Several suspects have been arrested in connection with an alleged medical insurance fraud scheme organized by employees of AstraZeneca China, the country’s National Healthcare Security Administration (NHSA) said on Saturday.
The arrests came after an investigation found evidence that staff members falsified genetic test results of tumor patients in an attempt to defraud medical insurance funds, according to the NHSA. AstraZeneca saw substantial growth in China despite the steep rebates it had to make to get on the country’s national drug reimbursement list, with revenue in the country up 10% in the third quarter to nearly of $4.7 billion for the first three quarters of the year.
However, the company noted that last year’s revenue was impacted by pricing pressure associated with the NRDL and volume-based sourcing (VBP) programs.
Without providing many details, AstraZeneca China said in a statement that it confirmed through its own investigation in August that “a few” of its employees in Shenzhen had “modified or participated in the modification of patient test reports” and are suspected of having medical insurance. fraud.
“According to our current understanding, these are individual cases. Government investigations are still ongoing and the company has not been informed of further details,” a spokesperson said. Terminal news.
AstraZeneca China said it proactively reported violations to the local health care safety office and “took serious disciplinary action” against staff members, although it is unclear whether they are still employed by the pharmaceutical giant. On Saturday, the NHSA said a “thorough investigation” had been carried out and “all suspects had been arrested”.
On December 27, AstraZeneca attended a joint meeting with the Department of Public Safety (MOPS) and NHSA, which urged the company to cooperate with the follow-up investigation, conduct its own internal investigation, “stop gaps in marketing oversight”. and educate its employees on compliance with the law.
“AstraZeneca China is committed to fully implementing these recommendations, further strengthening management oversight, and continuing to educate employees on applicable laws and regulations, ensuring that every AstraZeneca employee does their job. daily in the spirit of legal compliance and compliance,” the company said in a statement. .
China’s National Medical Insurance Bureau will now work with other agencies to lead a nationwide campaign against tampering with genetic test results, according to the NHSA.
The news comes nearly three decades after AstraZeneca set foot in China in 1993. Just over two years ago, the company unveiled three major initiatives in hopes of expanding its footprint there, including the creation of a new R&D center and an AI innovation center in Shanghai. , and a new Healthcare Industrial Fund in partnership with China International Capital Corporation Limited.
“China is rapidly becoming a global science powerhouse, which is why we’ve made this exciting decision to follow the science, expanding our R&D presence and working with the investment community,” he said. CEO Pascal Soriot at the time.
To date, the company claims to have invested around three-quarters of a billion dollars in Chinese pharmaceutical innovation. And it doesn’t hurt that the Chinese market has added billions of dollars to its revenue.
AstraZeneca isn’t the only big pharma to have problems with insurance fraud. In August 2020, AbbVie agreed to pay $24 million to settle an insurance fraud lawsuit related to the promotion of its cash cow Humira.
The settlement came nearly four years after a whistleblower first reported AbbVie’s practice of deploying registered nurses to visit patients in their homes or call them by phone to ensure that Humira’s ordinances are fulfilled. AbbVie has also been accused of illegally bribing doctors to encourage them to prescribe Humira for a range of anti-inflammatory conditions.