MIDDLETOWN, NJ — A Middletown woman who worked as a pharmaceutical sales representative testified in court Wednesday that as a New Jersey sales representative for Insys, an Arizona-based pharmaceutical company, she participated in a scheme in which doctors were paid kickbacks and bribes in exchange for prescribing Subsys, a powerful fentanyl-based opioid painkiller.
Michelle Breitenbach, 38, of Middletown, N.J., pleaded guilty today to a second-degree charge of conspiracy to commit commercial bribery. She admitted that doctors, in return for off-label prescribing of Subsys, were paid kickbacks and bribes in the form of purported speaker fees for marketing/education events.
Doctors who participated in Insys’ “Speakers Bureau Program” purportedly spoke at events to educate other doctors about Subsys. In reality, the events involved free meals at expensive restaurants, and doctors were paid as speakers even if they did not speak, or if other doctors did not show up to listen, the New Jersey Attorney General charges.
Breitenbach testified that management at Insys pressured sales representatives to promote the Speakers Bureau Program as a primary means to drive increased sales of Subsys. She admitted that the payments made to the doctors as “speakers” were actually rewards for prescribing more Subys.
The case occurs at a time when state and federal prosecutors are going after doctors who prescribe powerful opioids, and increasingly, the pharmaceutical companies that make them. Last year, the New Jersey Attorney General’s Office filed suit against Insys and its billionaire founder, John N. Kapoor.
The AG argues the pharmaceutical company puts the public at risk with an unlawful marketing campaign designed to exponentially increase sales of Subys. State attorneys say that Insys made fraudulent claims and unlawfully incentivized doctors to prescribe Subsys “to an inappropriately broad array of pain patients,” some of whom did not need the powerful and addictive pain killer.
Subsys is a spray form of fentanyl that has FDA approval only for intense breakthrough pain related to end-stage cancer. Doctors can legally prescribe drugs for off-label use – meaning purposes beyond what is approved by the FDA. But the state AG says the pharmaceutical company tried to influence healthcare providers’ prescription decisions with payments or other benefits, which is illegal.
On May 4, the Attorney General’s Office announced that the Board of Medical Examiners had revoked the license of a Cherry Hill, N.J., family physician, Dr. Vivienne Matalon, for indiscriminately prescribing Subsys to three patients, including a woman who died while taking the drug.
The Attorney General’s Office also has filed a pending complaint seeking to revoke the license of Warren County pain management practitioner Dr. Kenneth Sun for allegedly accepting over $136,000 from Insys while indiscriminately prescribing Subsys. His license currently is suspended.
The New Jersey Attorney General’s Office also filed suit last year against Purdue Pharma L.P. in connection with its alleged deceptive marketing of opioid painkillers, particularly OxyContin.
“This former sales rep admitted her role in a scheme to pressure doctors to prescribe more Subsys in return for so-called speaker fees and other perks,” said Director Veronica Allende of the Division of Criminal Justice, speaking of Breitenbach. “When doctors receive improper incentives to prescribe drugs, self-interest can cloud or supplant their medical judgment, with dangerous results, particularly when a risky, addictive opioid like Subsys is involved.”
Breitenbach will be sentenced July 6, and she is facing five years.
Photo provided by the NJ Attorney General’s Office.
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