An Arizona-based pharmaceutical company used “brazen and crass” marketing tactics to push 17 Minnesota doctors to prescribe a powerful opioid painkiller for unapproved conditions at higher than recommended doses.
A lawsuit filed Wednesday by Attorney General Lori Swanson and the Minnesota Board of Pharmacy alleges Insys Therapeutics Inc. illegally marketed a fentanyl painkiller by aggressively pressuring doctors to prescribe the drug. The company’s salespeople faced quotas and doctors were paid “sham” speaker fees to recommend the drug.
“I’ve see a lot of greedy conduct by pharmaceutical companies in this office,” Swanson said at a news conference. “This conduct in this case is as brazen as anything you could imagine a pharmaceutical company doing.”
In a statement, Insys said it takes allegations of “past wrongdoing by former employees with the greatest seriousness.” The company is “determined to take responsibility for the past and learn from it,” the statement said.
Minnesota is one of 10 states to accuse Insys of wrongdoing. Four of those state’s have settled with the company and the rest have ongoing cases.
The drug is sold under the brand name Subsys and it is administered with a spray under a patient’s tongue. Fentanyl is 100 times more powerful than other opioids and this drug was approved by the Food and Drug Administration in 2012 to treat severe pain in cancer patients.
Swanson’s lawsuit, filed in Hennepin County, alleges Insys illegally marketed the drug for other treatments and encouraged doctors to prescribe much higher doses than were approved by the FDA. About 80 percent of the Subsys prescriptions in Minnesota were above the FDA-approved dose.
Insys allegedly encouraged salespeople to “camp out” in doctor’s offices to get them to prescribe the drug, according to emails presented by Swanson. The company used “bonuses” of up to $3,000 to increase sales and paid two doctors $43,000 in speaker fees.
Those doctors became the top prescribers of the drug in Minnesota. Swanson’s lawsuit alleges the 36 speaking events they were paid for were “shams” to get around state laws prohibiting payments by drug companies to doctors.
Swanson said the conduct she’s alleging in the lawsuit against Insys disregarded patients’ wellbeing for profits.
“They are talking in such cavalier, crass ways about patients,” Swanson said. “Calling patients annuities. Saying you can ‘win big’ if you prescribe this drug … It seems like the companies are just playing games with the patients’ lives.
The U.S. is in the midst of an opioid epidemic that killed 401 Minnesotans last year. Cody Wiberg, the executive director of the state Board of Pharmacy, said investigators haven’t yet tied Subsys to any overdose deaths, but any opioid can be abused and addict a patient.
The two physicians who were paid to speak on behalf of Insys and its drug Subsys have been referred for disciplinary action, Wiberg said. The Board of Pharmacy is also considering punishing Insys.
The lawsuit announced Wednesday is different than other cases against pharmaceutical companies that have made headlines here and across the nation. Swanson said her office continues to gather evidence related to other opioid manufacturers and distributors and their alleged lies to doctors about the safety of prescribing opioids long-term to patients.
“Stay tuned for that,” Swanson said. “We are knee-deep in that investigation.”
Drug makers have denied allegations that they misled doctors or patients about the safety of opioids.