Justice 065

 

Physician took cash for prescribing fentanyl spray

DENVER – The U.S. Attorney’s Office for the District of Colorado announces that Dr. Jeffrey Kesten, age 61, formerly of Evergreen, Colorado, was sentenced to 24 months in federal prison, to be followed by three years of supervised release, for conspiring to violate the Anti-Kickback Statute, in connection with a scheme to take bribes and kickbacks from a pharmaceutical company in exchange for prescribing a powerful fentanyl spray to his chronic pain patients.

According to the plea agreement, beginning in late 2012 and continuing through November 2015, the defendant conspired with pharmaceutical company employees to take approximately $344,000 in bribes and kickbacks from Insys Therapeutics, Inc., the manufacturer of Subsys, a powerful sublingual fentanyl spray approved by the FDA in 2012 to treat breakthrough pain in cancer patients. The bribes were disguised as payments or honoraria for purportedly delivering educational speaker programs to the defendant’s medical peers. In fact, the defendant often delivered no programs at all—at one point taking payments of over $40,000 from Insys for 17 “programs” he allegedly delivered to his own staff at his medical clinic. As part of the plea agreement, the defendant admitted that he entered into a quid pro quo relationship with Insys, and that the payments affected his prescribing decisions. He abused his position of trust vis-à-vis his patients and the Federal healthcare programs in which he was enrolled, becoming one of Insys’s top revenue-generating prescribers. Prescriptions for Subsys typically cost thousands of dollars each month, and Medicare and Medicaid paid millions of dollars to cover Subsys prescriptions written by Dr. Kesten.

“You have to be able to trust your doctor’s medical judgment,” said U.S. Attorney Cole Finegan. “We’ll hold physicians and medical professionals accountable for taking bribes and kickbacks, especially when they are prescribing powerful drugs to vulnerable patients.”

“As we’ve seen over the past several years fentanyl abuse has become an existential threat across the nation,” said DEA Denver Acting Special Agent in Charge David Olesky. “There is no greater threat to our community than a doctor who violates a patient’s trust with no regard to patient safety and well-being beyond what profits it can bring him. We applaud this sentencing and will continue to work with our counterparts in the U.S. Department of Health and Human Services Office of the Inspector General and the U.S. Attorney’s Office to ensure other doctors who manipulate the system will be held accountable.”

“Accepting kickbacks and bribes in exchange for prescribing medication not only compromises the integrity of Federal health care programs; it can also gravely endanger beneficiaries,” said Curt L. Muller, Special Agent in Charge with the U.S. Department of Health and Human Services Office of the Inspector General. “HHS-OIG will continue to work relentlessly alongside our law enforcement partners to ensure the health and safety of beneficiaries and the efficient use of taxpayer dollars."

Fentanyl is at least 50 times more powerful than morphine, and to ensure patient safety, the FDA requires Subsys prescribers, patients, and pharmacies to enroll in and comply with the Transmucosal Immediate Release Fentanyl Risk Evaluation and Mitigation Strategy (TIRF REMS) program. The defendant disregarded the rules imposed by this program, failing to notify his patients of the risks posed by the Schedule II controlled substance prescription.

United States District Court Judge Daniel D. Domenico sentenced Kesten on February 24, 2022.

The Department of Health and Human Services Office of the Inspector General, and the Drug Enforcement Administration conducted the investigation.

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