Baltimore County doctor pleads guilty in drug kickback scheme

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A Baltimore County doctor specializing in pain management pleaded guilty in federal court Wednesday to conspiracy to receive illegal kickbacks for prescribing a drug company’s cancer pain relief medication to patients who did not have the disease.

Under the plea agreement, Dr. Howard Hoffberg said he received $66,600 from Insys Therapeutics Inc. in exchange for prescribing the company’s drug Subsys, a highly addictive fentanyl-containing medication that has only been approved for cancer patients. To conceal the kickback, Insys cast its payments as “honoraria” to Hoffberg for discussing the drug’s effectiveness to medical groups as part of  the company’s ”speakers bureau.”

The payments to Hoffberg were part of a nationwide kickback scheme orchestrated by top Insys officials that prosecutors say helped fuel the opioid addiction crisis.

“Hoffberg admitted that his participation in the Speakers Bureau Program was a sham,” the Maryland U.S. Attorney’s Office, which prosecuted the doctor, stated in announcing the plea Thursday. “Hoffberg often made these presentations at high-end restaurants, and to staff (at his medical practice) and/or to persons who could not even prescribe controlled substances. Hoffberg knew that these presentations were not designed to promote any bona fide educational initiative about Subsys but rather were required to receive the honoraria.”

Hoffberg, who practiced in Owings Mills and Towson, faces a punishment of up to five years in federal prison when he is sentenced Sept. 29 by U.S. District Judge George L. Russell III in Baltimore, the U.S. attorney’s office stated.

Hoffberg’s attorney, Joshua Treem, did not immediately return email and telephone messages Thursday seeking comment on the plea agreement. Treem is with Brown Goldstein Levy LLP in Baltimore.

Hoffberg’s plea followed the May 2019 racketeering convictions of Insys founder John Kapoor and four company executives related to the company’s payments to doctors to prescribe Subsys to non-cancer patients, an illegal scheme that helped fuel the opioid overdose crisis that has killed more than 100,000 Americans. Kapoor received the longest sentence, five and a half years, in January 2020.

In June 2019, Insys agreed to pay $225 million to resolve the federal government’s criminal and civil claims against the Phoenix, Ariz.-based company.

According to his plea, Hoffberg’s solicitation and receipt of payments from Insys and related entities began in June 2012, about six months after the U.S. Food and Drug Administration approved Subsys for use only by cancer patients suffering sudden onsets of pain.

When the number of qualifying cancer patients proved too small for the company, Insys paid Hoffberg to prescribe Subsys for other patients, according to the plea.

Hoffberg also switched several of his pain-medication patients to Subsys because of the kickbacks from Insys, even though he had certified to FDA his understanding that drugs containing fentanyl are not interchangeable and have high potential for abuse and addiction, the plea stated.

Hoffberg’s prescribing of Subsys for non-cancer patients ended in January 2018, according to the plea.

The criminal case is docketed at the U.S. District Court in Baltimore as United States of America v. Howard Hoffberg, 1:21-cr-00178-GLR.