Pain Hustlers - by Evan Hughes (Paperback)

About the Book

"The blistering inside story of a startup that made millions pushing opioids-until its cutthroat tactics were exposed and its executives put behind bars John Kapoor had amassed a small fortune in pharmaceuticals when he conceived of a new product. It was the 2000s, and opioids were big business. If Kapoor, an immigrant and the billionaire founder of Insys, could find a new way to administer the highly potent fentanyl, he could patent his invention and sell it to those in need-at a steep price. The only problem: There weren't enough people in need. Kapoor's drug was approved for breakthrough cancer pain. If Subsys was going to turn a profit, the company would need to persuade doctors to prescribe it "off-label," for other, lesser forms of pain. This is the story of how Insys turned a niche drug into big business. With executives leading the charge, Insys sales reps seduced doctors with charm, money, and sex. Its administrators lied to health care providers, claiming recipients had cancer when they did not. It pushed drugs onto patients that would have benefited from safer options, or no drugs at all. The strategy worked: When Insys went public, it notched the biggest IPO of its year. But several employees reached their limit and quietly blew the whistle, bringing the full force of the justice system upon the drug maker. In The Hard Sell, author and National Magazine Award-finalist Evan Hughes lays bare the pharma playbook. He shows how drug makers like Insys, fueled by greed and a hunger for market share, turn deception into profit. The book represents a stunning vindication, but also a cautionary tale. As Hughes shows, Insys didn't do anything its competitors weren't also doing. It was simply worse at covering its tracks"--

Book Synopsis

The inside story of a band of entrepreneurial upstarts who made millions selling painkillers--until their scheme unraveled, putting them at the center of a landmark criminal trial. - THE BASIS FOR THE MAJOR MOTION PICTURE PAIN HUSTLERS STARRING EMILY BLUNT AND CHRIS EVANS

"Unfolds with the velocity and verve of a Scorsese film...A tour de force."--Patrick Radden Keefe, New York Times bestselling author of Empire of Pain and Say Nothing

John Kapoor had already amassed a small fortune in pharmaceuticals when he founded Insys Therapeutics. It was the early 2000s, a boom time for painkillers, and he developed a novel formulation of fentanyl, the most potent opioid on the market.

Kapoor, a brilliant immigrant scientist with relentless business instincts, was eager to make the most of his innovation. He gathered around him an ambitious group of young lieutenants. His head of sales--an unstable and unmanageable leader, but a genius of persuasion--built a team willing to pull every lever to close a sale, going so far as to recruit an exotic dancer ready to scrape her way up. They zeroed in on the eccentric and suspect doctors receptive to their methods. Employees at headquarters did their part by deceiving insurance companies. The drug was a niche product, approved only for cancer patients in dire condition, but the company's leadership pushed it more widely, and together they turned Insys into a Wall Street sensation.

But several insiders reached their breaking point and blew the whistle. They sparked a sprawling investigation that would lead to a dramatic courtroom battle, breaking new ground in the government's fight to hold the drug industry accountable in the spread of addictive opioids.

In Pain Hustlers, National Magazine Award-finalist Evan Hughes lays bare the pharma playbook. He draws on unprecedented access to insiders of the Insys saga, from top executives to foot soldiers, from the patients and staff of far-flung clinics to the Boston investigators who treated the case as a drug-trafficking conspiracy, flipping cooperators and closing in on the key players.

With colorful characters and true suspense, Pain Hustlers offers a bracing look not just at Insys, but at how opioids are sold at the point they first enter the national bloodstream--in the doctor's office.

Review Quotes

"A fast-paced and maddening account.... Until I read [Pain Hustlers], about the outrageous behavior of an obscure drug company, I hadn't appreciated the full extent of the filth or the dark stain the opioid sector has left on the entire industry.... What's most surprising and powerful about [Pain Hustlers] is not one company's criminality--we've grown inured to corporations behaving badly--as much as how institutionalized these practices were across the modern drug industry."
--New York Times Book Review

"A feat of rigorous sleuthing and deft storytelling that unfolds with the velocity and verve of a Scorsese film. Everything about the Insys saga feels amplified to its utmost extreme--greed, ambition, criminality, hustle, intrigue, betrayals--and this is that rare story of the opioid crisis in which the bad guys face a genuine reckoning. I couldn't turn the pages fast enough. A tour de force."
--Patrick Radden Keefe, New York Times bestselling author of Empire of Pain and Say Nothing

"A richly reported, mesmerizing tale, and a devastating indictment of our broken pharmaceutical industry. Everyone should read this book."
--Sheelah Kolhatkar, staff writer at The New Yorker and New York Times bestselling author of Black Edge

"Filled with odd and scintillating details, [Pain Hustlers] plots the winding way one drug company and its associated doctors helped to beget the latest wave in our ongoing opioid crisis."
--Errol Morris, Academy Award-winning filmmaker

"When you're running a pharma startup, how does the obvious wrong thing to do become the thing you do anyway? [Pain Hustlers], fascinating in the fashion of a slow-moving train wreck, is a study of corruption in which we see how the actions of key executives make a kind of awful sense given the ecosystem in which they operate."
--Ted Conover, National Book Critics Circle Award-winning author of Newjack and The Routes of Man

"Vivid...A tightly focused and insightful account...As a gripping tale of one drug firm's unscrupulous efforts to profit from pain, [Pain Hustlers] is hard to beat."
--The Boston Globe

"Excellent...Hughes has somehow produced what feels like a seamless, fly-on-the-wall account that can be devoured in one sitting."
--The Globe and Mail

"A revelatory deep dive into the ignominious history of the pharmaceutical manufacturer Insys Therapeutics...Hughes does an excellent job of illuminating the inner workings of Big Pharma's malicious practices...A powerful indictment of abhorrent industry practices."
--Publishers Weekly (starred review)

"As compelling as a true crime documentary...Hughes perfectly captures the human impact of pharmaceutical sales and corporate greed...Anyone who picks up this title will be left reflecting on how the U.S. medical system and drug companies have recklessly destroyed countless lives. A book readers will not soon forget."
--Library Journal (starred review)

"A journalist pulls back the curtain on the scandals that sent the first pharmaceutical executives to prison for their role in the opioid crisis...A brisk and engaging account."
--Kirkus Reviews

"Unfolds like a blockbuster film. Fans of Bad Blood by John Carreyrou will be captivated by this story of unbelievable greed and hubris. A must-read."
--Booklist (starred review)

About the Author

EVAN HUGHES was a finalist for the National Magazine Award in Reporting in 2015. He has written for The New York Times Magazine, GQ, New York, Wired, and The New York Review of Books. He is the author of Literary Brooklyn.