A New York doctor has been sentenced to nearly five years behind bars because of his role in a kickback scheme that was centered around a potent fentanyl-based spray, Subsys. Jeffrey Goldstein 51, of New Rochelle, New York, was one of several doctors involved in a conspiracy that violated the U.S. Anti-Kickback Statute.

The drug at the center of this controversy is the powerful painkiller Subsys which is manufactured by pharmaceutical company Insys Therapeutics. The potent spray which has been approved by the FDA is used as a pain management tool for breakthrough pain in cancer patients. Subsys is roughly 50 to 100 times more potent than morphine and much like morphine, this fentanyl-based spray is highly addictive if not used properly.

According to the Department of Justice, in August of 2012, Insys developed an initiative to expand its distribution of the spray Subsys. Their approach was through a program called the “Speakers Bureau” in which the aim was to educate physicians about Subsys. In reality, the mission of the "Speakers Bureau" was to recruit doctors who would prescribe their drug to patients. Under the "Speakers Bureau," doctors led seminars known as “Speaker Programs” in which they educated other physicians about the drug. Doctors who prescribed the drug were compensated in the form of “Speaker Fees.” The larger the volume of Subsys prescribed, the higher the speaker fees were.

The doctors who led the “Speaker Programs” were supposed to put together an educational presentation that introduced and explained the drug to the doctor participants. In actuality, these educational presentations rarely took place. Instead, these medical conventions were often social gatherings where doctors were encouraged to prescribe the drug to their patients. In many instances, the attendance sheets for these events were often forged with doctors having been listed as "attended" when in actuality they were not in attendance.

In the DOJ’s press statement, U.S. Attorney Audrey Strauss explains that Goldstein, “prescribed Subsys, a powerful fentanyl opioid, in return for nearly $200,000 in bribes from the drug’s manufacturer, Insys Therapeutics.” Strauss adds, “Goldstein put his own patients at risk in order to satisfy his own greed, and will now spend time in federal prison for recklessly prescribing this highly addictive and powerful opioid. This sentence sends a loud and clear signal to the medical community that if you take bribes in return for prescribing, you will be prosecuted to the full extent of the law and risk significant prison time.”

According to the DOJ, Goldstein was the fifth highest-paid doctor by Insys Therapeutics and the sixth-highest prescriber of the fentanyl-based spray in the last quarter of 2014. His participation in the prescription of the drug helped Insys Therapeutics rake in nearly $809,275 during that quarter.

In addition to the substantial Speaker Fees, Goldstein is accused of taking bribes from the company in exchange for prescribing the drug. Prosecutors state that Goldstein and the co-owner of his Manhattan private practice, Todd Schlifstein, received bribes from Insys including a $4,000 evening at a Manhattan strip club where the pair enjoyed a private room, alcoholic beverages, and “lap dances." Insys also footed the bill for Goldstein's annual holiday party for his private practice.

This kickback scheme had a wide-reaching net with Goldstein being one of five Manhattan doctors who had been entangled in the operation. Schlifstein was also convicted and sentenced to two years behind bars in late 2019. Other doctors charged in this kickback conspiracy include Alexandru Burducea, Dialecti Voudouris, and Gordon Freedman.

Following his 57-month sentence behind bars, Goldstein was also sentenced to 24 months of supervised release. He was further ordered to forfeit $196,600.