Pain at Insys Therapeutics

If you have followed healthcare news, particularly pharmaceutical related news over the last year, then you have likely read some surprising articles about Insys Therapeutics. Insys is the maker of Subsys, the fastest acting form of fentanyl (a potent synthetic opioid pain killer). It is Subsys and its marketing that stand at the center of the controversy.

A recent Forbes video discusses some the issues. Some of the issues highlighted in the video include:

- 2015 a nurse practitioner in Connecticut pleads guilty to to violating anti-kickback laws and taking $83,000 to prescribe Subsys
- 2015 the state of Oregon reaches a 1.1 Million dollar settlement with Insys of unlawful promotion of Subsys
- 2016 anti-kickback charges brought against a former Insys salesperson in Alabama. Prosecutors allege she make $700k on a base salary of $40k.
- The video also makes a point of stating that Insys's founder, John Kapoor has a net worth of over $2 billion with his Insys holdings representing approximately $650 million

Other articles mention that a former sales manager and sales rep have been arrested for violating anti-kickback laws.

One article reports that a sales rep said the national sales manager at the time wanted reps to watch the movie “The Wolf of Wallstreet", calling it “...the best sales training video in history.”

An article mentions that one rep was a former stripper, and another a former playboy model.

Another article includes a recording of a meeting of the Insys unit responsible for prior authorizations of Subsys discussing ways to overcome insurance denials for non-cancer related pain.

The controversy is discussed regularly on cafepharma's message boards here

Quotes from threads include:
   - “ Meanwhile every doc is deathly afraid to ever write the drug again = should work wonders for the long term sales trajectory.
   - “i don't recommend this company unless you want to go to jail.

Topics include recent arrests of employees, lost bonuses, upper management, etc.

The primary thrust of the articles is that Insys went over the line to get Subsys approved for patients without cancer pain and that the company and employees were paid handsomely for doing so. What can be lost in a discussion that includes a sales reps who was a former stripper, one who was a playboy model, and reps making bonuses in the $1 million range, is that there are patients who suffer chronic excruciating pain. They want and need help in dealing with this pain, even if the options are not specifically indicated for their condition.

Did Insys take advantage of this situation? You can read some of the referenced sources and form your own opinion.

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