With the overwhelming realities of the opioid epidemic, it is shocking to hear about doctors over-prescribing the highly addictive drugs for profit. That is precisely what is happening according to a New York City indictment of five doctors. It seems they were paid huge bribes marked as “speaking fees” to meet quotas for new prescriptions.
According to court documents released late last week, the five doctors were paid in cash payments, lavish rewards and outright fraudulent invoices from a pharmaceutical company for writing scripts for a highly addictive nasal version of fentanyl. They were not giving patients the drug Subsys because they needed it. Instead, they were actively searching for new patients to take the medication in exchange for payments from Insys Therapeutics.
The five doctors in question are “…Drs. Gordon Freedman, Jeffrey Goldstein, Todd Schlifstein, Dialecti Voudouris and Alexandru Burducea.” Even though the 75-page indictment includes a variety of damning evidence against each doctor, they have each entered a not guilty plea and were released from custody after posting bail.
Each of the New York doctors posted a bond equal to $200,000.
The group of five were charged with a variety of crimes including conspiracy. If found guilty of all charges they each face up to 20 years in prison.
Allegations against the doctors are tied to an on-going investigation dating back several years. Two executives from Insys Therapeutics have already pleaded guilty to lesser charges.
Jonathan Roper and Fernando Serrano enjoyed great success with Insys. They both took a plea which means they have traded their cooperation in the investigation for lower level charges.
Other members of the Insys team, including the company founder John Kapoor, are still facing criminal charges. The original investigation dates back to 2014.
A large part of the evidence against the doctors is tied to emails between them and the sales team at Insys. Freedman exchanged emails with a sales representative that pushed him to sign up at least 20 new patients that were “commercially insured” each month.
Freedman was paid out $308,000 in “speaker fees” by the company as he became the fourth highest prescriber of Subsys in the United States. He alone was responsible for a million dollars in sales for Insys.
Goldstein fielded angry emails from Insys sales staff when he started writing too many scripts for drugs in direct competition with Subsys. After a great deal of pressure, he quickly changed the drugs he was prescribing.
He went as far as telling the sales team that he needed a home security system for protection. The company paid $9,800 for a home system, and Goldstein pocketed the money without buying the system.
In an odd move, Burducea went as far as lying about the fact that he married a sales rep from Insys. He was afraid the relationship would be connected to the high number of times he wrote new scripts for Subsys and the way it directly benefited his wife.
When Voudouris wanted in on the profits of handing out Subsys, she asked a sales rep, Serrano, to take the test she needed to pass to be able to write scripts for the drug. She wanted to be able to prescribe the medication without taking the time to learn enough about it to pass the required test.
Even after fake test results allowed her to write scripts, Voudouris was not keeping up with the agreed upon number of new prescriptions. Roper wrote a scathing email to sales staff about the lack of return on their money being invested in the doctor.
According to the email from Roper in regards to Voudouris, “…1 new PT [patient] a day is what was agreed upon. Don’t let the doctor sell you, you sell the doctor!”
With each email included in the colossal court document, the evidence against the doctors just kept getting worse.
They were each actively looking for any patients with good insurance to give Subsys. This was not done to treat the patients but instead, create a lifetime customer for Insys.
According to a statement from Manhattan U.S. Attorney Geoffrey Berman:
“…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.”
The doctors involved came from several well-respected clinics in New York City.
It is not clear if they can remain working at this time as they are awaiting trial. At this point, they do have the right to a fair trial.
There does seem to be enough evidence already presented to call into question their ability to act ethically in regards to patients in their care.
On a fundamental level, the doctors failed to serve the best interest of their patients. As Berman went on to say:
“Payments from pharmaceutical companies should not influence how doctors prescribe — especially when a potent and dangerous drug like fentanyl is involved.”