Fallacia alia aliam trudit

Fallacia alia aliam trudit
(One deceit drives out another)
(Un inganno tira l'altro)

Pharmaceutical Drug Addiction

"Posing as patients, undercover cops had discovered fraud at Awerbuch’s clinic. He had billed Medicare for hastily performed “needle measurements” using an “electronic probing device” that “did not generate any kind of printout or reading,” they alleged. More obviously harmful was his willingness to prescribe fentanyl even to patients who hadn’t reported cancer pain, a flagrantly illegal off-label use. He had ultimately bilked Medicare out of $7 million, the indictment alleged, for off-label prescriptions of Subsys.
For Insys, Awerbuch's didn't merit so much as a press release. For several short-sellers — I spoke to five who bet against Insys stock starting in 2014 — it signaled that the story was worth following.
One year later, in April 2015, two Alabama doctors were indicted for a similar crime. John Couch and Xiulu Ruan, who ran a pair of pain clinics in Mobile, were alleged to have distributed opioids “not for a legitimate medical purpose.”
The purpose appeared to be money. Between them the doctors owned an Aston Martin DB9, an Audi Spyder, a Bentley GT, a Ferrari F430, a Ferrari 599, a Lamborghini Diablo, a Shelby Series 1, a Spyker C9 Laviolette, a Maserati, a Porsche, a Land Rover, and a Cadillac, according to the indictment. Most troublingly, Couch and Ruan had received some $225,000 in direct payments from Insys in 2014 alone — putatively for consulting work, meals, and travel to conferences. That year, 28,647 Americans died of opioid overdoses, an increase of more than 250 percent over 1999.
On Wall Street, however, the question that mattered was whether the arrest of Couch and Ruan would hurt the share price. Analysts, who’d hitched their wagons to Insys with the buy recommendations and could not reverse course now, churned out notes to defend the company, putting a floor beneath the stock.
At Oppenheimer, Vanjani assured clients that he had spoken to “three physician consultants” and “conducted a 22-physician survey,” and not a single respondent reported having “received off-label messaging.” Further, Vanjani noted, these doctors had emphasized to him that “Subsys use was driven by patient needs.” Jefferies analyst David Steinberg reassured his clients: “Insys has been emphatic that its representatives are instructed not to stray from on-label promotions.” In plain English, there was nothing to worry about as long as no one connected the policies of Insys management to the actions of any abusive rogue employees.
In a circuitous way, the man who made the connection was President Barack Obama. Negotiating the Affordable Care Act in 2010, Obama had pressed for a tiny provision — section 6002 in the final law — known as the Sunshine Act. It required drug manufacturers to report to the government any payments they made to doctors.
The fact that a Sunshine Act was even considered useful indicated the prevalence in the U.S. medical system of informal kickbacks between drug companies and prescribers. Sales representatives regularly offer doctors “speaking fees” for addressing barely extant medical conventions, as well as three-course dinners and strip club excursions in Miami. In exchange they expect the doctors to prescribe their company’s drugs. Though it passed in 2010, the provision required four years to implement..."

Insys Therapeutics allegedly pushed doctors to prescribe extreme pain medication for minor discomfort. People died. Wall Street analysts missed it — but a handful of journalists and hedge funds knew.

How Wall Street Abetted an Opioid Disaster

H/T Tom From Florida ("If Wall Street willing to do this, what wouldn't they do to keep investors out of gold/silver/miners/asset class? Vanguard disposed of gold stocks but love a good felon drug dealer...f...ing w..res")

Addiction