INSIGHT-Valeant played a key role in building, operating Philidor RX

Thu Nov 12, 2015 1:00am EST
 
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By Carl O'Donnell

NEW YORK Nov 12 (Reuters) - A small cadre of employees at Valeant Pharmaceuticals International were deeply involved in directing the daily operations of a specialty pharmacy that has drawn scrutiny for its billing practices, according to four former employees at the pharmacy and company documents reviewed by Reuters.

The Valeant employees worked with the founders of the pharmacy, Philidor Rx Services, to set up the business in 2013 and expand its operations, three of the former employees said. The Valeant employees then remained closely involved in details of running the pharmacy.

At different points in the company's evolution, their roles included interviewing job applicants and involvement with billing. And the most senior of the Valeant employees, Gary Tanner, traveled frequently between Philidor's offices in Pennsylvania and Arizona and Valeant's U.S. headquarters in New Jersey, three of the former employees said.

Valeant first disclosed its ties to Philidor late last month, and concerns over the pharmacy's tactics to get insurers to pay for Valeant medications have helped push the drugmaker's shares more than 50 percent lower.

The new accounts of former Philidor employees and two emails provided by one of them raise questions about the degree to which Valeant was aware of the specialty pharmacy's methods.

For example, two Valeant employees were copied on a November 2014 email with an attachment explaining how Philidor employees could bill the highest amount an insurance company was willing to pay by resubmitting rejected claims at different price points. The email, reviewed by Reuters, was sent to Tanner and a colleague, Bijal Patel, who both used pseudonyms for their communications within Philidor, the former employees said.

Two of the former employees said they were sometimes told by their supervisors, also Philidor employees, to change prescriptions from doctors to allow the pharmacy to dispense a Valeant drug instead of a cheaper generic version.

Altering a physician's script to bill a payer for a more expensive drug could fall afoul of some federal and state laws designed to curtail insurance fraud and could also violate regulations established by state boards of pharmacy, according to Nicole Hughes Waid, an attorney at FisherBroyles LLP.   Continued...