Joe Amon/The Denver Post via Getty Images
Fentanyl Citrate, a CLASS II Controlled Substance as classified by the Drug Enforcement Agency in the secure area of a local hospital Friday, July 10, 2009.
On Thursday, the Centers for Disease Control released data showing that overdose deaths caused by synthetic opioids such as fentanyl—the drug that killed Prince—rose by nearly 75 percent in 2015. On the same day, federal prosecutors in Massachusetts announced the arrest of six former employees, including a former CEO and two former vice presidents, of the Phoenix-based and NASDAQ-traded fentanyl producer Insys Therapeutics. The individuals are charged with bribing doctors and otherwise conspiring to induce the overprescription of a fentanyl product called Subsys.
The indictment details a variety of brazenly dishonest methods by which doctors and insurance companies were allegedly convinced to issue and fund prescriptions of Subsys:
- Insys paid doctors to give educational lectures about the use of Subsys. That’s ostensibly legal, except that prosecutors allege that the company paid said doctors in direct proportion to the frequency with which they wrote Subsys prescriptions, with one Insys employee allegedly texting another that the doctors hired to give lectures "do not need to be good speakers" so long as they were high-volume Susbys prescribers. These "lectures," meanwhile were allegedly often nothing more than dinners at high-end restaurants attended only by the doctors getting paid, the Subsys employees paying them, and the doctor’s friends. One Florida doctor is alleged to have made $275,000 in speaking fee bribes in three years.
- Insys allegedly continued to work with some doctors who prescribed Subsys frequently even after becoming aware internally that those doctors were known for running dubiously legal Dr. Feelgood "pill mills." Wrote one Insys employee in an email about an Illinois doctor that the company would continue to work with and pay speaking fees to: "He is extremely moody, lazy and inattentive. He basically just shows up to sign his name on the prescription pad, if he shows up at all."
- Insys allegedly hired support staff employees to mislead insurance companies into approving payments for Subsys prescriptions. These support staff employees allegedly misled insurers into believing they were interacting with representatives of doctor’s offices rather than representatives of Insys—employees were allegedly instructed to hang up the phone when insurers "pursued the identity of their employer." These support staff employees are also accused of systematically falsifying specific diagnosis information—claiming patients had difficulty swalling, for example—that they knew would make insurers more likely to authorize Subsys purchases.
In a statement, Insys says it is "committed to complying with laws and regulations that govern our products and business practices" and "continues to cooperate with all relevant authorities in … ongoing investigations." (Several Insys employees and medical professionals affiliated with the company have also been arrested in recent years in cases that have led to at least two convictions.) An attorney for one of the arrested individuals—Alec Burlakoff—says his client is not guilty. The other individuals do not appear to have commented.
The surge in opioid deaths is one of the reasons that United States life expectancy declined in 2015 for the first time in 22 years. In that same year, Insys reported a profit of $58.5 million.