Doctors Receiving Kickbacks For Fentanyl Are Prosecuted
John Couch, an Alabama doctor, was sentenced on Thursday to twenty years in prison after he was convicted for prescribing pain medication through his association with two clinics that had no real purpose and receiving kickbacks. Couch and his colleague, Xiulu Ruan, ran a group called Physicians Pain Specialists of Alabama, with two locations in Mobile, and were found guilty of racketeering conspiracy among other felony charges.
The case, which was filed in 2015, focused on two brand name instant release fentanyl based drugs, Subsys, manufactured by Insys, and Abstral, which was then manufactured by Galena Biopharma Inc. Both are known drugs of abuse and have been approved by the United States Food and Drug Administration to treat cancer pain. Abstral can also be used for off-label uses to treat neck, back and joint pain. Fentanyl can a dangerous treatment option, leaving patients at risk for respiratory distress and even death when taken in high doses or when combined with other substances, especially alcohol or other drugs of abuse. Since these drugs are highly addictive, it is easy to find repeat clients once prescribed.
The court found Couch and Ruan to have been motivated to sell Subsys and Abstral for their own financial self-interest, and sales of the drug proved to be very profitable for the two doctors. They conspired to regularly write prescriptions for large quantities without any legitimate medical purpose, and time and again, patients would return to a new fix, making it easy for the scheme to continue until the two were caught.
Prosecutors said the doctors received illegal kickbacks, and became among the top issuers of Subsys in the nation. They were writing prescriptions for the fentanyl drugs left and right, receiving significant kickbacks from Insys Therapeutics Inc. The two also purchased $1.6 million in Galena shares in an attempt to adjust its stock price by significantly increasing sales of Abstral. Federal charges were brought against several former top level executives and managers at Insys, including former CEO Michael Babich. He was accused of bribing doctors into issuing Subsys prescriptions. Federal charges have also been filed in four states against at least five other ex-Insys employees. All former Insys have pleaded not guilty to the charges.
A statement released by Insys cited that company executives were working to settle the case. Couch’s attorney said his client planned to appeal the conviction. “We don’t think there was sufficient evidence in the case,” he said. Galena, which divested of Abstral in 2015, earlier this month said it had agreed to pay $7.5 million to conclude a U.S. investigation into its promotional practices for Abstral. Whether Couch’s appeal will be successful is yet to be determined, but with overdose rates skyrocketing nationwide, law enforcement is eager to put an end to drug rings and deaths associated with prescription drug overdoses. Alabama ranked number one in the state last year for prescription opioid use as well, according to a joint investigation by The Associated Press and the Center for Public Integrity.