In one of the largest healthcare fraud settlements in recent years, pharmaceutical giant Gilead Sciences, Inc. has agreed to pay $202 million to resolve allegations that it paid illegal kickbacks to doctors to boost prescriptions of its lucrative HIV medications, including Biktarvy®, Descovy®, and Genvoya®.
The settlement, announced by U.S. Attorney Jay Clayton of the Southern District of New York, resolves claims that Gilead lavished high-prescribing doctors with luxury meals, honoraria, and travel under the guise of “educational speaker programs” — a practice that violated the Anti-Kickback Statute and led to false claims being submitted to federal healthcare programs like Medicare, Medicaid, and TRICARE.
“Pay to Prescribe” Scheme Spanned Years
Between 2011 and 2017, Gilead allegedly spent tens of millions of dollars holding hundreds of “HIV Dinner Programs” at high-end restaurants across the U.S. According to court documents, one top prescriber received more than $300,000 in speaking fees and generated $6 million in claims to federal healthcare programs for Gilead drugs.
“These events were marketed as educational,” said U.S. Attorney Clayton, “but in reality, Gilead used luxury perks as bribes to doctors to pump up prescriptions and profits. This conduct drained taxpayer dollars and corrupted clinical decision-making.”
Doctors and healthcare providers were repeatedly invited to programs on the same topics — often multiple times in just a few months — at exclusive venues like James Beard House, Del Posto, and Asiate in New York City. Some events featured six-course meals with wine pairings, while others were held in desirable travel destinations like Miami, Hawaii, and New Orleans, with Gilead covering airfare and hotel costs.
The investigation found that more than 250 prescribers attended the same HIV program three or more times within six months, with 80 of them attending five or more times.
“These weren’t educational events,” said Naomi Gruchacz, Special Agent in Charge of the Department of Health and Human Services Office of Inspector General. “They were lavish marketing parties disguised as medical programs. This behavior undermines trust in our healthcare system.”
The U.S. government joined a private whistleblower lawsuit filed under the False Claims Act. Under the terms of the settlement approved by U.S. District Judge Paul A. Engelmayer, $176.9 million will go to the United States, with the remainder distributed among participating states.
Gilead Admits Misconduct
As part of the settlement, Gilead admitted to much of the government’s allegations, including:
- Paying honoraria to high-prescribing doctors,
- Holding programs at inappropriate venues,
- Repeatedly inviting the same physicians to the same presentation topics,
- Covering travel for speakers to desirable destinations upon request,
- And failing to enforce internal compliance policies.
The company did not contest that these acts induced prescriptions that resulted in millions of dollars in government reimbursements.
“This case reflects what happens when sales take priority over ethics,” said Christopher G. Raia, Assistant Director in Charge of the FBI’s New York Field Office. “This is not victimless. It erodes medical integrity and wastes taxpayer dollars.”
