Two former Teva sales representatives are claiming that the company used speaker programs to disguise unlawful prescription kickbacks for multiple-sclerosis drug Copaxone and Parkinson’s treatment Azilect.

In a recently unsealed second amended complaint, the reps, Charles Artstein and Hossam Senousy, claim Teva devised an illegal scheme—including unlawful marketing and promotional and sales practices—to sway physicians to write prescriptions for Copaxone and Azilect. They allege that Teva paid them as “speakers or consultants in connection with sham speakers programs and events.” The two whistleblowers filed the complaint against Teva in Manhattan.

A Teva spokesperson told MM&M, “Over the past year, the US Attorney’s office in the Southern District of New York has been conducting an investigation and Teva has cooperated with all aspects of this investigation. The government investigation is now complete and we are pleased that the government has declined to participate further in the matter. The case is now a civil case; however the complaint has not yet been served and therefore, there is no pending deadline for a response.”

The plaintiffs allege that physicians were compensated between $1,500 and $2,700 for each speaker program they participated in and that the payments were disguised as honoraria. They say that the sales representatives would give physicians payments in green envelopes, which were meant to convey the “tacit message to physicians that the more scripts they wrote, the more money they made.”

A Teva sales director, Gary Smith, touted at a company meeting in 2013 that 80% of Azilect prescriptions are written by paid physicians, according to the complaint, and stressed the importance of continuing physician speaker programs as a way to drive greater sales.

The accusers note that the total number of speaker programs for both drugs was 1,329 in 2011— a sum that jumped to 5,036 in 2012. As of August 2013, approximately 4,600 programs had been completed or scheduled. The programs were staffed by 420 trained Copaxone speakers and 410 trained Azilect speakers. In 2013, certain physicians spoke 56, 60 or 80 times.

The plaintiffs claim that one doctor, identified as Dr. O.K. of Detroit, allegedly participated in 80 sessions, earning him an estimated $216,000 in annual honoraria, and that he wrote $200 million in Copaxone prescriptions per year.

The whistleblowers say that many of these speaker programs offered no educational purpose, had very few attendees and often recycled the same content. They allege that the same two topics were repeatedly presented for Copaxone, while Azilect programs often presented the same four topics.  

The complaint alleges that in one Copaxone speaker program—attended by a single doctor and a Teva sales rep—the presenting physician “relegated his discussion to four cases from the New England Journal of Medicine, involving progressive multifocal leukoencephalopathy, a life-threatening disease associated with Biogen’s new oral [MS] agent, Tecfidera, none of which is relevant to Copaxone.” The complaint says the primary purpose of this program was to discourage the attending physician from prescribing Tecfidera.

The plaintiffs seek damages for violations of the False Claims Act.