Texas Attorney General Ken Paxton announced Tuesday that he’s suing drug manufacturer Eli Lilly for what he calls “bribing” drug providers to prescribe its medications, particularly high-demand products Mounjaro and Zepbound that are used for weight loss and diabetes treatments.
The bribe, Paxton’s office says, comes from “free nurses and reimbursement for support services.”
“Big Pharma compromised medical decision-making by engaging in an illegal kickback scheme,” said Paxton in the news release. “Eli Lilly fraudulently sought to maximize profits at taxpayer expense and put corporate greed over people’s health. I will not stand by while corporations unlawfully manipulate our healthcare system to line their own pockets.”
Paxton’s legal action is a welcome about-face for conservatives, Auron MacIntyre, a Blaze Media show host and columnist, said on American Family Radio Wednesday.
“One of the things that unfortunately was a black stain against conservatism for a long time was its support of Big Pharma and just thinking, ‘okay well ultimately corporations are at some level on our side even if they aren't the best people,’” MacIntyre told show host Jenna Ellis.
That thought line doesn’t match up with current realities.
“Corporate historians will look back on the past 10 years as the decade in which ROI and P&Ls were overtaken by ESG and DEI. The pace of the shift in corporate culture and communications — from predominantly conservative and understated to increasingly progressive and activist — has been stunning,” wrote John Burn-Murdoch in Financial Times last fall.
An awakening began during the COVID-19 pandemic, MacIntyre said.
“After COVID I think a lot of people finally recognize that actually these people are not on your side. They do not like you. They are not conservative or right-wing in any way, and you need to stand up to their abuses. It’s not okay to give them a free pass.”
President Donald Trump in May signed an executive order directing federal agencies to set targets for Most Favored Nation drug prices from major pharmaceutical companies, citing imbalance with how Americans were treated relative to pricing for other countries.
Drug companies who failed to comply stood to face federal response in several ways.
Now Paxton’s made a strong move against Big Pharma.
“We’re seeing big changes. It’s finally great to see the Republicans recognize that these are not good actors, and it's okay to go after them and exact a price when they are ultimately preying on the American people,” MacIntyre said.
What the lawsuit could mean
A Texas win against Eli Lilly could lead the Trump administration to adopt the case’s findings and bring nationwide enforcement actions under the federal Anti-Kickback Statute (AKS) or False Claims Act (FCA).
AKS bans anyone from knowingly and willfully offering, soliciting, paying, or receiving any form of remuneration—monetary or otherwise—in exchange for referring patients or triggering business reimbursed by federal healthcare programs such as Medicare or Medicaid.
FCA empowers the government—or whistleblowers through qui tam actions—to pursue individuals or entities that knowingly submit or cause submission of fraudulent claims for payment to federal programs.
Settlements and corporate compliance agreements in such scenarios could reshape how pharmacy companies interact with prescribers.
Other manufacturers are no doubt watching closely for a potential domino effect. If Texas proves that kickbacks led to inflated Medicaid spending, other states might try to recoup past overpayments, not just from Eli Lilly.
Consumers could also see negative impacts.
Drug-makers could be inclined to end or scale back free service programs such as nurses or administrative support for clinics. Some states, like Texas, argue these are indirect bribes.
Considering alternative options
“Bribe” might be a strong word for some individual cases, but standing up to the corporations is good policy, MacIntyre says.
“When you're a hammer everything looks like a nail, and when you've been trained as a doctor to say every single ailment has to be solved with a drug, then even if you're not being completely bribed in the sense that ‘this is how I solve these things,’ you’re being nudged in the right direction. I think that’s probably more the case for most doctors.”
In many cases, there are other options for treatment. They can work but will cause adjustment for doctors and patients alike, MacIntyre says.
“There are lifestyle approaches and other ways you can view these ailments. It’s not always just prescribing the most expensive thing. It doesn’t mean that ultimately you don’t use a modern medication when necessary.”
