XPost: alt.drugs.hard, sac.politics, alt.politics.usa.republican   
   XPost: alt.politics.economics   
   From: david.fritz@vzw.com   
      
   In March of 2013, Gordon Freedman, a doctor on Manhattan’s Upper East   
   Side, fielded a request from a regional sales manager for the manufacturer   
   of Subsys, a spray form of the highly addictive painkiller fentanyl.   
      
   Dr. Freedman was already a top prescriber of Subsys and also one of the   
   company’s paid promotional speakers. Now the sales manager was telling him   
   the company, Insys Therapeutics, would increase the amount of money it was   
   paying him and asked that he increase the number of new patients he was   
   prescribing Subsys.   
      
   “Got it,” Dr. Freedman replied, according to authorities. By 2014, they   
   said, Dr. Freedman had become one of the country’s top prescribers of the   
   painkiller drug — and also the company’s highest-paid speaker.   
      
   The exchange between the doctor and Insys was detailed in a federal   
   indictment unsealed on Friday in Manhattan, charging Dr. Freedman, of   
   Mount Kisco, N.Y., and four other New York doctors with participating in a   
   bribery and kickback scheme that prosecutors said sought to increase the   
   drug company’s sales and preyed on unwitting patients.   
      
   Insys paid the doctors, in some cases more than $100,000 annually, in   
   return for prescribing millions of dollars’ worth of the company’s   
   painkiller product, the indictment said. It charged that Insys funneled   
   the illicit payments to the doctors through a sham “speakers bureau,” in   
   which the doctors were paid for purportedly giving educational   
   presentations about the drug that, in many cases, were mere social   
   gatherings at high-end Manhattan restaurants.   
      
   Such gatherings involved no educational presentation, and attendance sign-   
   in sheets were often forged to include the names of health care   
   practitioners who were not actually present, the authorities said.   
      
   “These prominent doctors swore a solemn oath to place their patients’ care   
   above all else,” said Geoffrey S. Berman, the United States attorney for   
   the Southern District of New York. “Instead, they engaged in a malignant   
   scheme to prescribe fentanyl, a dangerous and potentially fatal narcotic   
   50 to 100 times more potent than morphine, in exchange for bribes in the   
   form of speaker fees.”   
      
   Mr. Berman announced the charges along with William F. Sweeney Jr., the   
   head of the F.B.I.’s New York office. The four other doctors charged in   
   the New York case are Jeffrey Goldstein of New Rochelle, N.Y.; Todd   
   Schlifstein of New York City; Dialecti Voudouris of New York City; and   
   Alexandru Burducea of Little Neck, N.Y.   
      
   All five defendants pleaded not guilty in federal court on Friday   
   afternoon and were released on $200,000 bond. None of the five responded   
   to reporters’ requests for comment as they left the courtroom.   
      
   Mr. Berman’s office also disclosed that two former Insys employees —   
   Jonathan Roper and Fernando Serrano — had pleaded guilty and were   
   cooperating with the federal investigation.   
      
   Insys, which is based in Arizona, has come under intense scrutiny over its   
   aggressive marketing of Subsys, a form of fentanyl approved in 2012.   
   Subsys is sprayed under the tongue and approved for use only in patients   
   who have cancer and who experience pain even though they are already on   
   round-the-clock painkillers.   
      
   Fentanyl can be deadly if it is prescribed in large doses to someone who   
   has not already become tolerant to opioids, yet the drug has been widely   
   sold to a variety of patients. An analysis in 2014 for The New York Times   
   by the research firm Symphony Health, for example, found that just 1   
   percent of prescriptions for Subsys were from oncologists.   
      
   Already, the federal authorities in Boston have brought charges against   
   Insys’s founder and former chief executive, John Kapoor, as well as   
   against several other top executives and sales managers. They have all   
   pleaded not guilty.   
      
   The New York indictment offers further evidence that investigators have   
   broadened their inquiry into doctors who were prescribing the drug to   
   patients. Earlier this month, another top prescriber, Jerrold Rosenberg of   
   Rhode Island, was sentenced to more than four years in prison after   
   admitting he took kickbacks from Insys.   
      
   The company did not respond to a request for comment on Friday.   
      
   The indictment unsealed on Friday charged that the drug firm had used its   
   speakers program "to induce a select group of practitioners,” including   
   the five doctors charged in New York, to prescribe large volumes of the   
   fentanyl spray. The selected doctors were often referred to within the   
   company as “top docs,” the indictment said.   
      
   The company’s executives meticulously “tracked and circulated statistics   
   for each speaker,” the indictment noted.   
      
   It also said Mr. Roper, then the district sales manager for a territory   
   that included Manhattan, emailed sales representatives, reminding them to   
   repeatedly tell their speakers of “one simple guideline” — if they did not   
   write prescriptions, there would be no speaking engagements. As he put it,   
   according to the indictment: “NO SCRIPTS. NO PROGRAMS.”   
      
   One of the defendants, Dr. Goldstein, sometimes did not even stay for a   
   meal at the programs where he was the featured speaker, instead ordering   
   food from the restaurant and leaving with it, according to the indictment.   
      
   Before one program in 2014, the indictment added, Dr. Goldstein wrote to   
   an Insys sales representative, asking, “Is dinner take out or we expecting   
   peeps?”   
      
   https://www.nytimes.com/2018/03/16/nyregion/fentanyl-subsys-drug-   
   kickbacks.html   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)