Former pharmaceutical sales exec says lack of conscience is key to success in selling opioids

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60 Minutes investigates the playbook of sales practices that triggered an explosion of prescriptions, Sunday.

(CBS) — Early this year in Boston, for the first time, top drug company executives were sentenced to prison for crimes related to the opioid crisis. It was a major victory for law enforcement, which has scrambled to hold pharmaceutical executives accountable for the deadly opioid epidemic. In a two-part report to be broadcast on 60 Minutes, Sunday, June 21 at 7 p.m. ET/PT, Bill Whitaker delves into the years-long investigations that uncovered greed and depravity and led to the convictions.
 
The story, the latest in a prize-winning 60 Minutes series investigating wrongdoers responsible for the opioid epidemic, shines a light on the brazen sales tactics of two multibillion-dollar companies and their executives. It follows the often-frustrated efforts of investigators and prosecutors to catch and convict them. “Sometimes white-collar criminals are more dangerous than violent criminals and more often than not, they get a kid-glove treatment,” said Assistant U.S. Attorney Fred Wyshak, referring to those executives whose drug sales fed an epidemic that kills tens of thousands of Americans each year.
 
Wyshak, who prosecuted Boston’s notorious crime boss, Whitey Bulger, helped prepare the racketeering case against former executives from Insys Therapeutics. And in January, a jury voted to convict five Insys executives; the judge sentenced them to prison terms of up to five and a half years—the sentence given Insys CEO John Kapoor. The 60 Minutes report exposes the sales and marketing playbook at two companies, Insys and Cephalon, that sold highly potent formulations of the fast-acting drug fentanyl. The drug was FDA-approved only for cancer pain. But internal Cephalon documents 60 Minutes persuaded an Oklahoma court to unseal expose the tactics it used to illegally promote its drug for off-label use, spawning huge profits.
 
Whitaker interviewed the prosecutors who brought the Insys case and two key insiders: Alec Burlakoff, a top Cephalon salesman who later became Insys’ VP of sales, and Greg Tremaglio, the former FDA senior special agent who investigated Cephalon as early as 2003. Agent Tremaglio reveals how, back in 2003, he recorded conversations of opioid sales reps at a conference with the help of an informant. “I was disgusted. It was just so open, the conversations, about disregarding the label and breaking the law,” he says. Cephalon was eventually penalized with fines that were dwarfed by the company’s huge revenues—a slap on the wrist, Tremaglio concluded. Settlements like this leave drug company executives smiling, says Tremaglio, “because [they] just made a billion dollars worth of profit.”
 
Burlakoff describes his key to success selling opioids: “The less of a conscience you have the better.” He and other Cephalon executives went to work for Insys in 2012, where former Insys CEO John Kapoor asked him to start a speakers’ bureau, which was used to bribe doctors to boost prescriptions.
 
Burlakoff, Kapoor, and six other executives were eventually indicted. Two pleaded guilty, including Burlakoff, who testified against his Insys associates. He was sentenced to 24 months in prison for his cooperation. He is sorry for his actions, he tells Whitaker, as he describes how he got his start and turned to corporate crime. “I was taught to forget the patient… Take the human aspect out of it. It’s like selling widgets,” says Burlakoff. “They push you right to the line, and if you go to that line every single day, what happens? Eventually, you start to cross the line. And they want you to cross that line.”

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