N Carolina sues pharma company over opioid marketing campaign

North Carolina state government lawyers are taking legal action against a pharmaceutical company whose former leaders already face criminal charges elsewhere regarding an alleged nationwide bribery scheme involving a powerful opioid.

Attorney general Josh Stein announced an unfair trade lawsuit yesterday, which was filed in Wake County Superior Court against Arizona-based Insys Therapeutics. The lawsuit relates to an unlawful marketing campaign which rewarded doctors who prescribed the drug Subsys, a powerful opiod spray.

Subsys, a mouth spray, contains fentanyl and is approved only for cancer patients dealing with extreme bouts of pain. According to the lawsuit, it is 50 times stronger than heroin and 100 times stronger than morphine.

Physicians who prescribed Subsys to non-cancer patients receive financial rewards from Insys officials. The company also allegedly sponsored presentations in Chapel Hill and Winston-Salem to expand use, according to the lawsuit, while seeking civil penalties and forcing the company to give up money generated through its scheme.

The company is also accused of misleading insurers about the drug to cover the use of the drug and providing incentives to its sales staff to get physicians to switch the medications of noncancer patients to Subsys.

To support his claim, Stein highlighted comments allegedly made by Alec Burlakoff, a Charlotte-based vice president of sales, at a national sales meeting in 2015 before he was indicted and arrested a year later.

''These (doctors) will tell you all the time, well, I've only got like eight patients with cancer,'' the lawsuit describes Burlakoff saying at the meeting. ''... Doc, I'm not talking about any of those patients. I don't want any of those patients. That's, that's small potatoes. That's nothing. That's not what I'm here doing.''

According to Stein, who is also involved in a multistate investigation of major opioid manufacturers, actions like those by Subsys are "unconscionable" and "unacceptable," especially in the context of the nation's opioid epidemic. Officials say nearly four die every day in North Carolina from unintentional drug overdoses, according to officials.

To bolster his claim, the attorney general highlighted comments that Alec Burlakoff, a Charlotte-based vice president of sales, is alleged to have made at a national sales meeting in 2015 before he was indicted and arrested a year later.

That strategy, according to the lawsuit, included ''giving illegal kickbacks - often in the form of speaking fees - to doctors who excelled at promoting and prescribing Subsys to non-cancer patients.''