United States of America ex rel. Steven M. Camburn v. Novartis Pharmaceuticals Corporation

CourtDistrict Court, S.D. New York
DecidedMarch 24, 2020
Docket1:13-cv-03700
StatusUnknown

This text of United States of America ex rel. Steven M. Camburn v. Novartis Pharmaceuticals Corporation (United States of America ex rel. Steven M. Camburn v. Novartis Pharmaceuticals Corporation) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States of America ex rel. Steven M. Camburn v. Novartis Pharmaceuticals Corporation, (S.D.N.Y. 2020).

Opinion

UNITED STATES DISTRICT COURT USDC SDNY SOUTHERN DISTRICT OF NEW YORK DOCUMENT --------------------------------------------------------X ELECTRONICALLY FILED UNITED STATES OF AMERICA; the States DOC #: __________________ of CALIFORNIA, COLORADO, DATE FILED: March 24, 2020 CONNECTICUT, DELAWARE, FLORIDA, GEORGIA, HAWAII, ILLINOIS, INDIANA, IOWA, LOUISIANA, MASSACHUSETTS, MICHIGAN, MINNESOTA, MONTANA, NEVADA, NEW JERSEY, NEW MEXICO, NEW YORK, NORTH CAROLINA, OKLAHOMA, RHODE ISLAND, TENNESSEE, TEXAS, VIRGINIA, WASHINGTON and WISCONSIN, the 13-CV-3700 (KMW) DISTRICT OF COLUMBIA, THE CITY OF CHICAGO and THE CITY OF NEW YORK ex OPINION & ORDER rel., STEVEN M. CAMBURN,

Plaintiffs,

-against-

NOVARTIS PHARMACEUTICALS CORPORATION,

Defendant. --------------------------------------------------------X KIMBA M. WOOD, United States District Judge: In this qui tam suit, Relator Stephen M. Camburn (“Relator”) alleges that Defendant Novartis Pharmaceuticals Corporation (“Novartis”) engaged in an unlawful kickback scheme to induce physicians to prescribe Gilenya, a medication used to treat multiple sclerosis, in violation of the False Claims Act, 31 U.S.C. § 3729, et seq., the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b, and analogous state and municipal laws. Novartis has moved to dismiss Relator’s Amended Complaint. Because Relator fails to plead the existence of a kickback scheme with adequate particularity, the Amended Complaint is dismissed, without prejudice to Relator to file a Second Amended Complaint by May 8, 2020. BACKGROUND I. Procedural History Relator filed a sealed qui tam complaint against Novartis on May 31, 2013 (the “Complaint”), alleging that Novartis engaged in a fraudulent kickback scheme to induce doctors to prescribe Gilenya, in violation of the False Claim Act (“FCA”), the Anti-Kickback Statute

(“AKS”), and analogous state and municipal laws. (ECF No. 16.) The FCA makes it unlawful to present false or fraudulent claims for payment to the federal government. See 31 U.S.C. § 3729. Private individuals, known as “relators,” may bring civil suits on behalf of the United States for violations of the FCA. See id. § 3730(b). The AKS prohibits, inter alia, offering or paying a “kickback, bribe, or rebate” in order to “induce” a person to “recommend” the purchase of any drug covered by a “Federal health care program.” 42 U.S.C. § 1320a-7b(b)(2). Any claim for services resulting from a violation of the AKS “constitutes a false or fraudulent claim,” and thus is actionable under the FCA. Id. § 1320a-7b(g). On September 1, 2017, the United States, along with all the States and municipalities on whose behalf the Complaint was brought, informed the Court that it had investigated Relator’s

claims and decided not to intervene. (ECF No. 18.) The Complaint was then unsealed. (ECF No. 15.) On August 20, 2018, Novartis moved to dismiss the Complaint. (ECF Nos. 24–25.) On September 10, 2018, before that motion was decided, Relator amended the Complaint (the “Amended Complaint”). (ECF Nos. 26–27.) Novartis then moved to dismiss the Amended Complaint. (ECF Nos. 28–29.) The United States submitted a Statement of Interest, setting forth its view that Novartis’ motion to dismiss the Amended Complaint misstated the law regarding scienter in the FCA context. (ECF No. 35.) II. Facts Novartis manufactures Gilenya, a medication the Food and Drug Administration approved in September 2010 to treat multiple sclerosis. (Amended Complaint (“AC”) ¶¶ 8, 88.) From August 2010 until July 22, 2013, Relator worked as an Executive Sales Specialist at Novartis in the Philadelphia area. (Id. ¶¶ 8–9.)

Novartis promoted Gilenya using “speaker events.” At the speaker events, a healthcare professional, usually a doctor, was paid to educate an audience about the benefits and drawbacks of Gilenya. (Id. ¶ 106.) At “Peer-to-Peer” events, the speaker addressed other healthcare professionals; at “Patient Events,” the speaker addressed prospective patients. (Id.) Novartis paid a per-event honorarium of $1,500 to $3,500 to its speakers. (Id. ¶ 98.) Speaker events typically took place at high-end restaurants. (Id. ¶ 106.) Novartis employed five speakers in Relator’s Philadelphia region, four of whom were doctors and one of whom was a nurse. In 2012, the four prescribing speakers accounted for 43% of Gilenya prescriptions written in the Philadelphia region. (Id. ¶ 111.) According to Relator, the speaker events did not actually serve their stated purpose of

educating healthcare professionals and prospective patients about Gilenya, but were in fact designed to provide a facially legitimate means for Novartis to funnel kickbacks, in the form of honoraria and lavish meals, to speaker-doctors who prescribed high volumes of Gilenya. Relator alleges that the speaker events did not fulfill their purported educational function. Speakers would often present to other paid speakers, their own medical groups, physicians and patients who had already attended Gilenya speaker events, or to no one at all. (Id. ¶ 95.) Novartis provided slide decks for presenters to use at speaker events, but the slides repeated the drug package label insert information and the information that sales representatives provided to doctors at weekly office visits. (Id. ¶ 96.) In Relator’s experience, speakers presented the full slide deck at only 10% of Peer-to-Peer Events and 20-30% of Patient Events. Relator recalls that speakers usually presented the slides for about twenty minutes. (Id.) Relator does not specify whether the full slide deck was or could be presented in this time period. Relator also alleges that the speaker events often exceeded Novartis’ internal spending limits, which Relator claims indicates that the true purpose of the speaker events was to provide

speakers with a lavish meal. Novartis had a $125 per attendee spending limit for meals at speaker events. (Id. ¶ 101.) Relator identifies five examples of speaker events that went over- budget. (Id. ¶¶ 103–04.) Relator also alleges that Novartis’ sales staff would often alter Novartis’ internal records to conceal the excessive spending. (Id. ¶¶ 102–03.) For each of the aforementioned five over-budget events, Relator states that sales staff added false attendees, “room charges,” and other false expenses to conceal the excessive spending. (Id. ¶¶ 103–04.) Relator claims Novartis perpetrated this scheme from 2010 or 2011 through September 10, 2018, the date of the Amended Complaint. (Id. ¶ 14.) LEGAL STANDARD

A complaint must be dismissed if it fails to state a claim upon which relief can be granted. Fed. R. Civ. P. 12(b)(6). “To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Aschroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). In addition, Rule 9(b) of the Federal Rules of Civil Procedure (“Rule 9(b)”) requires that a complaint “alleging fraud or mistake . . . must state with particularity the circumstances constituting fraud or mistake.” The “adequacy of particularized allegations under Rule 9(b) is . .

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United States of America ex rel. Steven M. Camburn v. Novartis Pharmaceuticals Corporation, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-of-america-ex-rel-steven-m-camburn-v-novartis-nysd-2020.