Here are two truisms from the world of pharmaceuticals: the easier it is to use a drug, the easier it is to sell it. But the easier a dangerous drug is to use, the easier it is to abuse; the more consumers become addicted to it and die from overdosing it.
Take, for example, OxyContin, a pain-killer based on the familiar opioidoxycodone. What Oxycontin delivered was a time-release formula which meant longer periods of relief and fewer times to have to take your medicine. But the key fact was, Oxycontin offered a far bigger dose of oxycodone than its competitors like Percocet and Percodan. Bigger hits on easier to fulfill schedules likely account for OxyContin’s comparatively high rates of addiction.
The addiction is to opioids, and former OxyContin addicts are known to switch to heroin or to fentanyl, the king killer of opioids currently on the market.
Marry potent fentanyl to spray-on convenience and you have Subsys, fentanyl delivered under the tongue, a plausible last resort for patients with high levels of pain or low levels of awareness or problems with swallowing.
But the stuff is dangerous. Not so much that it can addict you. It can, but as a last resort drug long-term effects are not the concern. The concern is that easy-to-administer Subsys, with its direct absorption and quick effect, can kill you. In just its first few years on the market, Subsys was tied to at least 63 deaths. Over its six years of use, Sybsys is estimated to have killed “hundreds” of people.
That’s why, when the FDA told Insys, the makers of Subsys, they could sell it, they limited sales only to cancer patients who were already taking round-the-clock opioid painkillers.
But there’s not much money is such a limited market, so federal prosecutors showed a jury how Insys grew its market, by selling the convenient under-the-tongue spray of fentanyl to be used by people with lower back pain or headaches. Annual sales went from $15 to $222 million in just two years.
People died. Dozens in those first two years Subsys was on the market, perhaps hundreds over all. And fortunes were made and lost on Wall Street, buying and selling Insys. Now the company’s founder John Kapoor and four of his top executives have been convicted of criminal racketeering for pushing Subsys on people not eligible to take it, bribing doctors to praise or prescribe the drug and lying to insurance companies to convince them to pay the hefty bill.
Insys declared bankruptcy just weeks ago, after working out a settlement with prosecutors that will direct $195 million to paying claims by abused customers or their survivors.
Among the people most responsible for uncovering Insys’ corporate crimes and encouraging prosecutors to indict them as criminals is our guest today, investigative report Roddy Boyd, founder of the Southern Investigative Reporting Foundation.
Roddy Boyd launched The Southern Investigative Reporting Foundation in 2012 with the goal of providing in-depth financial investigative reporting for the common good. According to The Huffington Post, Boyd one of the most feared financial reporters in America. His book about the near collapse of AIG, Fatal Risk, was long listed for 2011’s Financial Times and Goldman Sachs Business Book of the Year. A former staffer at Fortune, the New York Post, The New York Sun and Institutional Investor News, Boyd edits The Financial Investigator blog. In addition to teaching investigative reporting at the University of North Carolina (Chapel Hill), he regularly leads seminars at Investigative Reporters and Editors conferences on Financial Statement Analysis and Fraud Detection.