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Amgen Agrees to Pay Nearly $11 Million Nationwide Medicaid Settlement to Resolve False Claim Pricing Case

Attorney General Peter F. Kilmartin announced that Rhode Island, as part of a nationwide settlement against the drug manufacturer Amgen, Inc., has resolved allegations that the company violated certain state false claims acts, by reporting inflated pricing data for its prescription drugs Aransep, Enbvrel, Epogen, Neulats, Neupogen, and Sensipar, causing Rhode Island and other states Medicaid programs to overpay for those drugs. Rhode Island's recovery pursuant to the multi-state settlement is $54, 248.

The drug pricing data at issue in this settlement concerns the "Average Wholesale Price" (AWP) and "Wholesale Acquisition Cost" (WAC) benchmarks used by states' Medicaid programs, including Rhode Island, to set pharmacy reimbursement rates for pharmaceuticals dispensed to Medicaid beneficiaries. Rhode Island and 35 other states alleged that Amgen reported inflated WAP and WAC pricing data to drug pricing compendia, thereby creating an artificially inflated "spread" between the price for which Medicaid providers dispensed the named drugs to beneficiaries and the price at which the states reimbursed providers for those drugs.

The states further alleged that after creating the inflated spread, Amgen marketed that spread to Medicaid providers in order to boost Amgen's sales of the named drugs.

"Despite settlement after settlement, we continue to see pharmaceutical companies engage in practices that boost their bottom line at the expense of states' Medicaid programs," said Attorney General Kilmartin. "Our Medicaid Fraud and Control Unit works diligently with its counterparts across the nation to end these practices, hold the companies engaging in this type of activity accountable, and return vital funds to the state's Medicaid program."


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