While the movie’s sequence of events seems strange, thePain Husters’true story is just as bizarre and hard to believe. Directed by David Yates (State of Play),Pain Hustlersis a fictional retelling of the 2016 Insys Scandal, when racketeering charges were brought against the company and several employees. Emily Blunt stars as Liza Drake, a single mother hired to find doctors to bribe them to prescribe a specific pain medication to their patients, which helped the company make incredible profits.
Blunt is Liza, a single mother working as an exotic dancer to make ends meet when Peter Brenner (Chris Evans) offers her a lucrative job with the pharmaceutical company Zanna. On top of Blunt and Evans,Pain Hustlershas an all-star cast, including Catherine O’Hara, Andy Garcia, Jay Duplass, and Brian d’Arcy James. However, while the story inthe film was close to the real-life incidents from The Insys Scandal, several differences made the two stand apart.
What Really Happened In The Insys Scandal
The Drug Company Paid Doctors To Mis-Prescribe The Medication
In thePain Hustlers’true story, John Kapoor was the man who oversaw the criminal conspiracy to bribe doctors to sell highly addictive and deadly opioids to patients who didn’t need them.Dr. Jack Neel (Andy Garcia) is based on Insys' John Kapoor in the movie. During the time that thousands of Americans died of opioid overdoses, Kapoor became one of the wealthiest people in America, named byForbesmagazine as among America’s 400 richest people (viaAARP).
Burlakoff said any doctor could prescribe it for “off-label” purposes for any treatment.
In the true story, Kapoor hired Alec Burlakoff in 2012. According to the court testimony, Kapoor said that Insys had a problem because its new drug, Subsys, was a fast-acting painkiller only approved by the FDS for specific purposes - helping cancer patients who had already tried other pain relievers and saw no relief. He wanted doctors to prescribe it to more people. He felt the drug should be more profitable. Burlakoff said any doctor could prescribe it for “off-label” purposes for any treatment.
“We knew that if we got a patient on the drug, over time, they would become a greater revenue stream. The longer the patient stayed on the drug, the higher the dose that they were going to use, and the more revenue it was going to be worth to us.” - Michale Babich
A program already existed where pharmaceutical professionals paid doctors to teach their peers about a drug’s benefits. Instead of doing that, Insys instead paid doctors to prescribe Subsys for any ailments. The company hired reps to visit doctors and offer them money to prescribe the medications, and the ball was rolling. Soon, people were dying in masses via addictions to dangerous drugs.
In the salespeople program at Insys, some were paid over $400,000 a year in bonuses when they targeted doctors and got the medicine prescribed to patients at higher rates. The doctors most likely to compromise ethics for money were deemed “whales” and would often write up to $30,000 worth of prescriptions a month per patient. When Insys paid a doctor $100,000, they expected a $200,000 profit from that doctor.
Insys sales representative Maria Guzman filed a whistleblower suit.
In August 2013, Insys sales representative Maria Guzman filed a whistleblower suit, bringing the misdeeds public. Despite this, the company continued their actions, and in 2015, Kapoor was worth $3.3 billion. In 2016, six Insys executives were indicted on federal RICO conspiracy charges, and in 2017, Kapoor resigned. By 2019, Kapoor and his codefendants were found guilty, and Insys filed for bankruptcy. By 2020, the guilty players were sentenced to prison.
Everything Known About The Drug Subsys
The Drug Was Misrepresented By Insys
Subsys is a strong prescription pain medication meant for cancer patients who are already taking other opioid pain medications around the clock for pain. It is only FDA-approved for patients whose bodies have become “tolerant” of their other medications and need more help (viaNIH.GOV). Subsys was a sublingual fentanyl spray, a powerful but highly addictive opioid painkiller (HHS-OIG).
Is Lonafen A Real Drug In Netflix’s Pain Hustlers?
Chris Evans and Emily Blunt’s Netflix movie, Pain Hustlers, was inspired by a real-life opioid scandal and centers around the drug Lonafen.
The warnings indicate that it should only be used alongside other non-fentanyl narcotic pain medicines that are used around the clock. It should also not be used for any purpose other than cancer-related pain (viaDrugs.com). It remains highly addictive, and side effects can slow and stop breathing when not taken in proper dosages. According to AARP,over 8,100 people have died while taking Subsys.
How Was The Movie Different From The Book?
The Characters In The Movie Were All Fictional Or Composites
ThePain Hustlersmovie was based on the Evan Hughes non-fiction novel,The Hard Sell: Crime and Punishment at an Opioid Startup, itself based on an article calledPain Hustlers. This was one of several books about the opioid crisis in the United States, which also includes Patrick Radden Keefe’sEmpire of Pain(about the Sackler family),Dopesickby Beth Macy (which got its own Hulu miniseries), and two books by Sam Quinones -DreamlandandThe Least of Us- which were about the people affected by the opioid crisis.
None of the characters in the movie have the same names as those involved in the case.
There were several major differences between the movie and thePain Hustlers’true story. The film is based on the book, which tells the true story but takes creative liberties with the story and the characters involved. None of the characters in the movie have the same names as those involved in the case. In several instances, characters from the film are based on more than one person involved in the scandal.The lead character, Liza Drake, is a composite characterbased on different people.
“This isn’t the Insys story in detail at all. It’s inspired by that—the fringes of that industry and how they exploit one very marginal sector of the healthcare industry and make a fortune out of it.” - David Yates (EW).
The original article contained a line claiming a “former exotic dancer” worked for Insys. That line is likely whythe movie created the character of Lizaas a single mother and an exotic dancer who took the job to help with her medical bills, thanks to her epileptic daughter. Speaking of the daughter Phoebe, she was a completely fictional addition to the film’s story. As for Liza’s actions, Maria Guzman (the real-life whistleblower) and Sunrise Lee are the main people who inspired the character.
Pain Hustlers True Story: 10 Biggest Changes From The Real Pharma Scandal
David Yates’ new film, Pain Hustlers, is inspired by the real-life Insys opioid scandal, but what aspects of the story did the new movie change?
The movie also changed the location of the scandal, moving it strictly to Florida. In real life, the scam took place nationwide, all over the United States. It was much larger and more widespread than the movie made it appear. The film not only changed the characters involved but also renamed the company to Zanna, likely to protect the filmmakers from any unforeseen consequences of using the real company’s name. Thedrug was also renamed to Lonafin.
Where Are All The Real-Life People Today?
The Prison Sentences Have Completed
In 2020, afederal judge sentenced John Kapoor to five and a half years in prisonfor his role in the Insys Scandal (viaAARP). “This was an offense of greed,” U.S. District Court Judge Allison D. Burroughs said before the sentencing. Another Insys executive, former vice president of sales Alec Burlakoff, received 26 months in prison. Burlakoff became a government witness and testified against the company. The judge also sentenced several other players in the scandal to prison sentences.
Maria Guzman was the real-life whistleblower in the Insys case.
However,Kapoor only served two years of his sentence. He was released in 2023 and ordered to repay $6 million in legal fees (viaReuters). Insys paid for his criminal defense attorneys as required by its by-laws. A bankruptcy judge ruled he had to pay it back because he was not entitled to the defense for any “knowingly fraudulent or deliberately dishonest” misconduct. Alec Burlakoff received a 26-month sentence and has joined theWhite Collar Adviceteam to help other people facing white crime charges.
Maria Guzman, the whistleblower, was named the 2019 Whistleblower of the Year by Taxpayers Against Fraud (viaPhillips & Cohen). According to her LinkedIn page, she has been working for a different pharmaceutical company since 2011, as she is the Senior Sales Representative for Pfizer. It appears that everyone involved in thePain Hustlers’scandal is either out of prison or already moving on with their lives.
Pain Hustlers
Cast
Pain Hustlers is a crime drama film that follows the story of Liza, a high school dropout who lands a job at a corrupt pharmaceutical company. As she rises through the ranks, she finds herself caught up in a dangerous game of corruption and deceit.
