MONMOUTH COUNTY – A former sales representative for Insys Therapeutics, Inc. pleaded guilty on May 30 to involvement in a scheme to bribe doctors to increase off-label prescribing of a fentanyl-based opioid, according to Attorney General Gurbir S. Grewal. Insys Therapeutics is the manufacturer of the fentanyl-based opioid painkiller Subsys.
This sales representative is 38-year old Michelle Breitenbach of Middletown. She pleaded guilty to a second-degree charge of conspiracy to commit commercial bribery before Superior Court Judge Benjamin S. Bucca Jr. in Middlesex County on May 30.
Breitenbach revealed that she was involved in a scheme that paid doctors kickbacks and bribes in exchange for the off-label prescribing of Subsys. The bribes were paid to the doctors in the form of alleged fees for speaking at marketing/education events.
Under the terms of the plea agreement, Breitenbach may be facing up to five years in prison.
“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. “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.”
The fees paid to the doctors were allegedly in exchange for the doctors’ participation in Insys’ “Speakers Bureau Program,” to educate other doctors about the drug. However, these educational events, in reality, were most often free meals at expensive restaurants. Doctors participating in the “event” were paid even if they did not speak, or if other doctors did not show up to listen.
Breitenbach informed that Insys management pressured sales representatives to promote the Speakers Bureau Program in order to increase sales of Subsys. She admitted that the payments made to the doctors as “speakers” were actually rewards for prescribing more Subys.
In 2017, the New Jersey Attorney General’s Office filed a suit against Insys and founder John N. Kapoor, for endangering the public and unlawful marketing through their campaign to increase Subsys sales. The Attorney General’s Office accused Insys of making fraudulent claims and unlawfully incentivizing health care providers to prescribe Subsys.
Subsys, the powerful painkiller, is an addictive drug and a spray form of fentanyl. The drug has FDA approval, but only for use related to intense pain associated with end-stage cancer.
Doctors do have the ability to prescribe drugs for off-label use legally; however, drug companies’ false promotion of off-label use of their drug is illegal, according to the Attorney General’s office.
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.
“As we have alleged in multiple court filings, a primary cause of the devastating opioid epidemic gripping the country has been overprescribing of prescription opioids, driven by the greed of manufacturers like Purdue Pharma and Insys,” said Attorney General Grewal. “We are fighting the opioid epidemic on all fronts, including through criminal prosecutions and civil actions against mercenary pharmaceutical companies, their employees, and irresponsible prescribers.”
Breitenbach sentencing is scheduled for July 6.
Earlier in May, the Board of Medical Examiners hd revoked the license of family physician, Dr. Vivienne Matalon, from Cherry Hill for indiscriminately prescribing Subsys to three patients, including a woman who died while taking the drug.
The Attorney General’s Office has also 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.