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A former high-ranking executive of an Arizona-based drug company pleaded guilty Wednesday in federal court in Boston for his role in a nationwide conspiracy to bribe doctors to unnecessarily prescribe a fentanyl-based painkiller.

Alec Burlakoff, former vice president of sales of Chandler, Ariz.-based Insys Therapeutics, pleaded guilty to a count of racketeering conspiracy before US District Court Judge Allison D. Burroughs.

By agreeing to cooperate with prosecutors, he could become a crucial witness at the trial in January of six former Insys executives accused of participating in the scheme. They include the company’s billionaire founder, John Kapoor.

Burlakoff, 44, of West Palm Beach, Fla., and other Insys employees allegedly used a variety of schemes to bribe physicians and other medical personnel at pain clinics in different states to prescribe Subsys. Subsys is a powerful, fentanyl-based pain medication intended to treat cancer patients suffering intense pain.

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Those methods included paying doctors to be Insys speakers if they wrote prescriptions for Subsys, according to prosecutors. The more prescriptions written for Subsys — and the higher the dose — the more fees and speaking opportunities were awarded to the clinicians.

In other instances, employees in a doctor’s office were moved onto the Insys payroll, as were relatives and girlfriends of medical professionals who wrote a lot of Subsys prescriptions, prosecutors said.

As a result of the conspiracy, prosecutors said, many patients were inappropriately prescribed Subsys, which is highly addictive and dangerous.

The racketeering conspiracy charge carries a sentence of up to 20 years in prison, three years of supervised release, and a fine of $250,000.

The US attorney’s office in Boston has for years played an outsized role in the prosecution of health care fraud in the country, even if the companies involved are not based in Massachusetts.


Jonathan Saltzman can be reached at jsaltzman@globe.com

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