If you want to see the real underbelly of pharmaceutical sales and promotion, here it is. Insys Therapeutics makes a sublingual spray formulation of fentanyl called Subsys, and has been doing very well with it. But that seems to be, to a good extent, the product of, well, let’s just call them extremely aggressive sales tactics. There are repeated accusations of off-label promotions and of widespread kickbacks to physicians, and various investigations are underway.
But here’s a look at what makes Insys run:
Let’s start with sales. There’s no way around it: Insys’s sales force is very different from its competitors in the pharmaceutical industry. One reason is that a pharmaceutical sales background or even college science coursework isn’t required. Another is that if you appear to be driven and aggressive, the company will look past things that your local Starbucks might not. Scrolling through the LinkedIn profiles of Insys sales reps lends some credence to one of the assertions from an amended class action lawsuit filed against the company in October and which settled within the past week without disclosing terms: per three confidential witnesses, “most of Insys’s sales representatives were extremely attractive women.” (To be fair, Merck and other leading pharmaceutical companies have long drawn attention for constructing sales forces with a large percentage of attractive women.)
Take the sales head of the New York region, Jeff Pearlman. Before becoming what his peers say is a highly productive salesmen of Class II opioids, he appears to have installed aquariums. Prior to that, he ran a ticket sales agency called Sitting Pretty Seating Services which, in 2004, attracted the ire of the New Jersey Division of Consumer Affairs. Shortly after, records indicate that the company’s registration was revoked for not filing an annual report for two consecutive years. . .
. . .Before she joined the company in August 2012, (recently departed Western sales head Sunrise Lee) ran an adult-entertainment business of a sort called Sensuous Entertainment. Prior to that, she was a dancer at Rachel’s, a West Palm Beach strip club . . .It’s not clear what she did before adult entertainment.
I hope that this sort of thing stands out. The opioid market is a weird one, because there’s a lot of legitimate unmet need for pain medication, and the only things that work as well as opioid ligands are. . .other opioid ligands. And that means that there’s a lot of less legitimate prescribing going on, what with the risk of addiction and the street value of unused prescriptions. (People have tried for decades to come up with really effective pain medications that are non-addicting, with brutal lack of success). The whole area is a regulatory tangle because of this (which makes the financial results that Insys has achieved look even more strange).
So it’s a strange part of the business. But what this article details only differs in degree, not in kind, from the excesses of sales forces in other parts of the industry. And every time news like this breaks out, the reputation of, and the prospects for, the drug industry as a whole decrease.