-center billing employee may see the purchase cost, the payer’s response and the payment claim. The stockroom and operating-room records can show where the free units went.

We examine how those accounts fit together: what the customer was promised, what it received and what it bought afterward. A sample allocation tied to purchases tells a different part of the story from a reimbursement credit tied to a denied claim. The email in this complaint mattered because the customer described the connection itself.

If you know the terms offered to a surgery center, your view of the transaction can be the starting point for a pharmaceutical whistleblower case. Our work is to connect that knowledge to the manufacturer’s decisions and the government payments it sought to generate.

How Much Money Do Pharmaceutical Whistleblowers Get for Exposing Fraud?

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

The case began with a company that described what customers said and how the competing sales offer worked. Knowledge of the purchasing relationship was central to its account, alongside the reimbursement and sample records.

You Know What the Customer Was Promised

If you saw free inventory or reimbursement promises used to win surgery-center purchases, speak to one of our whistleblower experts about what the customer was promised. We build the case around the sales decisions and payment records, bring in pharmaceutical whistleblower lawyers who understand manufacturer kickbacks, and stay beside you through the pursuit of a recovery.