Beshear Alleges Arizona-based Pharmaceutical Company’s ‘Unrelenting’ Pursuit of Profits Exacerbated Opioid Epidemic in Kentucky

With ninth opioid lawsuit, Kentucky leads the country in addressing addiction crisis

FRANKFORT, Ky. (Nov. 19, 2018) – Attorney General Andy Beshear today filed his ninth lawsuit addressing the opioid epidemic.

The lawsuit, against Arizona-based pharmaceutical company Insys Therapeutics, alleges the company exacerbated Kentucky’s opioid epidemic by placing profits over the health of Kentuckians.

The lawsuit, filed in Hardin Circuit Court, claims the company exploited the market by fraudulently persuading physicians to prescribe its drug Subsys, a fentanyl-based opioid mouth spray, to treat chronic pain despite the drug being FDA-approved solely for breakthrough pain in cancer patients. 

Despite the limited FDA approval for Subsys, Beshear alleges Insys promoted and marketed its drug for off-label, non-cancer use, and promoted it to non-oncologist doctors in Kentucky. The actions by Insys, Beshear said, helped cause and fuel Kentucky’s opioid epidemic, which is one of the deadliest in the nation. 

Beshear alleges the company accomplished its scheme by fraudulently acquiring insurance coverage approvals, giving kickbacks to doctors, and incentivizing its salesforce to engage in unlawful and deceitful conduct. The lawsuit cites numerous company emails and promotional materials that describe the company’s alleged illegal behavior.

In one email, a company executive tells his salesforce, “The bigger the script, the more money you make.” Another company executive writes in an email, “What drives us all? Compensation.”

“Instead of assisting those suffering from cancer-related pain, it’s clear that Insys chose to place profits over the health of Kentuckians, no matter the cost,” Beshear said. “While the company’s owner and several executives are facing federal criminal charges, my goal is to hold Insys financially accountable for the harm to Kentucky and our people.”

Between 2016 and 2017, federal prosecutors indicted and arrested Insys founder John Kapoor and several Insys executives alleging they conspired to bribe prescribers, many of whom operated pain clinics, to prescribe Subsys off-label. Federal prosecutors filed a second superseding indictment against them in September 2018, narrowing the charges, but maintaining the earlier bribery allegations.

The lawsuit details how the company created an Insys Reimbursement Center that employed a number of fraudulent and misleading tactics to secure reimbursements, including falsifying medical histories of patients, falsely claiming that patients had cancer, and providing misleading information to insurers regarding patients’ diagnoses and medical conditions. 

According to the complaint, Insys executives stressed the importance of “owning” doctors, which meant that sales representatives monitored and controlled doctors’ prescribing behaviors. The lawsuit details how Insys expected a “return on investment” from doctors who participated in its speakers program, meaning the company expected the participating doctors’ prescribing to increase.  

In fact, Insys’ illegal and deceptive marketing practices were described in detail in a 2018 United States Senate Report entitled “Fueling an Epidemic: Inside the Insys Strategy for Boosting Fentanyl Sales.”

Beshear’s lawsuit seeks damages against Insys for violating state law and directly contributing to state opioid related deaths and overdoses.

Beshear said in Kentucky and the U.S., overdose deaths related to fentanyl now surpass deaths related to heroin. Fentanyl is 50-100 times more potent than morphine and 50 times more potent than many forms of heroin.

Today’s lawsuit is the ninth opioid related lawsuit Beshear has filed. Kentucky now leads the nation in the number of individual opioid lawsuits filed by an attorney general. 

Beshear has sued three national opioid distributors, Pennsylvania-based AmerisourceBergen, Ohio-based Cardinal Health and San Francisco-based McKesson Corporation, which together are responsible for supplying 85 percent of opioids in Kentucky; distributor and retail pharmacy Walgreens; and pharmaceutical manufacturers Johnson and Johnson, Mallinckrodt, Endo Pharmaceuticals and Teva.

Beshear’s office has won fights to keep four of his current opioid lawsuits in Kentucky courts. Three of the four additional suits are also pending in state court.

Kentuckians can track the progress of each case by visiting ag.ky.gov.

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