In the midst of America’s opioid crisis, five New York City doctors have been charged with accepting bribes and kickbacks from a pharmaceutical company in exchange for prescribing high volumes of the powerful opioid Subsys, a fentanyl-based pain medication spray typically prescribed to cancer patients. As a refresher: Fentanyl is driving the rapid rise in opioid overdose deaths. It is 50x stronger than heroin, and 100x stronger than morphine, according to the Center for Disease Control and Prevention.
Federal prosecutors say that Drs. Gordon Freedman, Jeffrey Goldstein, Todd Schlifstein, Dialecti Voudouris, and Alexandru Burducea accepted more than $800,000 from Insys Therapeutics Inc. since August 2012 in return for pushing prescriptions of Subsys, a fentanyl-based pain medication, onto as many patients as possible. The five were “indicted on conspiracy and other charges that carry up to 20 years in prison,” according to NBC News. All five doctors have pleaded not guilty and were released on $200,000 bond each.
The money was reportedly labeled as "speaker fees." However, while the purpose of Insys’ “Speakers Bureau” was reportedly to teach others in the healthcare field about Subsys, in reality, prosecutors claimed, the speaking events were social gatherings with attendance sign-in sheets filled with forged signatures. Perks of their partnership included tickets to sporting events, free meals, casino and nightclub outings, and even lap dances at a strip club, NBC News reports. According to the 75-page indictment unsealed on March 16, Goldstein has even been accused of smoking pot and snorting cocaine before or during his speaking appearances.
The indictment included emails between Insys sales reps and the doctors.
"I'd rather you put 20 (or more, of course LOL) new patients (commercially insured of course, as always) on it in April even if we wind up getting only 10-14 approved, rather than only have you go with the safe 6-7 that you think will all get approved," one Inys sales representative allegedly wrote to Freeman, who replied, "Got it."
Also unsealed last Friday were the guilty pleas of Jonathan Roper and Fernando Serrano, two former Insys executives who faced similar charges in 2016; both are cooperating with the investigation, prosecutors say.
A number of medical practitioners and former Insys employees, including billionaire founder John Kapoor, have been accused of participating in the multi-level scheme. Kapoor was taken into custody in October, with a federal judge setting his bail at $1 million and ordering him to wear an electronic monitoring bracelet, in addition to surrendering his passport, CBS reports. He resigned from the company’s board of directors (after stepping down as CEO and Chairman in January), and pleaded not guilty to charges of conspiracy to commit racketeering, mail fraud, and wire fraud in November.
Jerrold Rosenberg, a Rhode Island doctor, was sentenced earlier this month to more than four years in prison after pleading guilty to healthcare fraud and conspiracy to receive kickbacks in October. Rosenberg is the fourth doctor to be jailed since Insys came under investigation, Fortune reports; in May 2016, Alabama doctors John Couch and Xiulu Ruan, partners, were sentenced to 20 and 21 years in prison, respectively, for running a “pill mill” that involved pushing Subsys prescriptions onto their patients. In February 2017, Michigan doctor Gavin Awerbuch was sentenced to more than two years behind bars after admitting to accepting speaker fees from Insys in exchange for prescribing Subsys to patients that did not necessarily need it.
“Insys continues to cooperate with all relevant authorities in its ongoing investigations and is committed to complying with laws and regulations that govern our products and business practices,” the company said in a statement.
In 2016 alone, Insys made 18,000 payments to doctors that totaled more than $2 million, reported CBS News correspondent Jim Axelrod. The professionals on Insys’ payroll reportedly included headache doctors, back pain specialists, and even a psychiatrist. The drug is intended only for extreme cases, like cancer patients in severe pain.
The five recently accused physicians have remained tight-lipped on the case.
“We look forward to resolution of the charges,” said Nicholas Kaizer, a lawyer for Burducea, following Friday’s hearing. According to the recently unsealed indictment, prosecutors are claiming that Burducea, who is married to an Insys sales rep, lied to federal investigators about the length of their dating relationship so that it could not be linked to his high Subsys prescription rate.
Following the arraignment, other lawyers representing the defendants declined to comment, CBS reports.
In a statement, Manhattan U.S. Attorney Geoffrey Berman suggested that the doctors had betrayed the "solemn oath" each made to prioritize their patients’ health, and commented, "Payments from pharmaceutical companies should not influence how doctors prescribe — especially when a potent and dangerous drug like fentanyl is involved."
With more than two million Americans who are currently dependent on or are abusing opioids, the nation is in the midst of an opioid crisis, CNN reports; an average of 115 opioid overdose death occurred each day in 2016. Fentanyl and similar opioids played a bigger role in overdose deaths than any other drug — legal or otherwise.
On Monday, President Trump revealed his plans to tackle the crisis by focusing on, among other things, increasing awareness of the dangers of opioid abuse and exacting harsher penalties for drug dealers — including the death penalty.
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