The former district manager at Insys Therapeutics was irate. Several doctors were not prescribing enough of the company’s Subsys painkiller, which contains fentanyl, a powerful and addictive opioid.
So the manager, Jonathan Roper, wrote his sales team a pointed email, saying that “we invest a lot of time, money, blood, sweat, and tears on ‘our guys,’ ” — a reference to doctors who were paid to speak to other physicians about the medicine. “We hire only the best of the best to be a part of our speaker bureau and dropping script counts is what we get in return? This is a slap in the face to all of you and is a good indication as to why NONE of you are climbing in the rankings this quarter.”
Last Thursday, Roper and a former Insys sales rep named Fernando Serrano were arrested and charged with violating federal kickback laws. They allegedly ran a scheme between October 2013 and June 2015 in which doctors were paid thousands of dollars to participate in “sham educational programs” designed to boost Subsys prescriptions, according to Preet Bharara, the federal attorney for New York. The email from Roper two years ago was part of the indictment.
The arrests come amid intensifying controversy over the abuse and misuse of prescription painkillers and the extent to which these are appropriately prescribed. Federal health officials recently released new guidelines urging doctors to restrict their prescribing and some lawmakers want to pressure the Chinese government to toughen its laws to stop the illicit export to the United States.
This is not the first time that Insys has been named in connection with illegal activities designed to boost prescriptions for Subsys, which was approved in 2012 to treat cancer pain and generated nearly $330 million in sales last year (see here).
For instance, the company arranged “social gatherings at high-end restaurants in Manhattan” that were supposed to involve teaching doctors about Subsys but did not really involve any education. Doctors were enlisted to speak at these events, but often “lacked an appropriate audience of health care professionals,” according to the indictment. To make them appear legitimate, sign-in sheets were sometimes forged by adding names of doctors who did not attend.
Serrano and other reps received bonuses based, in large part, on the volume of Subsys prescriptions written by the doctors they were assigned to work with, according to the indictment. Serrano received a $70,000 bonus in the first quarter of 2014, which was the eighth-largest bonus among Insys reps at the time. In the fourth quarter of 2013, his bonus was about $100,000, the fifth-largest among Insys reps.
Is it any wonder that “Pharma Speaker Dinners are Popular with Docs”?; http://sco.lt/5dsmjR