世纪犯罪（2021）

给他们权限
to agree to give them access
来拿到病人的个人信息
to patients' personal information
以及病人诊断
and various pieces of information
最有用的部分
about their diagnoses.
咱就假设大夫开药是为了治腰疼
Let's say a doctor just wrote Subsys for back pain
或者是颈椎难受
or for neck pain.
而英瑟斯说的是
What Insys did was say...
是因为突破性疼痛
他们总结的一种话术是
One of the tactics that they figured out worked
说的一定要快
was talk really fast...
一次性地给对方一大堆信息
Give them a lot of information at once,
演的就跟你特别懂一样
sound like you know what you're talking about.
然后就是用假故事
And they would spin these stories
骗来骗去
that just weren't true.
具体是那种癌症呢
你说为了以防万一大夫就在旁边是吧
具体的应该是慢性疼痛
宫颈部分的慢性疼痛。。。是
他们有个单子
They had a list.
如果你是给哈门打电♥话♥
If you're calling Humana,
你就应该这么说
these are the lies you need to say.
如果你是给蓝十字蓝盾打电♥话♥
If you're calling Blue Cross Blue Shield,
你要说这个
say this.
然后这些保险公♥司♥，他们有自己的一套算法
And then insurance companies, they used the algorithm.
如果回答符合了他们的触发机制
So, if the answer triggered the right way,
就会引导进入决策导图
it would lead them down a decision tree
来决定是否批准
to approve or not approve.
英瑟斯了解这个，也占了这个的便宜
And Insys knew this and took advantage of this.
对
Yes, um...
你能听到这些打电♥话♥的人
So you'll hear these callers anticipate
不仅知道下一个问题，而且还知道后面三个会问什么
not only the next question, but the next three questions.
所以如果英瑟斯知道算法
So if Insys knows the algorithm,
那就等于破坏了流程
they've, like, broken the code.
对他们破坏了流程，破解了流程
They've broken the code. They cracked the code.
然后他们能每天都打电♥话♥
And they could call all day, every day
来获得这些批准
and get these approved.
好吧，药物已经批准一年了
Okay, the medication's been approved until one year...
批准了 批准了
It's approved. It's approved.
这一请求在3月13日前获得批准
The request is approved through March 13.
所以你可以给药房♥打电♥话♥了
So you can go ahead and call it in to the pharmacy.
这都是有John Kapoor驱动的
This was something driven from John Kapoor,
比如IRC的成功率有多少
driven at the top--what the success rate was on the IRC,
是如何行事的
how they were doing.
谎言 欺骗
The lies, the deceit.
为了获批让他们说啥都行
There's nothing they wouldn't say to get the drug approved.
而Kapoor的原则很简单
And Dr. Kapoor's philosophy was very simple.
大夫开药，在处方上写字儿
The doctor prescribes it. He puts pen to pad.
病人拿到药
That patient will get the drug.
明白我意思了么
Do you understand me?"
John Kapoor坚持
John Kapoor insisted
他们的获批率要在90%到100%
that their approvals be something like 90% to 100%,
根据证词来看这个标准
which according to the testimony was way beyond
要不行业内的标准高太多了
any kind of industry goal or standard.
这对我来说不是什么新鲜事儿了
I've been through this before.
我会看着然后说“行
I'm looking at this, and I'm going, "Okay.
我们这就是在犯法
Clearly, we're breaking the law."
这种药物是用来治疗
That medication's intended for the use and management
癌症患者的突破性疼痛的
of breakthrough pain in cancer patients.
Volking大夫认为这种突破性疼痛
Dr. Volking is treating the breakthrough pain
是...
as...
鸦♥片♥危机就是鸦♥片♥危机
The opioid crisis today is just that.
这是一场危机，是我们要共同面对的危机
It's a crisis. We all have to work together.
因为到2012年我们的处方量超过了2.5亿
Because our prescriptions by 2012 were over 250 million.
光美国就2.5亿
250 million in the United States.
根据法律的要求
Everybody who's registered
每个注册的管理人都要保证
to handle a controlled substance
高效安全的管理
has a requirement under the law
要防止药物被非法转销
to maintain effective controls against diversion.
制♥造♥商：“我们就是做药的”
Manufacturers--"Well, we just make the drugs.
我们又不是开药的
We don't prescribe 'em."
经销商：“我们就是物流
Distributors--"Well, we're just logistic companies.
我们不开药也不配药
We don't prescribe or dispense."
药房♥：“我们只是按大夫的处方
Pharmacies--"We just take valid prescriptions
开药啊
"written by doctors
从来不干没有医生批准的事儿
and dispense the medications as ordered."
大夫：“我们只是在治病
Doctors--"We're just treating our patients."
然后就转向了病人
And then it goes to the patients.
顺带说一下，死的就是病人
By the way, those are the guys that are dying.
每一个人都在推卸责任
And everybody's pointing the fingers at each other,
但是最后都会指向医生
but all downstream towards the doctors.
我不想然别人觉得是
I don't want you to think
我和大夫有什么不对付
that I have a problem with doctors.
事实上大部分的大夫都是好人
In fact, most of the doctors,the vast majority of doctors
都在做他们应该做的事情
are doing exactly what they're supposed to do.
但是坏医生是存在的
But there are bad doctors
他们用这些管制药物
that were doing really bad things
不干人事儿了啊
with controlled substances.
我阻止不了他们
I can't stop them.
但是制药企业可以啊
But the pharmacists can,
因为制药企业不需要去填补那些处方
because the pharmacists don't have to fill the prescriptions
但是如果这些制药商
But if the pharmacist continues
不停的去填补处方
to fill the prescriptions,
那么根据管制物管理办法
the Controlled Substances Act supplies a check
就要在分销和药店水平上进行检查了
at the distributor-to-pharmacy level.
当药企制♥作♥这些药物
When the manufacturer makes the pill,
是不允许直接发往药店售卖♥♥的
they're not allowed to sell it directly to a pharmacy,
所以他们就把药送到三个经销商那里
so they sell it to one of these three companies
基本是被垄断的
almost exclusively--
麦克森、嘉德诺和美源伯根
McKesson, Cardinal Health, and AmerisourceBergen.
而这三家公♥司♥
And those three companies own
垄断了市面上90%的阿片类
something along the lines of 90% of the opioid market.
当我刚开始调查的时候
When I first started doing this investigation,
我都不知道这御三家
I had never heard of these companies.
我没听说过麦克森
I had never heard of McKesson.
他们不仅是美国
They are not only
最大的药品经销公♥司♥
the largest drug distribution company in America,
他们还是美国第五大的企业
they are the fifth-largest company in the United States.
这个公♥司♥低调的不行
These companies keep very low profiles.
他们不想有曝光率
They don't want to be in the press,
而且他们保持低调
and they do a very good job
保持的太成功了
of just staying off the radar screen.
你好？有什么我能帮你的？-吃了么
Hello? Can I help you? - How you doing?
你在拍什么？-就拍拍大卡车
What are you shooting? - The trucks coming in and out.
你为什么要录像？-就是拍个纪录片
What are you shooting for?- It's for a documentary.
不好意思不让拍
Nope. Cannot do that. Nope, not here.
经销商，御三家
The distributors, the big three--
当订单进来
when an order comes in,
他们是有义务要去
they have an obligation to have a system in place
甄别这个订单是否合理
that identifies whether the order is suspicious.
如果这个订单不合理
If the order is suspicious,
那就要停下来运输
they need to stop the shipment.
所以你如果看到一个药企
So, if you see a pharmacy
过去的两年只有5000粒的订单
that's been ordering 5,000 tablets for the last two years
现在有了四万、然后六万
and now they're ordering 40,000, then 60,000,
然后十万，这就很可疑啊
then 100,000, that's suspicious.
咋可能拍着胸脯子说没问题的
You--there's no way you could say it's not suspicious.
但是我们所看到的是
But what we saw was
经销商啥也没说
distributors not filing suspicious orders
该咋样还咋样
and then continuing to ship.
当经销商提交了上百份
When distributors recklessly filled hundreds
可疑订单之后
of suspicious orders,
缉毒局就可以使用一种手段
the DEA had the ability to shut them down
关停这些订单