For those that remember Solaraze, it is one of the name brands for Diclofenac. Diclofenac is commonly known today as Voltaren. In 2018, the OIG conducted a study that reflected that there were some strong fraud indicators on the off-label use of Diclofenac (under the name Solaraze). Specifically, it was being prescribed off-label for uses other than for arthritic conditions. There were a number of prosecutions for kickbacks as they related to the prescribing and dispensing of Solaraze and it appears that the fraudsters have since moved on; I speculate that some of that movement went to the topical pain creams and ointments, such as lidocaine 5% (not to be confused with the 4% that you can buy over the counter as a much lower price than what insurance reimburses for the additional 1%).
If you are keeping track of the news, you likely are aware that Ozempic has been getting a ton of press. Outside of its ability to help those with certain types of diabetes better control their condition, but it has the side effect of facilitating weight loss. Ah, as a country, we are always looking for the magic bullet for weight control. Some published reports have suggested that as much as 10% of body weight can be lost by using Ozempic. Will this lead to an increase in FWA? Maybe…
I have always said that the circus never changes but the clowns do circulate. For this conversation, just replace Solaraze with Ozempic. The doctor writes a prescription for a patient that now has become a type II diabetic and now suddenly needs Ozempic (but are they really diabetic). The patient has never been diabetic, has never had any symptoms and has no medical condition that would require Ozempic; other than the patient is overweight and is looking for that magic bullet.
Where is the FWA issue, keen reader, you are asking? The prescriber writes the prescription and has the patient go to a “friendly” pharmacy, relying upon the false diagnosis of diabetes Type II. The pharmacy pays the prescriber a kickback in return for the referral and the patient gets their medications through the false diagnosis. So….will Ozempic become the new Solaraze? While it remains to be seen, I can certainly see this being a target area for the OIG.
Eric Rubenstein
Ret. OIG Sr. Special Agent and Director at Advize
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