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Friday, May 15, 2020 8:42:48 AM
I agree that the $600M fine is based on multi-year alleged mispricing of Acthar. It doesn't matter how many years it took. A $600M judgment comes due all at once after a judgment becomes final. Appeals (with judgment interest accruing) can put off the day of payment, but it's $600M. The additional amount to states that claim Medicaid pricing fraud is extra.
On the merits, I think MNK has a winner if it had time to pursue appeals (because the lower court judge is unlikely to reverse himself). MNK can't have an indefinite overhang, however. The CMS suit is standing in the way of the Opioid settlement, much of it owed to state and local governments. It's preventing refinancing. And CMS is on record in its most recent filing that it is willing to work out a multi-year settlement. It's not going to do something which trashes the separate Opioid recovery of so many state and local governments. (Think back to tobacco.)
We've potentially got a $600M overhang on the Acthar market, with the likelihood that MNK could agree to settle all (or part) with bargain priced/free Acthar. Most importantly, MNK becomes a preferred provider, simply through pricing, to the governments. Arthur hadn't predicted who ANIP's best customers would be, but I strongly suspect he was thinking of the medicare/medicaid programs.
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