A ticket to a Novartis speaker program treated medical profession attendees to top-shelf alcohol, exquisite meals, and other “lavish goodies,” according to Acting U.S. Attorney Audrey Strauss for the Southern District of New York.

Furthermore, high-volume prescribers of the Novartis drugs were paid as speakers at these events, which numbered in the tens of thousands, further deepening their incentive to write even more prescriptions for these drugs. Following such a speaking engagement, sales reps pressured speakers to beef up their Novartis prescriptions or be dropped from the speaker program—a lucrative arrangement that paid aggressive prescribers to speak at social events that often never discussed Novartis and others of which never took place.

Or course, the events amounted to nothing more than cleverly disguised bribes aimed at encouraging physicians across the country to prescribe Novartis’ drugs.

This kickback practice is one of two that landed Novartis in hot water via a lawsuit, United States ex rel. Bilotta v. Novartis Pharmaceuticals Corp. And now the pharma company will pay a settlement of over $591 million to resolve FCA claims. Novartis will also lose over $38 million, per the Civil Asset Forfeiture Statute. The pharma company will also pay over $48 million to resolve state Medicaid claims in the matter. Oswald Bilotta, the whistleblower who filed the case, will receive an amount that has yet to be determined.

In another settlement, Novartis will pay to resolve claims that the company unlawfully paid the copay obligations for patients who took Gilenya. This drug was sold by Novartis to treat forms of multiple sclerosis (MS). Novartis transitioned 300 patients who the company learned were receiving drugs from the company’s free drug program to Medicare Part D, so that the pharma company would receive the revenues from Medicare when patients filled their Gilenya prescriptions.

Gilenya is a costly medication, one for which many patients would not be able to afford the copay. Rather than risk losing these patients—and the revenue they brought the company—Novartis created an MS plan with a foundation to cover these copays.

One role of the copay is to help Congress keep a check on health care costs, and these shell-game maneuverings obfuscated any such data stemming from Novartis.

The government further alleges that Novartis donated to the fun as a charitable donation that offered copay assistance for patients taking treatment medications for advanced renal cell carcinoma (RCC). The donation was predicated on the condition that the foundation would narrow the definition of eligibility to disproportionately elevate the copay support given to patients taking Novartis’ RCC drug, Afinitor.

For this practice, Novartis agreed to a $51.25 million settlement.

Sara Stephens is a freelance writer who has developed a hefty portfolio of work across several industries, with a strong emphasis on law, technology, and marketing. Her work has appeared in the New York Times, as well as various technology and consumer publications, both print and online. Sara also works as a freelance book editor, having developed and edited manuscripts for bestselling and novice authors alike, and as a verbal strategist for a Miami branding consultancy.