Biohaven settlement keeps spotlight on drug speaker programs

A Pfizer settlement over speaker programs at its Biohaven subsidiary is being cited in debates over how drugmaker payments to doctors could influence treatment choices in ATTR-CM.

Pfizer agreed in January 2025 to pay nearly $60 million to resolve allegations that Biohaven paid doctors speaker fees and bought meals at high-end restaurants to induce prescriptions of its migraine drug Nurtec ODT. The alleged conduct ran from 2020 to 2022, before Pfizer acquired Biohaven. The Justice Department said the claims were allegations only, with no determination of liability.

Recent commentary on speaker fees and buy-and-bill argues that such incentives deserve attention in ATTR-CM, where a small number of specialists treat patients for years with drugs costing hundreds of thousands of dollars a year.

Payments to physicians for speaking, meals and other services are reported in the federal Open Payments database. A ProPublica analysis found that doctors who received industry payments were more likely to prescribe branded drugs.