Around the country, lawsuits and criminal charges are becoming more and more common for drug manufacturers and doctors relating to the opioid crisis. As the nation becomes more aware of the deadly epidemic that has been growing since the 90’s, people want answers and are looking for people to blame. Drug makers are being investigated for manipulative and even fraudulent marketing tactics and prescribers are being investigated for malpractice. With the astronomical rates of opioid addiction, there are clearly doctors prescribing opioids when they aren’t needed. One doctor in Rhode Island has just pleaded guilty in one of the largest opioid scams in the country involving highly addictive fentanyl spray.
What is Fentanyl Spray?
Fentanyl spray is a powerful opioid that is 50 times stronger than heroin. It is used in terminally ill patients, like those dying from cancer. It is drug meant to be used as a last resort and ease the pain of death so patients can try to enjoy their final days. It comes in a spray to make ingestion easier than taking a pill since many of the patients needing the medication have difficulties swallowing.
Fentanyl has recently gained national attention because it is being used to cut heroin. Fentanyl is easier and cheaper to make than heroin, making it a desirable alternative for drug dealers. The drug is the biggest reason for the spike in heroin overdose deaths in recent years. The drug is either manufactured in China or South America, then smuggled into the United States. Unlike fentanyl made by large corporations, black market fentanyl can’t be synthesized into more potent variations, similar to designer drugs like bath salts.
Fentanyl spray can lead to a powerful dependency. Withdrawal is stronger than heroin withdrawal, leaving patients helplessly addicted to the medication. This is why it is so rarely prescribed. But, in recent years, the drug company Insys Therapeutics has been caught in schemes with doctors to overprescribe the drug.
What Happened
Jerrold Rosenberg, a Rhode Island doctor, pleaded guilty in U.S. District Court in Providence to one count each of health care fraud and kickbacks conspiracy. The doctor admitted on Wednesday that he prescribed Subsys, a brand of fentanyl spray, to people who didn’t have cancer. He then falsified their records so that insurance companies, including Medicare, would pay for it. The doctor also admitted he conspired with Insys executives and others to receive $188,000 in kickbacks for writing the prescriptions through a sham “speakers program.” These fake speaker programs have been identified with several drug manufacturers and distributors throughout the country.
Rosenberg was by far the largest prescriber of fentanyl spray in Rhode Island and even one of the largest prescribers in the nation. In his indictment, it stated that the doctor even refused to switch patients to different medication when they complained of side effects or ineffectiveness. The doctor’s son also worked as a sales representative for Insys and was heavily compensated via commission directly stemming from sales by his father. Rosenberg faces up to 15 years in prison.
The former Insys CEO along with 5 other executives have also been indicted but have pleaded not guilty. They will go to trial next year. In other parts of the country, several other former Insys employees are awaiting trial for similar schemes, particularly in Alabama and Connecticut.
An Insys spokesman says the company is under new management and has replaced nearly all of its original sales staff. “We have taken necessary and appropriate steps to prevent past mistakes from happening in the future, and are committed to conducting business according to high ethical standards and the interests of patients,” the company said in a statement. “We also continue to work with relevant authorities to resolve issues related to the misdeeds of former employees.”
This case is one of many to come. Some of the biggest names in the pharmaceutical industry are facing charges and lawsuits, like Purdue Pharma and Johnson & Johnson. Many of these companies practiced similar sales tactics, making incentives for doctors to overprescribe opioids when they were not needed. Some of these companies even mislead doctors, making them believe the drugs were not addictive or dangerous. The US Attorney General, Jeff Sessions, has even promised to go after doctors and drug makers who manipulated the country to ignite the current opioid crisis. Fentanyl spray is just one of the many drugs under review. Some health insurance companies, like Cigna, are even halting payments for OxyContin prescriptions. OxyContin is another drug that has been heavily overprescribed across the country.
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