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Pills, file 2012 REUTERS Srdjan Zivulovic

Court blocks whistle-blower suit over unapproved meds

2/27/2013 COMMENTS (0)

By Terry Baynes 

Feb 27 (Reuters) - A federal court in Massachusetts has dismissed a whistle-blower suit accusing nearly two dozen drugmakers of selling unapproved medications on grounds that the claims were based on publicly disclosed information.

U.S. District Judge Rya Zobel ruled on Monday that whistle-blower Constance Conrad could not pursue her claims against drugmakers including Abbott Laboratories Inc and Teva Pharmaceuticals USA Inc because the facts underlying her lawsuit could be pieced together from public reports.

The federal government increasingly has relied on the False Claims Act to combat fraud against the government in the healthcare and pharmaceutical sectors. Under the act, private citizens can bring a lawsuit on behalf of the government against anyone who makes a false claim for payment from the government, and then share in any monetary recovery.

However, to prevent opportunistic plaintiffs from combing through public records to find companies to sue, the law bars whistle-blower claims based on publicly available information unless the whistle-blower was the original source of that information.

Conrad, described as having over 30 years of experience in federal healthcare programs, filed the whistle-blower suit in 2002. She accused the drugmakers of misrepresenting unapproved drugs as approved outpatient drugs eligible for Medicaid reimbursement. As a result, the federal government paid state Medicaid programs over $500 million for purchasing these products, the suit said.

The drugmakers asked the court to dismiss the case, arguing that the claims were barred by the public disclosure rule. They pointed to numerous publicly available sources of the information, including drug product data published by the Centers for Medicare and Medicaid Services, state data on drug reimbursements and the Orange Book, which lists all drugs approved by the Food and Drug Administration.

FINDING DISCREPANCIES

The drug product data from the Centers for Medicare and Medicaid Services would show if any of the companies represented their products as FDA-approved, and Conrad could have looked the drugs up in the Orange Book and other sources to see if they were in fact approved, the companies argued.

The judge agreed that the information could have been pieced together through public domain sources, though she said that a plaintiff would need significant expertise in the field to find any discrepancies.

Nevertheless, a whistle-blower cannot sue "based on publicly disclosed facts, even if her expertise makes her the first to understand the alleged fraud," Zobel wrote. Because the public disclosure bar applied, the court lacked the authority to decide the case, she found.

Conrad's lawyers, John Roddy and Elizabeth Ryan, did not immediately respond to requests for comment. Nor did Jay Lefkowitz, who argued the case on behalf of the drugmakers.

Lawyers for drugmakers have expressed concern that the Affordable Care Act may have made it more difficult to use the public disclosure defense in False Claims Act litigation.

The 2010 health reform law narrowed the exception so that publicly disclosed information now can only include information from federal information sources and the news media, not state or local sources. Though the new law also gives the Justice Department more discretion to support a whistle-blower suit, in Conrad's case, the agency declined to intervene.

The case is United States ex rel Conrad v. Abbott Laboratories Inc, U.S. District Court for the District of Massachusetts, No. 02-11738.

For the plaintiff: John Roddy and Elizabeth Ryan of Bailey & Glasser.

For the defendants: Jay Lefkowitz of Kirkland & Ellis.

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