As a snarl of pharma-focused lawsuits from Texas Attorney General Ken Paxton play out, Gilead Sciences has worked out a deal to put its own litigation to bed.
Gilead—best known for its tranche of HIV meds and other antivirals—will pay $45 million to settle a lawsuit (PDF) brought by Paxton alleging that the company used an illegal kickback scheme to induce prescriptions of its drugs on Texas Medicaid.
The resolution marks the end of a legal saga that kicked off in October 2023, when Paxton first accused Gilead of taking part in unlawful marketing practices, including claims that the California drugmaker offered illegal incentives to medical providers, including “free nurses” and reimbursement support services, according to a Thursday release from the AG’s office.
Because many of those prescriptions were covered by Medicaid, the practice allegedly led to millions of dollars in claims submitted to the state that were “tainted by Gilead’s illegal inducements,” Paxton’s office contends.
“Doctors ought to prescribe medication in accordance with what is in the best interest of the patient,” the attorney general said in a statement. “When Big Pharma attempts to bribe providers by offering kickbacks, the integrity of our healthcare system is jeopardized.”
The win for Paxton’s office comes as the embattled Republican AG takes part in a contentious U.S. Senate race against Democratic state representative James Talarico.
Gilead, for its part, has denied the claims in the lawsuit, which Paxton originally brought alongside a whistleblower. In inking the settlement agreement, the company has not admitted to breaking the law.
"Gilead expressly denies the allegations which never went to trial, and no judge or jury in this case found that Gilead’s patient support programs violate the law," a company spokesperson said in an emailed statement.
The settlement will allow patients continue accessing Gilead's drugs in Texas, the spokesperson added, noting that the case was first brought by Health Choice Advocates before the state joined. In its statement, Gilead framed Health Choice Advocates as an "entity formed to file lawsuits against pharmaceutical companies," noting that the settlement has come as a result of "a compromise on disputed issues of fact and law.
More broadly, the Gilead spokesperson said the company "believes these programs are lawful, appropriate, beneficial, and consistent with its commitment to patients."
Paxton has been pursuing multiple major drugmakers in his state, frequently around similar kickback claims to those at the heart of Gilead’s lawsuit.
In late June, AstraZeneca agreed to pony up $34 million to resolve allegations that it too provided free nursing services and reimbursement to healthcare providers to influence prescriptions in the Lone Star State, with the AG’s office suggesting at the time that AZ carried out these practices “under the guise of non-branded counseling.”
Last year, Paxton also accused Eli Lilly of running kickback maneuvers in a lawsuit that concerned popular diabetes and obesity medications Mounjaro and Zepbound, and he subsequently sued Sanofi and Bristol Myers Squibb on behalf of the state last November over different claims of “false, misleading, and deceptive” marketing practices tied to the long-approved blood thinner Plavix.
Beyond the bounds of Texas, Gilead has secured several other recent settlement agreements and wins revolving around alleged kickback practices.
Last April, the company agreed to pay $202 million to federal authorities to resolve long-running kickback claims tied to its promotion of HIV medicines. Several months later in Sept. 2025, Gilead won a separate whistleblower lawsuit—without needing to ink a settlement—that alleged the drugmaker used expensive meals and cushy travel donations to incentivize high-volume prescribers of the hepatitis C antivirals Sovaldi and Harvoni.
Editor's note: This story has been updated with a statement from Gilead Sciences.