NEWARK, NJ --  Attorney General Gurbir S. Grewal announced on Monday that his office has filed complaints against several state physicians, including one from Hamilton, for allegedly inappropriately writing “off-label” prescriptions for high dosages of the powerful opioid and cancer pain medication “Subsys” without regard for the associated risks of addiction, overdose, and death.

The doctors are accused of writing prescriptions for non-cancer patients after receiving substantial payments from the drug’s manufacturer, Insys Therapeutics, Inc., which tried to disguise the kickbacks to doctors by funneling them through a sham speaker program funded by the company.

Hamilton urologist Dr. Mukaram Gazi is accused of accepting Insys-funded dinners described as “lectures,” trips for “training,” and payments totaling more than $132,000, which Insys thinly disguised as “speaker’s fees" between 2013 and 2015. 

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In addition to allegations of indiscriminate prescribing for multiple patients, the State’s complaint notes that Gazi’s signature appeared on forms used to obtain insurance coverage for Subsys prescriptions, which incorrectly identified Gazi’s specialty as oncology and provided false explanations for why Subsys was being prescribed.

“We will hold accountable all those whose misconduct has helped fuel the opioid epidemic in New Jersey,” said Attorney General Grewal. “We’re taking action against multiple doctors who sold their medical licenses and prescription pads to Insys and put their personal financial interests above their patients’ health and well-being. These actions should serve notice to those who unlawfully push opioids from their exam rooms that they are not above the law and are no different than those that push heroin on street corners.”

Subsys, a highly addictive, fast-acting fentanyl spray fifty times more potent than heroin, is approved by the Food and Drug Administration (FDA) only for the narrow purpose of treating breakthrough cancer pain in opioid-tolerant patients.  Because this type of medication can carry a high risk for misuse, abuse, addiction, overdose, and serious complications due to medication error, the FDA has subjected these medications to significant restrictions.

The doctors whose licenses the State seeks to suspend or revoke for their role in the scheme and for inappropriately prescribing Subsys.  

The Attorney General's office said these filings are part of a continuing New Jersey’s efforts to hold accountable those responsible for fueling the State’s opioid epidemic. 

“As our actions today demonstrate, we are committed to holding everyone accountable who is involved in illegal and unethical kickback schemes that have contributed to the overdose epidemic in this state,” said Paul R. Rodríguez, Acting Director of the Division of Consumer Affairs. “We will not allow patients in this state to be used as pawns in moneymaking schemes that pose extreme dangers to patient safety, violate basic principles of medical ethics, and erode trust in the medical profession.”

“These five doctors acknowledged that they had read the risks associated with Subsys and understood that it was approved only for narrow uses as a cancer pain medication,” said Sharon Joyce, Director of NJ CARES. “Nevertheless, they chose to ignore the unequivocal risks to their patients in favor of the easy money Insys was offering. Their unsavory collaboration with Insys endangered their patients and undermined efforts to end the opioid crisis and prevent more lives from being lost.”

Three additional doctors who were charge in the scheme alongside Gazi are Dr. Serge Menkin of Holmdel, Dr. Kieran Slevin of Hainesport, and Dr. Felix Roque of West New York. 

Finally, a separate lawsuit brought by the State against Insys’s founder, John N. Kapoor is pending in Superior Court in Middlesex County that accuses Kapoor of directing and approving the payment of bribes to New Jersey doctors who participated in the speaker program so that they would inappropriately prescribe Subsys, among other fraudulent conduct. 

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