Novartis slapped with $12.6M fine for fuzzy Medicare pricing math
- Amidst allegations of misrepresenting medication pricing data to the Centers for Medicare & Medicaid Services (CMS), Sandoz is paying what amounts to the largest such fine ever paid to the federal government.
- The specific allegation against Sandoz, which is owned by Novartis, is that company misrepresented the average price data to Medicare between January 2010 and March 2012, according to the Office of the Inspector General (OIG).
- In addition to paying the fine, Sandoz has agreed to provide certification of putting a government pricing compliance program in place.
According to WSJ's Pharmalot, Novartis spokespeople insisted that the company was not actually copping to any wrongdoing or admitting any liability. "Sandoz continues to be committed to providing high-quality, affordable medicines to U.S. patients and conducting business with customers and the government with integrity."
This is an obvious area of concern for payers as any good-faith pricing negotiation necessitates accurate market data.