In mid-2013, through investigation using my training as a physician and an experienced healthcare investment professional, I uncovered the remarkably simple and secretive pharma/health insurer/PBM price collusion “fee” scheme behind widespread massive U.S. brand drug prices over the past 15 years.
There is no other explanation for massive U.S. brand drug price increases. That was true in 2013 and is more so now as the irrefutable evidence has mounted and patient/public harm has greatly accelerated.
However, even with the extensive investigative evidence, I filed my whistleblower cases for a very specific reason – because “insiders” admitted the whole thing to me.
I filed the whistleblower cases because I sat in a conference room (along with another PBM expert colleague) on October 7-8, 2013 in Philadelphia and listened in shock for two days as 50-60 directly involved executive insiders, attorneys and consultants openly discussed and admitted the illicit and intentional “fee” scheme.
As a leading attorney stated at the conference: I “hope the conference is not being recorded”.
And as an audience questioner asked of a pharmaceutical general counsel: “When would the government be “dangerous enough to understand how industry works”?
You can review this definitive one-of-a-kind “insider” conference and see more disturbing firsthand commentary in the whistleblower documents at this link: /wp-content/uploads/2020/03/SDNYComplaintFeeConference-1.pdf
And what did I do with the shocking firsthand information from this October 2013 one-of-a- kind conference?
Within two weeks I relayed the details of the conference and my investigation of the “fee” scheme to the Department of Justice (DOJ).
With DOJ’s support, I filed the first of my two whistleblower cases less than three months later, regarding the U.S. multiple sclerosis(MS) drug market where the fee/pricing abuse was uniform and severe.
Prior to filing in January 2014, my attorney and I repeatedly and openly discussed with DOJ that my attendance at the insider conference was the reason for filing the whistleblower case.
We also repeatedly discussed with DOJ that pursuing these conference insiders was an obvious top priority in investigating the cases in the public interest. DOJ seemed to agree.
With that goal, I included the names and contact information for 40-45 directly involved insiders from the conference in the whistleblower documents.
Here is a link to the “fee” conference presenters and attendees provided in the whistleblower complaint: /wp-content/uploads/2020/03/SDNYFMVConflist.pdf
And what did the Department of Justice do with the information and witnesses from the definitive October 2013 conference I attended?
Apparently nothing, according to the Department of Justice (DOJ) itself.
Every six month or so in our investigative update calls with DOJ (when they standardly requested our consent for additional investigative extensions from the Court), I would ask the U.S. attorneys the same list of questions regarding this straightforward “fee” scheme and its investigation.
At the top of the list would always be the most obvious one:
Have you spoken to the insiders from the conference? What do they have to say?
DOJ repeatedly admitted to my attorney and I that they never brought a single insider from the conference in for an interview. And no one from the conference was ever put under oath. Never.
Hard to Imagine, right? Especially since the list of insiders from the conference includes an array of senior executives from the whistleblower Defendant companies, including Pfizer, Amgen, AbbVie, Sanofi and Express Scripts.
In its 4+ year whistleblower investigation of the largest cases in history ($175+ billion and counting), DOJ repeatedly admitted that only ONE witness, an undisclosed PBM executive, was put under oath.
Only ONE person under oath among 13 major pharmaceutical Defendants and the 4 dominant health insurer/PBMs in this nation? Really?
And DOJ also repeatedly admitted that NOT a single pharmaceutical executive was EVER put under oath. Not one, really?
Hard to imagine, right? Sure remains so to me.
And then DOJ went on to claim it did an extensive and thorough investigation in getting our two whistleblower cases dismissed by two Federal District Courts, thereby preventing our investigation.
And astoundingly, DOJ’s dismissal effort was successful with both Courts despite my providing a 12-page affidavit (under oath) of our extensive and disturbing firsthand admissions of investigative failure by DOJ officials. DOJ did not refute my truthful affidavit in either Federal Court.
Here is a link to my affidavit, which includes lots of other disturbing interactions with DOJ beyond the definitive October 2013 “fee” conference: /wp-content/uploads/2020/03/SDNYJBRevisedDecl11319.pdf
See additional evidence of the “fee” scheme in the “Definitive Proof” section of this website at this link: https://drugpricetruth.org/evidence/
In discussing my whistleblower experience, people have repeatedly asked me: Can this really be true?
I commonly say that I wouldn’t have believed it either, if I had not lived through it myself.
The truth is much worse than anything I could have imagined.
I welcome the opportunity to speak to any interested parties.
My focus remains on stopping the severe patient, family and public abuse.
“People Before Profits”
I can be easily reached via email at firstname.lastname@example.org
John R. Borzilleri, M.D.