North Carolina has become the latest state to file a Subsys Spray lawsuit accusing Insys Pharmaceuticals of bribing doctors to prescribed the powerful fentanyl spray to non-cancer patients.
According to a report from the News & Observer, North Carolina Attorney General Josh Stein contends that the company developed a strategy to push the opioid painkiller on “headache clinics” in order to widen its limited market. To back his claims, Stein highlighted comments that Alec Burlakoff, a Charlotte-based vice president of sales, is alleged to have made at a national sales meeting in 2015.
“These (doctors) will tell you all the time, well, I’ve only got like eight patients with cancer,” the fentanyl spray lawsuit describes Burlakoff saying at the meeting. “… Doc, I’m not talking about any of those patients. I don’t want any of those patients. That’s, that’s small potatoes. That’s nothing. That’s not what I’m here doing.”
At a news conference announcing the Subsys lawsuit, Stein asserted that Insys paid kickbacks to doctors – often in the form of speaking and consulting fees – who “excelled” at prescribing the drug to non-cancer patients.
Stein also accused Insys of pushing doctors to switch patients being prescribed other less potent drugs to Subsys, often at a starting dose more than 10 times what the label directed.
Subsys spray was approved in 2012 to treat cancer patients suffering from intolerable levels of pain. Because it contains fentanyl, an opioid painkiller 80-times more powerful than morphine and 50-times more powerful than heroin, the highly addictive drug may only be prescribed by a medical practitioner registered with the Drug Enforcement Administration.
The U.S. Department of Justice is currently pursuing criminal charges against several former Insys executives, including founder John Kapoor. Following Kapoor’s arrest in October, Insys announced it was cooperating with the Department of Justice and had set aside $150 million for a possible settlement.
A number of other states are pursuing their own Subsys Spray lawsuits. In August 2015, Insys agreed to pay $1.1 million to the state of Oregon to resolve allegations that it deceptively promoted Subsys spray for non-cancer conditions. A similar lawsuit was settled by the state of New Hampshire in January 2017.
Insys has also been named a defendant in a growing number of Subsys lawsuits filed on behalf of non-cancer patients who allegedly suffered overdoses and other complications after using the fentanyl spray.