As opioid crisis raged, Insys pushed higher doses of addictive drug and pushed salespeople to ‘own’ doctors

Published: Oct 19, 2018 7:19 a.m. ET

Concerning sales tactics involving a potent opioid medication were highlighted in a new Senate committee report

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Family members of those who died of opioid overdoses take part in a rally to end the opioid epidemic in Washington, D.C., in 2016.

To sell addictive opioids, sales representatives were encouraged to “own” doctors, keeping a close eye on how and how much they prescribe.

Speaker programs that helped drive sales left out safety problems and, in one instance, didn’t say that Insys, the drug’s manufacturer, was sponsoring the event.

And high dosages of the addictive opioid Subsys were linked to bonus payments, with company presentations encouraging this behavior through slogans like “Strength Makes the Difference” and “Don’t Forget the Doses.”

“It is much easier to take an existing patient and double their units (which in essence is the same as generating a new prescription),” one sales manager wrote, referring to patients as “low hanging fruit.”

Those tactics and more were hallmarks of drugmaker Insys Therapeutics Inc.’s INSY, -2.20%  approach at the height of the opioid crisis, according to a new report from the Senate Homeland Security and Governmental Affairs Committee’s minority staff.

The Chandler, AZ-based Insys has become notorious for the role it played in advancing America’s devastating, drawn-out opioid crisis, which continues to this day.

Subsys consists of the potent opioid fentanyl, formulated in a spray that allows the drug to work faster. Approved for use in managing cancer patients’ pain, Subsys came on the U.S. market in 2012, and sales grew to roughly $329 million in 2015, at what appears to be the peak.

After a Department of Justice investigation into the company’s promotion of the medication, Insys agreed to pay at least $150 million in fines. Former executives as well as doctors also had criminal charges brought against them.

The new report “pertains to past events involving former employees that would have occurred well before 2016 and have since been dealt with by the company,” said Insys spokesperson Joe McGrath. McGrath had not reviewed the report when he spoke with MarketWatch and did not comment specifically on the facts cited in the report.

Pharmaceutical companies often bring in speakers, usually doctors, to discuss their products and drive sales. Insys viewed speaker programs as the crown jewel of its sales strategy.

The programs “are basically the ONLY thing you should be focusing on to increase your sales,” Sales executive Alex Burlakoff wrote to all sales personnel in 2013, according to the Senate committee report. “If you are not living, eating, and breathing [Insys speakers programs] to drive sales, you should not be in specialty pharma.”

In fact, speaker programs generated six times more revenue per prescriber, according to an internal company presentation cited in the report. Doctors also got more speaking opportunities when they met the prescribing expectations that Insys set for them, the report said.

However, the speaker programs had serious problems, including the omission of safety information in more than one presentation — something an outside consultant brought up with the company in 2014.

Insys later cut down on, and then stopped, the speaker programs, the Senate report — based on 1.6 million pages of internal company documents that were requested by Sen. Claire McCaskill — noted.

Insys also encouraged salespeople to push off-label prescriptions of Subsys, or prescriptions of the drug intended for non-cancer patients, the report found.

An external consultant called this strategy “troubling” in 2016, according to the report, saying that it “incentivized non-compliant behavior and was way outside the norm.”

Internal company communications also instructed employees that they must “own” doctors, including by tracking doctors’ prescribing rates and encouraging them to prescribe more, according to the new report.

Representatives should “[o]wn your territory — own a doctor — and own your destiny,” Burlakoff wrote in another email to sales representatives.

Insys’ opioid sales tactics have been the subject of many additional lawsuits, including from the state of New Jersey and health insurer Anthem. Opioid litigation, which has been brought against many drugmakers and drug distributors, could well rival the well-known lawsuits against Big Tobacco.

Insys shares rose 1% in Wednesday trade. Shares have surged 21.7% over the last three months, compared with a 0.1% rise in the S&P 500 SPX, -0.04%  and a 2.5% rise in the Dow Jones Industrial Average DJIA, +0.26%  . (Click to Source)
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Jeff Sessions Orders The Arrest of Top Big Pharma Executives

76 doctors charged for their roles in prescribing and distributing opioids

By: Daniel Newton  |@NeonNettle on 6th July 2018 @ 9.00pm

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76 doctors charged for their roles in prescribing and distributing opioids.

Attorney General Jeff Sessions has announced the largest ever health care fraud enforcement action involving the 165 Big Pharma executives and medical professionals for their alleged participation in a $2 billion fraud scheme.Of the 162 defendants charged, there are 76 doctors charged for their roles in prescribing and distributing opioids and other dangerous narcotics for profit.”This is the most fraud, the most defendants and the most doctors ever charged in a single operation — and we have evidence that our ongoing work has stopped or prevented billions of dollars’ worth of fraud,” said Attorney General Sessions.

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Here’s what you need to know:According to beckersasc:

1. The defendants are accused of taking part in schemes to submit claims to Medicare, Medicaid, TRICARE and private insurance companies for medically unnecessary treatments or ones that were never provided.

2. Of the 162 defendants charged for their roles in prescribing and distributing opioids and other narcotics, 76 were physicians.

3. Attorney General Jeff Sessions and HHS Secretary Alex M. Azar III announced the charges June 28. It was the largest healthcare fraud enforcement action in American history, which Mr. Azar referred to as “Takedown Day” in the news release.

4. Since July 2017, HHS has excluded 2,700 individuals from participation in Medicare, Medicaid and all other federal healthcare programs. The agency excluded 587 providers for opioid diversion and abuse.

5. In many cases, patient recruiters, beneficiaries and other co-conspirators allegedly received kickbacks for giving providers beneficiary information to help the providers falsely bill Medicare.

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According to justice.gov:

The charges announced today aggressively target schemes billing Medicare, Medicaid, TRICARE (a health insurance program for members and veterans of the armed forces and their families), and private insurance companies for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries.

The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department.According to the CDC, approximately 115 Americans die every day of an opioid-related overdose.US President Donald Trump recently called for the death penalty of drug dealers on Monday as part of a massive opioids policy rollout that will target the growing epidemic amongst young people.A Trump administration official said on Sunday that president’s plan to tackle the opioid epidemic head-on as part of the nationwide campaign will be announced in New Hampshire on Monday. (Click to Source)

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