An Insys Therapeutics sales representative who has worked closely for several years with a Kansas doctor facing federal charges for his alleged role in an opioid kickback scheme has been revealed as a whistleblower cooperating with the U.S. government.

The Kansas City Star’s report on Torgny Andersson, an Insys rep from Kansas City, Missouri, shows how the U.S. government is working with drug company insiders to fight the deadly epidemic of opioid addiction that has swept the U.S. over the past decade.

According to the report, Mr. Andersson filed a federal whistleblower complaint against his employer in October 2013, alleging Insys orchestrated a kickback scheme designed to reward physicians for the volume of prescription they wrote for the opioid drug Subsys.

Subsys is an extremely potent oral fentanyl spray approved by the U.S. Food and Drug Administration (FDA) only for the treatment of breakthrough pain in cancer patients. The narcotic pain reliever is 100 times more potent than morphine and 50 times more potent than heroin as a pain reliever.

Mr. Andersson is one of five industry insiders working with the federal government in its case against Insys for the role it played in creating the deadly and costly opioid epidemic.

Illegal Kickbacks Boosted Sales

The government’s covert investigation of Insys involved using Mr. Andersson as an inside source of information about the company’s Subsys kickback scheme and other unlawful activities.

One of the ways Mr. Andersson gathered evidence was by frequenting Dr. Steven Simon, an Overland, Kansas, doctor who was the top recipient of Subys kickbacks in Mr. Andersson’s sales territory, which included Missouri, Kansas, and Nebraska. Dr. Simon was also the eighth-highest paid recipient of Subsys nationwide, according to The Kansas City Star. In drug industry jargon, Dr. Simon would be described as a “whale.”

Mr. Andersson’s whistleblower complaint alleges that Insys executives paid Dr. Simon and other doctors for Subsys prescriptions but disguised the kickbacks as speaker fees. Insys told sales reps to base the speaker fees on how many Subsys prescriptions physicians wrote.

According to Mr. Anderrson’s whistleblower complaint,

Insys often pays these speakers between $1,200 and $2,400 for talking even if the event is as short as 15 minutes long … Sometimes speakers are paid although they never speak to any other physicians. They are paid to speak to no one although attendance forms may be falsified to give the appearance that other physicians attended the engagement.

Speaker programs are one of the most common marketing tools in the drug industry. Insys and other drug makers often recruit doctors to talk about the benefits or a particular drug to doctors, pharmacies, and other medical professionals.

1,000 Percent Sales Increase

However, when speaker fees are tied to actual prescriptions with the intent of boosting sales for a particular drug, speaker fees become more like bribes. According to The New York Times, after Insys implemented its speaker-kickback program, net revenue from Subsys soared by more than 1,000 percent.

According to The New York Times, new Insys reps being trained to push Subsys became worried about their company’s speaker program, and rightfully so. That program was responsible for growing Subsys sales exponentially. It’s also why seven former top Insys executives, including its billionaire founder, John Kapoor, are now facing federal criminal charges for racketeering.

Deadliest Drug Crisis in U.S. History

Subsys came on the market in 2012, years after the U.S. opioid epidemic began taking root. Prescription opioid sales started their steep climb in the late 1990s but aggressive and unlawful sales practices in which Insys and other opioid drug makers engaged propelled the sky-high addiction and overdose rates that have become a major public health crisis.

The epidemic of synthetic opioid addictions has become the deadliest drug crisis in U.S. history. In just one year, U.S. opioid deaths climbed from 33,091 in 2015 to 42,249 in 2016. By contrast, there were about 15,000 heroin deaths in 2016, but four out of five heroin addicts started out by abusing prescription opioids. Approximately 3 million adults in the U.S. are addicted to opioids, resulting in 91 deaths every day.

In addition to criminal charges, many pharmaceutical companies, their executives, and opioid prescribers face hundreds of civil complaints. As of May 2018, more than 600 state, county, and city governments have filed opioid-related lawsuits in an effort to recover costs incurred in fighting the epidemic, which are estimated to cost more than $55 billion annually.

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