Senior writer and co-founder of C-HIT, Lisa Chedekel is an award-winning investigative reporter who wrote for the Hartford Courant for 15 years, covering a wide range of beats, from politics to healthcare. In 1999, she was among a team of reporters awarded the Pulitzer Prize for breaking news reporting. In 2002, she was among a handful of U.S. journalists who visited Saudi Arabia in the year after 9/11 to report on the aftermath of the terrorist attacks. More recently, she co-authored a series on mental health in the military that won a George Polk Award, the Selden Ring Award for Investigative Reporting, and was a 2007 finalist for the Pulitzer in Investigative Reporting. Before writing for The Courant, she was a staff writer and columnist for the New Haven Register. You can contact Lisa at chedekel at c-hit.org
Connecticut saw one of the highest increases in the nation in preventable deaths from unintentional injuries from 2010 to 2014, mainly because of a spike in opioid overdoses, according to a new report from the Centers for Disease Control and Prevention (CDC). An analysis of the report shows that the state’s rate of potentially preventable deaths from accidental injuries jumped 97 percent – the sixth- highest increase nationally, after Maryland, Massachusetts, New Jersey, New York and Virginia. Nationally, preventable deaths from accidents – namely, overdoses from prescription and illicit drugs, as well as falls – rose 23 percent. Connecticut had 1,142 unintentional injury deaths in 2014— the second highest in New England, after Massachusetts. About half (568) were accidental drug intoxication deaths, according to the Office of the Chief Medical Examiner.
Ten Connecticut prescribers, including a Derby nurse who is at the center of a federal kickback probe, were responsible for more than 23 percent of the state’s Medicare spending on opioids in 2014, suggesting that the largest share of those prescriptions is concentrated among a small number of clinicians. Recently released federal Medicare data show that Heather Alfonso, formerly a nurse with the Comprehensive Pain & Headache Treatment Centers, LLC, in Derby, and four other advanced practice registered nurses (APRNs) at the clinic in 2014 dispensed more than $8.4 million in opioids in the Medicare program – accounting for a full 15 percent of all such prescriptions in the state. They were among the top 10 opioid prescribers in 2014, who accounted for $13 million of the $56 million spent on the drugs, the data show. More than 4,800 Connecticut clinicians, mostly physicians, wrote Medicare prescriptions for oxycodone, fentanyl and other opioids. But the prescribing was not evenly spread out – only two-dozen prescribers wrote out more than $250,000 worth of prescriptions.
The state has taken custody of more than 860 children since 2011 because their families could not access or provide “specialized care” for their mental health or physical conditions, according to judicial department data.
A former executive of Insys Therapeutics has been criminally charged for leading a special “reimbursement unit” at the company that defrauded insurers into paying for a potent opioid pain medication by falsely claiming patients had cancer and other conditions needed for pre-approval. Elizabeth Gurrieri, a former manager of reimbursement services for Arizona-based Insys, was charged with wire fraud conspiracy in a criminal complaint filed in federal court in Boston. The complaint sheds light on a Connecticut case involving a Derby nurse who has been charged with taking kickbacks from Insys in exchange for prescribing the company’s fentanyl spray, Subsys. The nurse, Heather Alfonso, has been cooperating with investigators in Boston and Connecticut in an ongoing probe of Insys’ sales tactics. The complaint against Gurrieri notes that patients needed prior authorizations from insurance companies to cover the costs of Subsys, an expensive drug approved by the Food and Drug Administration in 2012 for the management of breakthrough pain in patients with cancer who already were receiving opioid pain treatment.
Ten years have gone by, but Lisa Vincent and her son, Jose, flash back to their goodbye with fresh anguish and faltering voices. He is 21 now, but the 11-year-old boy he was back then easily re-surfaces, all anger and confusion. “I didn’t understand. I was under the assumption I was going back to her,” Jose says. “For a long time, I felt that whole ‘she gave up on me like everyone else did.’ Now, I realize it wasn’t her.
Fifteen months after a Derby nurse admitted taking drug-company kickbacks in exchange for prescribing a powerful opioid painkiller, a former district sales manager for the company was arrested Thursday on federal charges that he helped to orchestrate the kickback scheme. Jeffrey Pearlman, of Edgewood, NJ, who was district sales manager for the New York region for Insys Therapeutics through 2015, and the sales representatives he managed “induced certain physicians, advanced practice registered nurses (APRNs) and physician assistants to prescribe the pharmaceutical company’s fentanyl spray by paying them to participate in hundreds of sham ‘Speaker Programs,’” according to a release from the U.S Attorney’s Office for Connecticut. The scheme “defrauded federal healthcare programs” of millions of dollars that was paid out improperly for the drug, Subsys, which is approved for use only in cancer patients with breakthrough pain. Federal prosecutors allege that Pearlman “personally profited” from the scheme through inflated quarterly bonuses he received that were based, in large part, on the sales results of the employees he managed. Pearlman, who is no longer employed by Insys, could not be reached for comment Thursday.
Four nurses, all of them affiliated with a Derby pain clinic, were responsible for nearly all of the state’s 2014 Medicare spending on the powerful opioid painkiller Subsys, which is at the center of a kickback probe. New Medicare data for 2014 show the four nurses, all who worked at the Comprehensive Pain and Headache Treatment Center of Derby, were responsible for 279 claims for Subsys, at a cost of $2.3 million. The highest prescriber was Heather Alfonso, an advanced practice registered nurse (APRN) formerly employed by the clinic who is awaiting sentencing on charges she took kickbacks from Arizona-based Insys Therapeutics for dispensing Subsys to patients. The new data is the first indication that the propensity to prescribe Subsys extended beyond Alfonso, to other clinic staff. None of the other three nurses has been implicated in an ongoing federal probe of Insys’ marketing of Subsys that resulted in the criminal charges against Alfonso.
Dozens of Connecticut doctors accepted six-figure payments from drug and medical device manufacturers in 2015 for consulting, speaking, meals and travel, with six of the 10 highest-paid physicians affiliated with academic institutions, new federal data show. The top 10 doctors – less than 0.1 percent of the 11,000 who received payments – took in $3.6 million, or nearly 15 percent of the total $24.9 million paid out. Among them is the dean of the Yale School of Medicine, Dr. Robert Alpern, who received $445,398 in 2015 from two companies – Abbott Laboratories and AbbVie – in consulting fees, meals and travel expenses for serving on the boards of both companies. In 2014, he received $458,194 from the two companies. The Yale medical school began a research partnership with AbbVie in 2013, after the pharmaceutical company spun off from Abbott Laboratories.
Connecticut still ranks high among states in the use of antipsychotic drugs for elderly nursing home residents, but its rate of use has dropped 33 percent since 2011 – a bigger decline than the national average — new government data show. The data released in June by the Centers for Medicare & Medicaid Services (CMS), show that nursing home residents in Connecticut, many with dementia, are still more likely to be given antipsychotics than their counterparts in 31 other states. But the state’s usage has fallen in the last 4 ½ years at a greater rate than the average drop of 27 percent, and it is now about the same as the national average — 17.4 percent. That’s down from 26 percent in 2011. CMS has been working with states for the past five years to address the overuse of antipsychotic medications in nursing homes.
Connecticut’s shift next month from weekly to “real-time” reporting of prescriptions for opioids and other controlled substances is an effective way to help stem opioid-related deaths, a new study suggests. Researchers from Vanderbilt University who analyzed states’ prescription drug monitoring programs – central databases that log controlled substances dispensed to patients — found that programs that were “updated with greater frequency” and that reported data for a broad range of drugs were associated with greater declines in opioid-related deaths. The study in the journal Health Affairs comes as Connecticut prepares to put a policy in place requiring that pharmacies report controlled substance (Schedule II to V) prescriptions “immediately,” or at least within 24 hours after they are dispensed, into the central database, known as the Connecticut Prescription Monitoring and Reporting System (CPMRS). The CPMRS, maintained by the Department of Consumer Protection, can be accessed by doctors and pharmacists to give them a complete picture of a patient’s medication use, including prescriptions by other providers. It also can be used by law enforcement officials to investigate physician prescribing.