10 Dec Fentanyl spray prescriber to face jury over kickback charges | Courts
Lawyers will start picking jurors on Tuesday to decide whether a former physician assistant at the Pain Care statewide pain clinic received kickbacks to prescribe a highly addictive fentanyl spray to patients.
Christopher Clough has indicated that he will testify on his own behalf in the trial in U.S. District Court, and his lawyer is attempting to prevent prosecutors and witnesses from mentioning the term “opioid crisis.”
Clough faces eight kickback-related criminal charges. Allegations say he received payments for prescribing a fentanyl spray to hundreds of pain patients, even though it was designed for adult cancer patients who have developed tolerance to other pain killers.
Clough worked for Somersworth Pain Care of New Hampshire, which at its height had 10 clinics across the state. He was one of the largest prescribers of opioid and pain-related medication in the state earlier this decade, according to previous newspaper articles.
In 2016, the New Hampshire Board of Medicine permanently revoked his license.
Indictments filed against Clough allege he hosted presentations at high-end restaurants in the Seacoast and Boston, ostensibly to introduce other health care professionals to the benefits of the Subsys fentanyl spray.
But most of the time, no one attended. Nonetheless, Clough, who ended up being one of the biggest fentanyl spray prescribers in the country, received fees of $1,000 or $1,500 for hosting the no-show events, according to the indictments.
Court papers identify the fentanyl spray as the product Subsys, which was developed by Insys Therapeutic Inc. of Chandler, Ariz.
Two years ago, Insys paid the state of New Hampshire $2.95 million for its part in a scheme to over-prescribe Subsys, according to past newspaper articles. It has also been sued by several New Hampshire cities.
According to the indictment, Clough frequently met with Insys sales representatives to discuss new patients that Clough could recommend for the spray or existing patients who could see a dosage increase.
“Clough and the sales representatives of the Pharmaceutical Company discussed that Clough needed to prescribe the fentanyl spray to more patients if he wanted to receive more paid speaking programs. Clough agreed to do so,” reads one part of the indictment.
Over about 1½ years, Clough wrote 700 prescriptions for Subsys, the indictment reads.
Last year, federal prosecutors in Massachusetts charged John Kapoor of Phoenix, the founder and majority owner of Insys, with using bribes and fraud to distribute Subsys nationally.
Insys has said little about that indictment, or suits brought by attorneys general from other states.
“We do not believe it is factually accurate to link Insys with materially contributing to the opioid crisis in the state of New York or the nation,” Insys said when New York Attorney General Barbara Underwood sued them in February.
More recently, Insys announced a third-quarter loss of $30.6 million. It also said it had been licensed to sell Subsys in the Middle East.
In court papers, prosecutors said they have provided Clough’s defense lawyers with 100,000 pages of documents; charges similar to Clough’s have been brought in Massachusetts, Connecticut and Rhode Island.
In one filing, Clough’s lawyer disputed allegations that it is improper to induce medical professionals to prescribe Subsys for treatment other than cancer-related pain.
“While it is correct that the FDA has only approved Subsys for breakthrough cancer pain, there is nothing inappropriate about promoting the off-label use of any pharmaceutical drug,” wrote Patrick Richard, Clough’s lawyer from Lowell, Mass., in court papers.
With trial approaching, Richard has filed a number of requests with Judge Joseph Laplante. He doesn’t want the jury to hear about Clough’s license revocation. He doesn’t want former patients of Pain Care to testify about their addiction.
He also wants to bar prosecutors from using the term “opioid crisis.”
Many jurors are likely to approach a trial with negative, preconceived notions as to any individual, like Mr. Clough, who made his living working for a clinic that regularly prescribed opioids and speaking on behalf of a company producing opioids,” Richard wrote.