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.
The rates of asthma-related emergency room visits and hospitalizations dropped in many Connecticut communities, the latest data from the state Department of Public Health show. Overall, 58 percent of communities saw a decrease in the age-adjusted rate of emergency room visits, while 63 percent saw a decrease in the rate of hospitalizations for asthma, according to a C-HIT analysis of the data. Some 36 percent saw improvement in both areas. The data compares age-adjusted rates for each town for 2005-2009 and for 2010-2014 per 10,000 people. Meanwhile, the state’s overall rate for emergency room visits in 2014 was lower than recent years but still was higher than it was 10 years ago.
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 had the highest total number of foodborne illness outbreaks in New England from 2005 to 2014, according to federal data – a distinction that experts say is fueled by better reporting, while higher rates of certain pathogens also may contribute. An analysis of data from the Centers for Disease Control and Prevention (CDC) show that Connecticut had 2,259 cases of foodborne illness in 154 single-state outbreaks in that 10-year period. For five of those years, Connecticut reported more single-state outbreaks than any other New England state. For eight years, its outbreak count exceeded that of its more populous neighbor, Massachusetts. And for nine of those years, it topped New Jersey.
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.
Five Connecticut physicians have received letters from the U.S. Food and Drug Administration (FDA) alleging that they may have purchased unapproved drugs that put patients at risk of adverse health consequences, documents obtained by C-HIT show. The FDA documents show the five doctors were alerted as part of a wide-reaching federal probe involving Gallant Pharma International Inc., which sold more than $12.4 million in unapproved chemotherapy and injectable cosmetic drugs in the United States before the government shut down the operation in 2013. The letters to the doctors, dated April 1, 2015, say that “In addition to putting patients at risk, receiving misbranded or adulterated drugs and devices in interstate commerce and delivering or offering to deliver those drugs and devices to (or use on) others violates federal law.”
None of the doctors has been charged with wrongdoing, and only one acknowledged receiving the letter from the FDA. The case comes to light as drug companies and pharmacies are urging Congress and law enforcement officials to crack down on an increasing number of dangerous unapproved and counterfeit drugs being sold to doctors and consumers nationwide. Sales of counterfeit drugs and drugs not approved by FDA have soared into a multi-billion dollar industry with the growth of the Internet, and drug companies say efforts by governments to tackle illegal online drug sales are not sufficient.
The rate of denials by the state’s largest managed care insurers of requests for mental health services rose nearly 70 percent between 2013 and 2014, with an average of about one in 12 requests for prescribed treatment initially rejected, a new state report shows. At the same time, the proportion of enrollees in the largest managed care companies who received outpatient or emergency department care for mental health doubled, from an average of 9.4 percent in 2013 to 20.8 percent in 2014, according to an analysis of the 2015 Consumer Report Card on Health Insurance Carriers in Connecticut, issued by the state Insurance Department. The percentage of members who received inpatient mental health care also doubled, although it remained low, with most companies providing inpatient services for less than .5 percent of all enrollees. The rise in rejections by the state’s 10 largest indemnity managed care companies – private health insurers, not including Medicare or Medicaid — came as state officials focused on improving mental health outreach and treatment, in the wake of the Sandy Hook school shooting in December 2012. The managed care organizations include companies such as Aetna Life Insurance Co., Anthem Health Plans, CIGNA Health and Life Insurance Co., and UnitedHealthcare Insurance Co.
Nearly 60,000 Connecticut children under age 6 were reported with lead exposure in 2013, and an additional 2,275 children had high enough levels of the toxin in their blood to be considered poisoned. While those numbers, the latest available from the state Department of Public Health, may seem high, health experts say they actually must be higher because of significant gaps in state-mandated testing. Even though Connecticut has some of the strictest lead-screening laws in the country – requiring every child to be tested twice, before age 3 – DPH figures show that only half were screened twice, as mandated. Unlike in Flint, Mich., whose residents were poisoned when a corrosive water source was directed through aging lead-lined pipes, the main culprit in Connecticut is lead paint. Though banned in 1978, lead-based paint is present in countless older apartment buildings and homes, especially in urban centers, such as Hartford, New Haven and Bridgeport.
A new report that identifies the most distinctive cause of injury death for each state, compared to national rates, has some findings that might be expected:
Seven states in Appalachia and the Southwest, for example, had unintentional firearms deaths roughly two to four times the national rate. Those states have high gun ownership rates and lack safe-storage laws. Three states – Montana, South Dakota and Nebraska – had as their most distinctive injury motor vehicle crashes involving passengers. Four safety provisions – primary seatbelt laws, mandatory key ignition locks for drunk drivers, booster seats, and nighttime driving restrictions for teens – are absent in Montana, while South Dakota and Nebraska have only one each. Connecticut had as its most distinctive cause of injury death “unintentional suffocation” – the only state with that outlier cause.