Doctor, drug rep plead guilty in Nuedexta drama

The following is an excerpt from MedPage Today.

A doctor and a drug rep from Ohio pleaded guilty on Monday to their roles in a kickback scheme that pushed prescriptions for dextromethorphan/quinidine (Nuedexta) onto patients who didn't need it, according to the U.S. Department of Justice.

Deepak Raheja, MD, and Frank Mazzucco, a regional business manager for Avanir Pharmaceuticals, allegedly conspired to boost scripts for Nuedexta in exchange for monetary kickbacks and other items of value, according to DOJ.

The guilty pleas are the latest in an ongoing drama around Nuedexta, which was originally approved in 2010 to treat pseudobulbar affect (PBA).

The drug's label specifically states that it has not been shown to be safe in other conditions such as Alzheimer's disease or dementia, but that didn't stop drugmaker Avanir's sales force from aggressively pushing the drug for off-label uses, frequently on elderly patients who may be harmed by the drug, according to reports.

Raheja joined Avanir's speaker's bureau in February 2011 and received about $331,550 to give talks about the drug from October 2011 to April 2016, according to the DOJ. During this time, Raheja wrote about 10,088 Nuedexta prescriptions, the highest in the country, DOJ said.

Court documents show that in one text exchange, Mazzucco texted the following to Raheja and another colleague: "Good morning Dr. Raheja! As of the 12/4 sales report, you posted the single greatest week of sales in Avanir History! 89 [prescriptions] in a single week. I am completely blown away by this number. Your leadership and effort is unparalleled, nationally."

As part of the plea agreement, Raheja will surrender his medical license and will serve 30 months in prison. He will also pay about $1.2 million in restitution and another fine to be determined, according to the DOJ.

Last month, another doctor involved in the scheme -- Bhupinder Sawhny, MD -- pleaded guilty to accepting kickbacks in exchange for writing Nuedexta scripts for patients who didn't need them, according to reports. 

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