A former drug sale representative for Insys Therapeutics has admitted in court that she participated in a scheme that awarded doctors for prescribing the company's painkiller drug Subsys.

Speakers Bureau Program

On Wednesday, 38-year-old Michelle Breitenbach said that in exchange for off-label prescribing of Subsys, doctors were paid kickbacks and bribes in the form of speaker fees.

Those who participated in the so-called "Speakers Bureau Program" were supposedly paid for speaking at events that educate other doctors about Subsys.

In reality, the doctors still received their payments regardless whether they did not speak, or even if no one showed up at the purported speaking events. The events also actually involved free meals at expensive restaurants.

Breitenbach admitted that the speaker fees were the doctors' rewards for prescribing more Subsys. She also said that the Insys management pressured its sales representatives to promote the Speakers Bureau Program to boost the sales of the drug.

Off-Label Use

Subsys is a powerful fentanyl-based opioid painkiller in spray form. It was approved by the FDA only for intense breakthrough pain associated with end-stage cancer.

Doctors, however, can legally prescribe the drug for off-label use, which refers to purposes beyond what the FDA green-lighted.

The New Jersey Attorney General's Office said that drug companies tried to influence the prescription of healthcare providers with payments and other benefits, which is considered illegal.

5 Years Jail Time

Breitenbach pleaded guilty to a second-degree charge of conspiracy to commit commercial bribery before Superior Court Judge Benjamin Bucca Jr. in Middlesex County. She faces five years in prison and will be sentenced on July 6.

"A primary cause of the devastating opioid epidemic gripping the country has been overprescribing of prescription opioids, driven by the greed of manufacturers," said Attorney General Gurbir Grewal.

Opioid Prescriptions And Payouts

Doctors prescribing too many opioids is driving the opioid epidemic in the United States.

A study published in JAMA Internal Medicine earlier this month showed that more gifts from drug companies can convince doctors to prescribe more drugs to their patients.

Arizona-based Insys Therapeutics, which paid doctors the most money, is now under federal investigation. The company paid doctors $4.5 million a year.

Minnesota's attorney general has also announced a lawsuit against the drug company for illegally marketing the drug for unapproved conditions at higher doses that approved by health regulators.

"To enrich its balance sheet, the company encouraged physicians to prescribe this highly-potent fentanyl product to patients who didn't have cancer, even though it was only approved for severe breakthrough pain in cancer patients," Attorney General Lori Swanson said.

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