Humana Files Lawsuit Over Eylea Charging Regeneron With Racketeering, Fraud

Humana has filed a racketeering and fraud suit against Regeneron Pharmaceuticals, alleging that the company engaged in a kickback scheme so it could inflate the price of its macular degeneration drug Eylea.

The suit, filed in U.S. District Court for the Southern District of New York, is based on allegations filed by federal authorities last year that Regeneron engaged in an illegal arrangement with the Chronic Disease Foundation (CDF), which Humana calls a “sham charity.”

Humana claims that as a result of this illegal arrangement, Regeneron was able to defraud Medicare and its contracted payors out of hundreds of millions of dollars.

The suit accuses Regeneron of inflating the price of Eylea (aflibercept) from $1,500 a dose to $1,950 — $10,000 for one year of treatment — by partnering with the charity to cover cost-sharing expenses for Eylea but not for an allegedly equally effective drug, Avastin made by Genentech, which was 3 percent of the price of Eylea.