How a Fentanyl Drugmaker Bribed Doctors, Harmed Patients and Collected Millions

Insys Therapeutics is the only drug marketer whose top executives were jailed as part of the opioid epidemic. The fallout from the company’s cash-for-scrips strategy that made it a Wall Street favorite reverberates today. With two weeks to go in the year, Alec Burlakoff dashed off an urgent email to sales representative Daniel Tondre.

Tondre was assigned to a pain specialist in Sarasota, Florida, who was one of the most prolific prescribers of the potent fentanyl spray called Subsys. And Insys Therapeutics sales executive Burlakoff wanted the doctor, Steven Chun, to prescribe more of the addictive and potentially deadly drug to meet his company’s goal.

“My best chance of hitting this is for Dr. Chun to turn it on this week,” Burlakoff wrote to Tondre in the December 2012 message. “He is my ace in the whole (sic). Ask him NOT to hold back, I need a big bump this week.”
Insys pursued Chun and doctors like him across the country as part of a multiyear effort to juice sales and bribe doctors willing to prescribe the company’s pain-relieving drug Subsys, according to court testimony and new documents released this week.

While major pharmaceutical companies such as Purdue Pharma and Mallinckrodt have garnered far more attention for their respective roles in the opioid crisis, Insys remains the only drug marketer whose top executives were jailed as part of the opioid epidemic. The fallout from Insys’ cash-for-scrips strategy that made the company a Wall Street favorite reverberates today.

On Monday, Chun was sentenced by a federal judge in Florida to three years and six months for charges of accepting bribes in the form of sham speaker fees from Insys. The doctor collected $278,000 in payments that federal prosecutors described as kickbacks and bribes to prescribe the fentanyl spray for his patients. Tondre, an Insys sales rep also convicted in the bribery scheme, will be sentenced Dec. 15.

The email exchange between Burlakoff and Tondre is among more than 760,000 emails and other documents released this week that reveal details about the company’s culture of greed, power and sales. The documents, released first to USA TODAY, were published in an archive run by Johns Hopkins University and the University of California, San Francisco.

The documents shed light on the company’s intense focus on sales during daily 8:30 a.m. calls and frequent emails demanding sales reps prod doctors referred to as “whales” to prescribe Subsys to more patients in higher dosages to collect more money from insurers.

The documents include transcripts from the executives’ 2019 criminal trial and details about the company’s center where employees learned to deceive insurers to get Subsys prescriptions covered. The archive has access to about 3 million Insys records with follow-up document releases planned.
In all, more than 8,000 people died after taking Subsys since 2012, Food and Drug Administration records show. The company filed for bankruptcy in 2019 and its top executives went to jail — including founder John Kapoor, a once-billionaire entrepreneur who became the highest-ranking pharma executive to be jailed in the opioid crisis.

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