“I’ll Take ‘Unscrupulous’ for $30,000, Alex.”


With Subsys, an expensive and powerful morphine, Big Pharma hit the Jeopardy Daily Double!


This highly addictive painkiller is 100 times stronger than morphine and is approved by the FDA for cancer patients with breakthrough pain. Nevertheless, the manufacturer has been successful in a broader marketing push that has generated a billion dollars over the last five years.


Writing in NBCNews.com, Corky Siemaszko highlights the allegations from a former drug rep who claimed “she was part of a scheme to get the drug Subsys to patients who never should have had it.” Some of the quotes from the article are chilling:

  • “It was wrong, but it was genius.”
  • “Trick the insurers into believing it was medically necessary.”
  • “Mention oncology records that didn’t exist.”
  • “Provide specific diagnosis codes, whether or not the patients had those conditions.”
  • “A 30-day supply costs anywhere from $3,000 to $30,000.”


Subsys is a potentially dangerous substance. Laced with fentanyl and delivered in a spray, it is different than many other painkillers.


Don’t let Big Pharma determine what’s medically necessary.


Doing better requires aggressive pharmaceutical UR and peer-to-peer intervention. Don’t get stumped on the final Jeopardy question.


Call us. We can do better.


William Faris, JD
Chief Executive Officer

Posted in Medical Cost Containment, OMCA, Workers’ Compensation