From Dr. Forest Tennant
To Advocates and Concerned Parties
RE: Key Points in DEA Search and Seizure Warrant of Nov. 13, 2017
This lengthy search warrant shows some issues which are serious and, if implemented, will hurt pain patients and physicians throughout the Country. Even physicians and patients without pain issues will be affected.
There are 2 major issues that must concern all parties. 1. Claims of fraud and “kick-backs” for prescribing Subsys® (fentanyl sublingual spray) off-label to 2 Medicare patients, and then receiving “kick-backs” or “bribes” by receiving speaker fees and/or under-the-table money from Insys Pharmaceutical and/or United Pharmacy which is the distribution pharmacy for Subsys® in Los Angeles. The labeled indication for “Subsys®” in the PDR and REM agreement is cancer breakthrough pain.
One of the 2 patients in question actually was post-surgical, ovarian cancer and was in pain treatment for abdominal adhesions/neuropathies and possible cancer recurrence. My last speech for Insys was in 2015 and I prescribed Subsys® before and after my short speaking endeavor with Insys. At no time has Insys, United Pharmacy, or other party offered a “Quid Pro Quo”, directed prescribing, or offered money to prescribe.
Serious questions:
1. Are we now saying that prescribing off-label or accepting speaking fees is a crime?
2.
The search warrant claims that every patient who is receiving a high opioid dosage and/or a benzodiazepine and/or carisoprodol (Soma®) cannot be completely taking the drugs, are diverting them to the streets, and somehow kicking back money to me. Their basis is a review of pharmacy records by a Kaiser General Practitioner who can’t believe that some rare, very ill pain patients might need a dosage over 100 mg MED. Not stated, but implied, is that these patients are endangered. Our clinic, since 1975, has only taken intractable pain patients (some recent exceptions) who have failed standard treatments. All patients must have family involvement, physician referral, sign multiple consents describing risks, and undergo genetic, hormone, and other testing. Be clearly informed that my clinic in the past 10 years has not had an overdose death, suicide, automobile accident, or report of diversion. We know that some intractable pain patients only respond to a risky regimen that may include benzodiazepines, opioids, and carisoprodol.
SERIOUS QUESTION: Are physicians, patients, and families now going to be accused of crimes simply based on pharmacy records without even interviewing patients, family, and physician to determine the pathologic state of patients?
Sincerely, Forest Tennant M.D., Dr. P.H.
Filed under: General Problems
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