Insys insider claims sales bonuses were tied to pushing high doses of fentanyl on patients

A longtime pharmaceutical sales rep for Insys Therapeutics testified Wednesday that he broke the law for the company that made him a rich man with its alleged scheme to bribe medical practitioners to hook patients on Subsys, its potentially fatal fentanyl pain reliever.

“Did you agree to commit a crime?” K. Nathaniel Yeager, chief of the U.S. Attorney’s Office’s Health Care Fraud Unit, pointedly asked Brett Szymanski.

“Yes,” said Szymanski. “This was my first pharmaceutical job. I was just starting to do well, to learn the business.”

Besides, he said, by age 26 Insys had made him a millionaire.

Szymanski has been immunized against federal prosecution in return for his insider testimony against five former bosses who face up to 20 years in prison if convicted of racketeering and fraud – among them, Insys’ billionaire founder John Kapoor and Sunrise Lee, 39, an exotic dancer who became Szymanski’s manager.

Szymanski told jurors that when he started at Insys in 2012 pitching Subsys, a new opioid mouth spray originally intended to ease breakthrough pain in cancer patients, his base salary was $40,000. By the time he left in 2016, he’d earned nearly $2 million.

“The more of the drug you sold the more money you would make,” he explained.

Subsys launched in March 2012, but six months later, evidence suggests Insys executives were frustrated because physician clients were cautiously prescribing such low doses that the majority of patients were returning the product as ineffective.

Yeager asked Szymanski to read from an email he and other Insys agents received from Alec Burlakoff, former vice president of sales operations. Burlakoff, 44, of West Palm Beach, Fla., pleaded guilty to racketeering conspiracy in November and is expected to be a star witness for the feds.

Burlakoff ordered Szymanski and others by email to “vehemently drive home the EFFECTIVE DOSE message on every sales call” with the desired result being, “These patients will continuously refill their monthly prescriptions indefinitely.”

Szymanski testified he also fabricated speaking engagements for physicians so Insys could slip them cash rewards. When he asked Burlakoff how to fill out a signup sheet for a program no one was attending, he said Burlakoff replied, “I don’t care if people show up. Stop at a playground and get signatures.”