serostim bust-ny dailey news

Pumped by AIDS drug

Illegal injections give gym rats their incredible bulk

By THOMAS ZAMBITO
DAILY NEWS STAFF WRITER

"Every topnotch bodybuilder in the world uses" Serostim, said Dave Palumbo, editor in chief of RxMuscle magazine.

Bodybuilder Shawn says Serostim, meant to fight AIDS wasting, helped him pack on 20 pounds of muscle for a competition.

Bodybuilder Shawn, in pose

Psssst! Wanna buy an AIDS drug?
Bodybuilders across the city are saying yes to that offer and injecting millions of dollars' worth of an AIDS drug that helps them build rippling, competition-ready muscles.

In the past year, state investigators have uncovered a number of schemes to cash in on the underground demand for Serostim, a bioengineered human growth hormone that costs $6,300 for a month's supply and was approved to counteract the loss of weight and body mass that AIDS patients can experience.

One recent scam directed by an official at Montefiore Medical Center in the Bronx swindled Medicaid out of at least $1.7 million to funnel the drug to the sweat-and-barbell set.

Serostim has become one of the hottest sellers on New York's multimillion-dollar black market in prescription drugs.

"Drug diversion schemes are a nationwide problem that not only robs the city, the state and federal government of millions of dollars each year but places the public in jeopardy," said state Attorney General Eliot Spitzer.

His office estimates that fraudulent sales of Serostim and other prescription pharmaceuticals amounted to 10% of the state's $3 billion Medicaid drug tab last year.

"If you were to make a list of the top 10 diverted drugs, Serostim would be at the top and it would make up 40 to 50% of the cost of all diverted drugs," said Ken Karp, an investigator with Spitzer's Medicaid fraud control unit.

Despite efforts by Serostim's maker and law enforcement officials to ensure the drug gets into the right hands, it remains plentiful in the city's gyms.

"Every topnotch bodybuilder in the world uses it," said Dave Palumbo, a champion bodybuilder from Long Island and the editor in chief of the muscle magazine RxMuscle.

AIDS patients are often the suppliers, according to some of the city's leading AIDS doctors. One Manhattan doctor told the Daily News he recently caught a patient trying to sell the drug to bodybuilders. Since then, he has required the patient to come to his Manhattan office for his daily injection.

"He was selling it to pay his rent," said the doctor, who did not want his name used.

Via AIDS grapevine

Word of Serostim's swift muscle-massing powers swept through city gyms almost from the day the Food and Drug Administration approved it in 1996 for use in treating the condition known as AIDS wasting.

Bodybuilders, who often work as weight trainers, may have first heard about it from clients with AIDS.

The drug - which works by mimicking natural human growth hormone, the complex biochemical compound the body uses to build muscle, bone and organ tissue - can add pounds of muscle in a few months.

Bodybuilders love it because they say it has few of the unpleasant side effects - nausea, or skeletal distortions such as protruding foreheads - that come from steroids or other growth hormones.

During a break from training a client at a downtown Manhattan gym, Shawn, a 30-year-old bodybuilder, said he paid a pittance - $450 - for a six-week supply of Serostim. He used it in the months leading up to a competition a few years ago and said he put on 20 pounds of muscle.

"I've tried a lot but this works the best," said Shawn, a former high school football player who agreed to discuss his use of Serostim as long as his last name was not used.

"It gets you there a little faster," he said. "It's clean. It doesn't alter your skeletal structure. If I could afford it, I'd use it year-round."

Because Serostim is not classified as a controlled substance, possessing the drug is legal. But it is illegal to sell the drug for anything other than its approved use.

Serostim is one of the most expensive AIDS drugs on the market. But in the locker rooms of city gyms, it goes for about $3,200 for a month's supply - considerably less than its retail value. That usually means four boxes, each containing seven 6-milligram doses in powder form that are mixed with a solution before being injected.

"It's so overprescribed that AIDS patients take one box and sell three boxes," said Palumbo, 35, who placed second in the superheavyweight division at last year's Dallas bodybuilding championships.

Because of the drug's popularity, the maker of Serostim, Swiss-based Serono Laboratories, has been dogged by questions about distribution.

Investigators with the U.S. attorney's office in Boston wanted to know whether the company promoted Serostim for AIDS patients who had been losing weight but may not have been experiencing AIDS wasting, according to a doctor who was questioned.

The disorder causes the body to consume muscle and organ tissue, instead of stored fat, for energy. Those suffering from AIDS wasting have lost 10% or more of their body weight, mostly from the loss of lean body mass.

The state Health Department, responding to complaints that New York doctors were incorrectly prescribing the drug, began requiring physicians last year to get state approval before prescribing it.

"This was a new, sophisticated drug," said state Health Department spokeswoman Kristine Smith. "It was not always being prescribed appropriately. Some patients were not having a wasting syndrome."

Stepped-up security

New York's Medicaid tab for Serostim dipped to $20 million last year from $50 million in 2001. Karp, who is also president of the New York chapter of the National Association of Drug Diversion Investigators, said the effort has limited the amount of Serostim on the street.

To counter fraud, Serono revamped its distribution network to track the drug from warehouse to patient. The result was a drop in sales to $95 million last year from $124 million in 2001. The company attributed the loss to its increased security.

But despite efforts to control sales, illegal shipments of Serostim continue. Spitzer said his investigators are continually adapting to counteract new schemes to funnel legitimate drugs onto the black market.

"Health care professionals and others who sell this drug on the black market are on notice," Spitzer said. "My office will continue to investigate and prosecute those who engage in this dangerous and unlawful enterprise."

$1.7M Medicaid scheme

When a box of Serostim turns up in the gym bag of a New York City bodybuilder, there's a good chance that Enrique Rojas had a hand in putting it there.

Almost single-handedly, Rojas has been responsible for dumping at least $1.7 million of the popular human growth hormone onto the city's underground drug market.

Rojas, 43, was an HIV education coordinator for clinics run by Montefiore Medical Center a few years back when he came up with a scheme to use the drug to bilk Medicaid.

According to investigators from the state attorney general's Medicaid Fraud Control Unit, the scam worked like this: Rojas took the names and identification numbers of legitimate Medicaid patients, as well as those of hospital physicians, to generate fake prescriptions for Serostim.

He then would pay Medicaid recipients and friends $50 to $100 to agree to have the drugs shipped to their home and business addresses. When the packages arrived, he would gather up the drugs and sell them on the black market to bodybuilders and others.

State Health Department auditors became suspicious after Medicaid billings for a Pittsburgh pharmacy used by Rojas jumped to $4.5 million in 2000 from less than $1 million in 1999.

During one nine-month period, from January to September 2000, a network of pharmacies linked to Rojas improperly received more than $1.7 million in Medicaid funds.

Rojas pleaded guilty to his role in the scheme in July and was sentenced in March to 1 2/3 years to five years in state prison and ordered to pay back what he stole.

A spokesman for the hospital said Rojas left for another job in September 2000, before the scheme was uncovered.

Only a few packages of Serostim were recovered.

Originally published on June 2, 2003