Prison-bound doc prescribed fentanyl drug to patients he knew it could kill

A disgraced Michigan neurologist who pocketed $138,000 as reward for being Insys Therapeutics’ reigning prescriber of Subsys said he dispensed the cancer drug to the elderly, mentally ill and even a drug abuser despite knowing it might kill them because it meant “easy money.”

“I really didn’t treat patients with cancer at all … I prescribed it to patients who really didn’t need it just to increase my number of prescriptions. I was aware of the risks,” the ex-Dr. Gavin Awerbuch testified Thursday in U.S. District Court in Boston.

Awerbuch took the stand as a prosecution witness in the racketeering trial of the pharmaceutical company’s billionaire founder John Kapoor, 75, and four former executives.

The 60-year-old pleaded guilty last year in Michigan to healthcare fraud and illegal distribution of Subsys. He is scheduled to begin a 32-month sentence March 19 at the Morgantown Kennedy Center federal prison in West Virginia — a so-called “Club Fed” for white-collar offenders.

At his peak, Awerbuch said he was writing 26 Subsys prescriptions per week. He lamented he’s on the hook for $4.1 million in restitution. As of last week, he had paid off more than $3,459,330 of his debt, records in the U.S. District Court of Eastern Michigan show.

“More pertinently, I lost my ability to practice medicine, which means everything to me,” said Awerbuch, arrested in 2014 after the FBI raided his practice in Saginaw and seized thousands of patient files.

Even knowing Subsys could kill by stopping breathing in patients it wasn’t suited for, Awerbuch said he prescribed it to a young girl who was abusing drugs, women with mental illness and a man with a head injury prone to forgetting whether he’d already taken his medication. He also provided it to an elder with a history of epilepsy. Subsys is 100 times more potent than the hydrocodone she was previously treated with, he said.

When Insys launched its fentanyl-based pain-management mouth spray in 2012, Awerbuch jumped at the company’s lucrative offer to serve as an educational speaker promoting Subsys to fellow physicians at $1,500 or more per appearance. But when his prescription rate was initially flat, he said former vice president of sales Alec Burlakoff shut him off.

“I’m embarrassed, but I said I’d be willing to prescribe more Subsys,” Awerbuch testified. “I was afraid if I told him no that he wouldn’t include me.”