Michigan-based pharmacist Riad “Ray” Zahr and two specialty pharmacies that he “formerly owned and operated” will pay the U.S. $1 million “to resolve allegations that they submitted false claims for the drug Evzio,” according to a December 8 U.S. Department of Justice (DOJ) press release. The civil settlement resolves a whistleblower’s allegations, and as part of the settlement the whistleblower will be awarded a share of the government’s recovery.
The press release states that “Evzio was the highest-priced version of naloxone on the market, and insurers frequently required the submission of prior authorization requests before they would approve coverage for Evzio.” The U.S. alleged that between August 1, 2017 and June 30, 2019, “Plymouth Towne Care Pharmacy dba People’s Drug Store (People’s Drug Store) and Shaska Pharmacy LLC dba Ray’s Drugs (Ray’s Drugs) submitted false claims for Evzio to Medicare.” Allegedly, the People’s Drug Store and Ray’s Drugs “submitted false and misleading prior authorization requests for Evzio that contained clinical assertions for which the pharmacies lacked any factual bias.”
The press release states that Zahr and the two pharmacies “initiated Evzio prescriptions based on rudimentary patient lists with only basic biographical details. Zahr and the pharmacies also included assertions in Evzio prior authorization requests purportedly authored by prescribing physicians regarding the comparative effectiveness of Evzio that the pharmacies or Zahr...
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