In the early 2000s, John Kapoor was a rich entrepreneur who created a new startup called Insys Therapeutics with the intent to formulate and distribute Subsys, a new type of fentanyl spray to treat the breakthrough pain of cancer sufferers. Of course, just because a medication is meant to be prescribed for one type of ailment doesn't mean that doctors have to abide by that, and the pharmaceutical industry as a whole has plenty of tricks up their sleeve to "encourage" doctors to prescribe medications off-label. In this book, Evan Hughes outlines all the ways this particular company evaded, bent, and broke the law in the quest for more sales and more money.

I didn't find anything particularly surprising about this story and Hughes makes it clear that what sets Insys apart isn't necessarily what they did, but rather that everything they did was done openly and often with a paper trail. This a boys club and it seems clear there was little expectation of any consequences unfolding for the major players.

The book itself is well-written, but spare. This is not non-fiction that reads like a novel, but Hughes does work hard to tell a clear story filled with factual information. For me, though, something was missing and I can't really put my finger on it. I was interested in the story, but simultaneously didn't feel the story was especially interesting. Perhaps this would have been better as a longform essay rather than a book.

This is a very thoroughly researched book that will make you steaming mad. It's everything that's wrong with drug companies, insurance companies, and doctors all in one horrifying package. It's not as riveting a true crime narrative as something like Bad Blood, but if you want to know about one small plot within the larger opiod crisis, it is very interesting.

A brisk, readable title that sheds light on a player in the opiod crisis that's not Purdue Pharma. Hughes explains some of the facets of the drug market that made Insys a very profitable company for John Kapoor and his employees. Similar to Bad Blood (about Theranos), this books will be of interest to general readers, true crime aficionados, and those interested in the business side. One of my new favorite books!

⭐️⭐️⭐️⭐️

The Hard Sell by Evan Hughes (out on 1/18/22)

Lately, I’ve been interested in non-fiction books about big pharma, white collar crime, and their connection to the opioid crisis. So, when I saw The Hard Sell on NetGalley, I knew I needed to read it!

This book describes the Insys company, their crimes related to their fentanyl spray product, and the trial of the company’s top employees and founder.

Overall, I think this book provides an engaging and thorough depiction of Insys, it’s top employees, their motivations ($$), and the crimes committed. It wasn’t too long or overly descriptive, like some other non-fiction books I’ve read recently. I’m shocked I hadn’t heard of this case, especially since it’s so recent.

I do think it’s important to remember when reading books about this topic that there are many people who NEED these medications to survive and function. So, we should be careful that discussions like these don’t increase stigma or make readers forget that there are people who very much need these medications!

If you’ve read Dopesick or Empire of Pain, then I think The Hard Sell is a book you’ll want to add to your shelves!

Thank you @netgalley and @doubledaybooks for the #gifted copy!

I could not put The Hard Sell down once I started reading. It documents how the company Insys inappropriately marketed their fentanyl based pain killer, Subsys, to doctors (including bribes and kickbacks) and encouraged those doctors to prescribe Subsys inappropriately to patients. It starts from the beginning to the company all the way to the legal battles that took down the major players. It really focuses on the company itself and it's practices, but underlying it all is the real harm done to patients who had no idea what was going on behind the scenes. I think anyone who found Bad Blood fascinating, will be similarly interested and horrified by The Hard Sell as well.

This book is a must read for anyone interested in the social, political and economic issues of medicine and pharmaceuticals today. It may make you unnerved about what your doctor is prescribing you, but its in depth reporting into one small pharmaceutical company's quest for profits at the expense of patients will make you feel knowledgeable and empowered.

This is a well written and fascinating look at the world of Insys, a pharmaceutical company. It was formed by eccentric immigrant John Kapoor, who became a millionaire looking to get even richer. He developed a new form of fentanyl delivery called Subsys, and hired a bunch of shady people to push it to some iffy doctors. They found ways to target doctors that wrote a lot of opioids and went about trying to get them to switch to their new drug.

The book shows things that went on that were pretty shocking in how Kapoor had things done. Insys, with its drug Subsys joined Purdue Pharma and Cephalon, who both were in trouble over OxyContin and Actiq respectively. Purdue paid $600 million in 2007 to resolve charges, and Cephalon in 2008 paid a $425 million dollar fine over wrongdoing. It’s also about the US Department of Justice investigators from Boston who went after Insys and its executives. An incredible true crime story that shows what some people will try to get away with, given half a chance. Advance electronic review copy was provided by NetGalley, author Evan Hughes, and the publisher.