HHS’ Office of Inspector General (OIG) said Novartis is free to pay for low-income patients to receive its pricey CAR-T therapy Kymriah (tisagenlecleucel), and those payments will not be considered illegal.

OIG told Novartis that while payments for the $475,000 one-time gene therapy could in theory compel doctors or treatment centers to use the treatment or influence patients to choose it, patients are able to get the drug at many different healthcare centers so they would be unlikely to accept the payment simply to get the drug at one specific place or from one specific doctor.

Novartis provides Kymriah for free to eligible patients who do not have insurance coverage or have been denied coverage.

Approved by the FDA in 2017, Kymriah, which makes use of the body’s own T-cells to fight cancer, is used to treat B-cell acute lymphoblastic leukemia.