Pro-Fentanyl Rap Video..."Great By Choice"

That drug companies have fueled the opioid crisis by flooding the market with deceptively advertised, highly addictive painkillers is no secret. But the antics of Insys Therapeutics, now being revealed in an ongoing federal court battle, seem especially evil. Well, evil and incredibly, supremely ridiculous.

On Wednesday, the AP reported, it emerged in court that Insys employees produced a rap video to motivate sale reps to keep pushing an especially potent spray applied under the tongue that’s derived from the synthetic opioid fentanyl.

The company’s spray, called Subsys, was approved for patients with severe, otherwise untreatable cancer pain. But in the face of flagging profits, the company is alleged to have done everything in its power to get its product sold, including breaking the law. Several states have sued the company or former executives over claims they orchestrated a kickback scheme of bribing doctors to prescribe Subsys. These lawsuits, along with a Congressional investigation, have also accused the Arizona-based company of setting up a program that had employees falsify cancer diagnoses for patients in order to get around payment restrictions set up by insurers.

Insys settled with the government over many of the individual state cases brought against it last December, to the tune of at least $150 million in fines. But the former executives the company has since dropped, including founder John Kapoor, are still on the hook for several lawsuits. The federal case currently on trial in Boston, where Kapoor and other former executives of the company are being prosecuted for racketeering, is the background for this latest bizarre revelation.



The video, a parody of A$AP Rocky’s 2012 song “Fuckin’ Problems,” was originally played for sales reps at Insys’ national sales meeting in 2015, according to prosecutors. It’s been rumored to exist since 2017, but it wasn’t until Wednesday that the jury got to see it. Gizmodo obtained a copy of the video from the Massachusetts U.S. District Attorney’s Office.

Titled “Great By Choice” and featuring two Insys employees who styled themselves “Z Real” and “A Bean,” it contains spellbinding lyrics referencing the process of titration, whereby doctors increase the dosage of a drug until it’s deemed to be correct: “I love titration, yeah it’s not a problem. I got new patients and I got a lot of ‘em.”

And even as the rappers encourage the reps to “build relationships that are healthy,” the song also talks up how great it is to drive more sales by buying doctors and their staff lunch. It closes by featuring Alec Burlakoff, the company’s former VP of sales, taking off a costume of the Subsys spray, though not before a version of the costume danced along to a parody of Eminem’s “Rap God.” Burlakoff later pleaded guilty to racketeering charges and is set to testify for the prosecution.

The video comes on the heel of yet another bombshell from the Boston case. Last month, a former Insys employee testified that she saw one of the co-defendants, former regional sales manager Sunrise Lee, provide a lap dance to a Chicago doctor whom they were trying to convince to sell more of their product. Lee’s attorneys argued that the doctor, Paul Madison, was in fact taking advantage of Lee, who had formerly worked as a exotic dancer. Madison was later convicted of unrelated charges, including health care fraud.

The trial is expected to last for several more weeks, the AP reported, so who knows how many more awful things we’ll learn before it’s all said and done?

In 2015, the year this creatively and morally bankrupt video was first shown, 33,000 Americans died from opioid overdoses. A shocking number that would soon be dwarfed by 2016's death toll of over 42,000 and 2017's toll of over 47,000.