The Patient

Change Healthcare, a UnitedHealth Group subsidiary, handles about 15,000,000,000 healthcare transactions a year and touches one in three American patient records. Most of the people in those records had never heard its name. Intruders entered through a Citrix portal on 12 February 2024, and the ransomware group ALPHV, also called BlackCat, locked the systems on 21 February. UnitedHealth paid a ransom of $22,000,000 in bitcoin. The data taken included Social Security numbers, diagnoses, medications, test results and insurance IDs. UnitedHealth confirmed the theft publicly on 22 April 2024 and offered two years of credit monitoring. Letters to the individuals themselves began going out in late July, five months after the attack. The final count reported to the HHS Office for Civil Rights was approximately 192,700,000 people.

“They called it Change Healthcare. My identity changed without my consent.”

Merck withdrew Vioxx on 30 September 2004. On 22 November 2011 its subsidiary pleaded guilty to one misdemeanor count of introducing a misbranded drug into interstate commerce, for promoting Vioxx for rheumatoid arthritis for nearly three years before the FDA approved that use. A civil settlement resolved that marketing along with allegations that Merck's representatives made inaccurate, unsupported or misleading statements about the drug's cardiovascular safety. FDA scientist David Graham estimated in The Lancet that Vioxx caused 88,000 to 140,000 excess cases of serious coronary heart disease in the United States, and told the Senate Finance Committee that 30 to 40 percent of those patients probably died.

“They knew the risk. They just didn't put it on the label.”

Pfizer subsidiary Pharmacia & Upjohn pleaded guilty to a felony for misbranding the painkiller Bextra, which it promoted for uses and doses the FDA had specifically declined to approve over safety concerns. The $1,195,000,000 criminal fine was, in the Justice Department's words, the largest ever imposed in the United States for any matter. A civil settlement of $1,000,000,000 covered Bextra, the antipsychotic Geodon, the antibiotic Zyvox and the epilepsy drug Lyrica, along with kickbacks paid to health care providers. The department called the total the largest health care fraud settlement in its history. Six whistleblowers shared more than $102,000,000.

“The world's biggest drugmaker, caught selling the world's biggest lie.”

Benjamin Poehling, a former UnitedHealth finance director, filed a whistleblower suit on 24 March 2011. The Justice Department joined it on 16 May 2017. Medicare Advantage pays an insurer more for a sicker member. The department alleges that UnitedHealth sent reviewers through patient charts to find diagnoses that would raise its payments and ignored what the same reviews showed about diagnoses the charts did not support. By its figures Medicare paid UnitedHealth more than $7,200,000,000 on the strength of those reviews from 2009 through 2016 and would have paid $2,100,000,000 less without the unsupported codes. UnitedHealth denies the allegations. On 3 March 2025 a court-appointed special master recommended judgment for UnitedHealth. The department objected, a hearing was held on 19 November 2025, and Judge Fernando M. Olguin has not ruled.

“They didn't just profit off my sickness. They upcoded it.”

Depakote is approved for seizures, bipolar mania and migraines. Abbott pleaded guilty on 7 May 2012 to misbranding it. From 1998 through 2006 the company marketed the drug to control agitation and aggression in elderly dementia patients, and from 2001 through 2006 for schizophrenia, with neither use approved by the FDA. The resolution carried five years of probation, and the Justice Department called it the second largest payment by a drug company. On 17 October 2016 Omnicare, the country's largest nursing-home pharmacy, agreed to pay $28,125,000 to resolve allegations that it solicited and received kickbacks from Abbott, in the form of grants, educational funding and rebates, to promote the drug in the nursing homes it served.

“They didn't just treat seizures. They seized the profits.”