Greed and Lust Drove Doctor to Push Insys Opioids on Patients
Greed and Lust Drove Doctor to Push Insys Opioids on Patients
(Bloomberg) -- A Michigan doctor convicted of illegally distributing Insys Therapeutics Inc.’s opioid painkiller Subsys said the company’s beautiful sales reps and “easy money’’ helped persuade him to write unnecessary prescriptions for the highly addictive drug.
Gavin Awerbuch told a Boston jury Wednesday he made more than $130,000 over 18 months just for showing up to sham educational sessions. Earlier this week, the jury heard that a former sales manager at Insys had been a stripper who once wooed a Chicago doctor with a lap dance.
"They had beautiful sales reps and I liked the attention I was getting,” Awerbuch said. "I felt like I was becoming friends with these Insys employees.”
Awerbuch testified in a racketeering case against Insys founder John Kapoor, 75, and other executives who prosecutors say conspired to bribe doctors with phony speaker’s fees and then duped insurers into covering the subsequent wave of Subsys prescriptions.
Insys officials set up the speaking engagements but often couldn’t get any doctors to attend, Awerbuch said. So, he said, he’d have his neighbors and friends show up. And, sometimes, it was just him and a sales rep at the dinner table, he recalled.
“They were a farce really,’’ said Awerbuch, 60, who had been sentenced to more than two years in prison for illegally prescribing the drug to patients who didn’t need it. “It was just easy money for me. I got paid $1,600 to show up, have a nice meal and go home.’’
Kapoor’s is the first prosecution of a pharmaceutical company chief executive tied to the national opioid epidemic, which claims more than 100 lives in the U.S. daily, according to government research.
Drug companies can legally pay doctors to tout opioid painkillers to their colleagues at educational dinners, but prosecutors say Insys executives used the fees illegally to get physicians to write more prescriptions for Subsys. Then, the executives lied to insurance companies about what kinds of patients were receiving the painkiller, the government argues.
During his four hours of testimony, Awerbuch said he and Insys sales representative Brett Szymanski would order extra dinners for their wives to make it look like more people showed up at the events. Szymanski promised to take care of getting signatures on the events’ attendance sheets, Awerbuch told jurors.
Immunity Agreement
Szymanski, who testified under an immunity agreement with the government, told jurors Tuesday he would either fake names on the attendance sheet or get doctors who hadn’t attended to sign them. The sales rep said he knew what he was doing was wrong, but continued the practice to rake in about $2 million in salary and bonuses over his four years at Insys.
Szymanski testified Alec Burlakoff, the company’s former head of sales, told him he didn’t care if other doctors attended the dinners or signed the attendance ledger. Szymanski said Burlakoff told him to “stop at the playground and get signatures’’ to make it look like the speaker events were well attended.
Burlakoff, who pleaded guilty to conspiracy and racketeering charges, and Michael Babich, Insys’s former CEO, will be the government’s star witnesses. Burlakoff is credited with coming up with the idea of using a speaker’s program to boost Subsys sales.
Awebuch admitted he repeatedly violated U.S. law by prescribing Subsys to patients simply to protect his ability to earn speaker fees. The drug was only approved for cancer patients suffering from so-called “breakthrough’’ pain and specifically banned for those dealing with migraines.
Despite that, Awebuch said he prescribed Subsys to migraine patients, along with those suffering from Fibromyalgia, sleep apnea, arthritis, depression and anxiety. He wrote those prescriptions solely “to keep my speakers’ programs,’’ the physician said. “I hate to admit it but that’s the reason why,’’ Awebuch said at another point in his testimony.
He said prosecutors put off the start of his prison term until March so he could testify. He’s hoping a judge will reduce his sentence because of his cooperation with the government. “I know I’m going to jail,” he said.
Prosecutors noted in opening statements that Kapoor didn’t personally use email. He had aides receive messages and type out his responses. Nellie Oquendo, one of the health-care entrepreneurs’ assistants, testified Thursday she sometimes typed as many as 50 email responses for Kapoor in a day. She worked for Kapoor’s investment firm that was run out of his Phoenix home.
Kapoor didn’t even have an Insys email until he stepped in as CEO in 2015, after Babich was ousted as the company’s top executive, Maury Rice, a technology manager at Insys, testified Tuesday. Babich later pleaded guilty to conspiracy and mail-fraud charges in connection with the investigation of the company’s handling of Subsys.
The case is U.S. v. Kapoor, 16-cr-10343, U.S. District Court, District of Massachusetts (Boston).
To contact the reporters on this story: Jef Feeley in Boston federal court at jfeeley@bloomberg.net;Janelle Lawrence in Boston at jlawrence62@bloomberg.net
To contact the editors responsible for this story: David Glovin at dglovin@bloomberg.net, Joe Schneider, Steve Stroth
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