Pharmaceutical Corporation Faked Its Number of Cancer Patients to Sell Drugs

What was this fraud for? It was for selling more powerful opioids, for more corporate profits, even during the ongoing opioid crisis.

When Insys Therapeutics got approval to sell an ultra-powerful opioid for cancer patients with acute pain in 2012, it soon discovered a problem: finding enough cancer patients to use the drug.

When Insys Therapeutics got approval to sell an ultra-powerful opioid for cancer patients with acute pain in 2012, it soon discovered a problem: finding enough cancer patients to use the drug.

To boost sales, the company allegedly took patients who didn’t have cancer and made it look like they did.

The drug maker used a combination of tactics, such as falsifying medical records, misleading insurance companies and providing kickbacks to doctors in league with the company, according to a federal indictment and ongoing congressional investigation by Sen. Claire McCaskill, a Democrat from Missouri.

The new report by McCaskill’s office released Wednesday includes allegations about just how far the company went to push prescriptions of its sprayable form of fentanyl, Subsys.

Because of the high cost associated with Subsys, most insurers wouldn’t pay for it unless it was approved in advance. That process, likely familiar to anyone who’s taken an expensive medication, is called “prior-authorization.”

So Insys set up an elaborate charade — with employees that pretended to be doctors’ offices — to fool insurance companies into approving the drug, according to the Senate report.

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Insys is currently in the midst of an avalanche of criminal and civil legal trouble.
In December, federal prosecutors in Boston criminally charged six former Insys executives, including its former CEO, with fraud and racketeering charges related to Subsys. Prosecutors described a “nationwide conspiracy to bribe medical practitioners to unnecessarily prescribe a fentanyl-based pain medication and defraud health care insurers.”

“As alleged, top executives of Insys Therapeutics, Inc. paid kickbacks and committed fraud to sell a highly potent and addictive opioid that can lead to abuse and life threatening respiratory depression,” said Harold H. Shaw, special agent in charge of the Federal Bureau of Investigation’s Boston field office, in a statement in December.

Other federal charges have also subsequently been brought against individuals connected to Subsys, and several state attorneys general have filed lawsuits of their own.

The six executives in the original December case have pled not guilty, and their cases are currently pending. But other former employees have since made guilty pleas.

In May, Motahari, then just weeks into his new job, told analysts on a corporate earnings call that the company hoped to resolve the federal investigation against it with a settlement.

“We continue to engage in discussions with the DOJ and remain highly committed to resolving this matter,” Motahari told the analysts.