Washington joins suit accusing Regeneron inflated Medicaid prices for eye treatment

PORTLAND, Ore. ( KOIN ) – Washington State Attorney General Bob Ferguson is partnering with five other states in a federal lawsuit against Regeneron Pharmaceuticals — alleging the company inflated Medicaid prices for a critical eye medication.

Attorney General Ferguson’s office announced the partnership on Friday, claiming the New York-based company increased the price it charged Medicaid for Eylea, which ended up costing state Medicaid programs millions of dollars for the medication.

“We’re fighting corporate greed in order to protect public health care dollars and improve the affordability of medications,” Ferguson said. “This is how we protect Medicaid dollars that allow us to provide access to health care for nearly two million Washingtonians, including children and the most vulnerable.”

Between 2013 and 2023, Medicaid programs in Washington, Colorado, Texas, Georgia, North Carolina, and Michigan collectively spent more than $175 million on Eylea, an FDA-approved medication made by Regeneron to treat macular degeneration and other eye conditions, Ferguson’s office said.

To determine the reimbursement rate for each claim submitted for Eylea, the state’s Medicaid programs used the Average Sales Price reported by Regeneron to the federal Centers for Medicare and Medicaid Services.

The lawsuit alleges that Regeneron was required to include all price concessions for Eylea as part of its ASP reporting, but knowingly excluded credit card processing fees that Regeneron paid its distributors to allow them to charge customers a lower drug price.

The states claim Regeneron paid the credit card fees so doctors who purchased Eylea could use credit cards at no additional cost and receive hundreds of millions of dollars in “cash back” rewards and other credit card benefits.

The states seek monetary damages and penalties under state false claims acts and other state laws.

Ferguson’s office noted the Washington State Medicaid Fraud Control Division received 75% of its funding from a U.S. Department of Health and Human Services grant totaling more than $9 million in the fiscal year 2024. The remaining 25% totaling over $3 million was funded by state Medicaid fraud recoveries.

KOIN 6 News reached out to Regeneron Pharmaceuticals. This story will be updated if we receive a response.

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