A former Boca Raton high school counselor who developed a scheme to have doctors prescribe a fentanyl spray is heading to prison.
Alec Burlakoff was sentenced to 26 months in prison on Thursday in a Boston courtroom.
As vice president of sales at Arizona-based Insys Therapeutics, he recruited strippers, waitresses and cheerleaders to work as sales representatives who would convince doctors to prescribe the fentanyl spray Subsys by paying them for fake speaking engagements. Burlakoff and Insys funneled $16.3 million into the doctors’ pockets over a two-and-a-half-year period.
“I didn’t think of who we were at Insys, and how unethical what we were doing was,” Burlakoff told U.S. District Judge Allison Burroughs on Thursday. “The only thing I could think was how could I keep up with the fast and furious pace necessary to get ahead.”
Burlakoff allegedly threatened to fire any representative who could not get their doctors to write at least one script every day, according to a federal lawsuit.
The higher the dose, the more money his company would make, for a drug that typically costs $1,800 retail for 30 spray bottles at the lowest strength or as much as $6,000 at the highest dose.
Insys made $500 million in 2014 and 2015 under Burlakoff’s watch, and Subsys sales rose by 3,200 percent. The company filed for bankruptcy last year.
“This was an offense of greed,” Burroughs said. She also told Burlakoff that he has “to live with the fact that some of these other people got swept into this because you recruited them.” She gave him six more months than prosecutors had requested.
According to The Palm Beach Post, at least 908 patients died with Subsys the primary factor in their deaths.
The fentanyl spray was approved by the Federal Drug Administration (FDA) only for cancer pain. However, doctors under Burlakoff’s plan also prescribed it for everything from routine back pain, migraines and intestinal disorders.
Prosecutors asked Burroughs to “hold your nose” and give Burlakoff a 20-month sentence, which would have been significantly less than other executives and doctors involved in the scandal, since he had testified at trial against Insys’ owner and chairman John Kapoor, who received five-and-a-half years in prison on Thursday.
Other executives received sentences of between 27 and 33 months.
Doctors have also been prosecuted, although Florida physicians who also earned speaker fees have mostly avoided the eye of federal prosecutors.
Insys paid Florida doctors more than $2.1 million from August 2013 through 2015, according to a report on Medicare data. In addition, the state topped the nation for Subsys claims in 2014 and 2015.
Burlakoff brought the fake speaker programs from his previous job at Cephalon, which settled with the Justice Department for $425 million for pursuing off-label prescriptions of its fentanyl lollipop as well as two other drugs.
Before that, he was fired from Eli Lilly and Co., a pharmaceutical company, and as a sales representative in Palm Beach and Broward counties. He and two other salespeople sent unsolicited Prozac through the mail in the local case.
He worked as a school counselor and basketball coach at Pine Crest School in Boca Raton from 1997 to 2001, before going into pharmaceutical sales.
Burlakoff’s attorneys and supporters reminded the judge that he once counseled teens and coached them but lost his way after his brother committed suicide by cop after shooting and killing his wife in Boca Raton.
In a letter to the judge, one of Burlakoff’s friends said after his brother’s death, “his thinking was a little out of whack.”
“This shocking trauma took place in October 2013 when Mr. Burlakoff was in the mids of the conspiracy at Insys,” attorney Joshua Ruby responded in a sentencing memorandum. “Tellingly, Dr. Kapoor ordered Mr. Burlakoff to return to work after only a matter of days of grieving.”
He added that Burlakoff “let his drive and competitiveness — which had served him so well as a coach — overcome his judgment.”