‘Pain Hustlers’ True Story: How Insys Therapeutics Inspired the Chris Evans Netflix Movie

Hey, has anyone ever thought of doing a movie or TV show about the opioid crisis? Seems like there’s a lot of potential there.

Kidding! I know there are lots. I write about them for a living. Pain Hustlers, a new Netflix movie that began streaming today, is the latest movie to depict how pharmaceutical companies engaged in illegal practices that helped get millions of Americans addicted to painkillers, while executives were making fast money.

Directed by Harry Potter alum David Yates, with a screenplay by Wells Tower, Pain Hustlers boasts an A-list cast that includes Emily Blunt, Chris Evans, Andy García, Catherine O’Hara, Jay Duplass, Brian d’Arcy James, and Chloe Coleman. The story follows a poor, single mother (Blunt) who is swept out of poverty by a pharmaceutical sales dude (Evans) and helps the company illegally bribe doctors to prescribe a highly addictive opioid.

Americans know very well that this is a thing that happened in real life—but you might be surprised how much was changed from the Pain Hustlers true story. Let’s dive into how accurate Pain Hustlers is to the true story of Insys Therapeutics.

Is Pain Hustlers based on a true story?

Yes, Pain Hustlers is loosely based on the true story of Insys Therapeutics, an Arizona-based pharmaceutical company that supplied a pain-relief opioid drug called Subsys, which was a liquid form of fentanyl. In May of 2019, Insys Therapeutics founder John Kapoor and four Insys Therapeutics executives were convicted of racketeering conspiracy, for bribing medical practitioners to prescribe the highly-addictive drug to patients who did not need it.

The drug was supposed to be exclusively for breakthrough cancer pain—meaning cancer patients who still felt pain that “broke through” all the other drugs they were on—but, according to Evan Hughes’s 2018 New York Times Magazine article, court filings suggest roughly only 20 percent of patients prescribed Subsys were actually suffering from breakthrough cancer pain. Insys executives, the court case proved, openly bribed doctors into prescribing the drug by paying them via “speaker’s fees,” at sham speakers programs that often barely had an audience.

The Insys case was notable as one of the first successful prosecutions of drug executives in connection to the opioid crisis and certainly deserves to have its story told. However, though the movie was adapted from the 2022 book of the same name by Hughes, about the real-life downfall of Insys Therapeutics, quite a few details were changed for the Netflix movie.

How accurate is the Pain Hustlers movie to the true story of Insys Therapeutics?

Don’t use Pain Hustlers as a documentary, because a vast number of things in the film were either changed or invented.

The company name, Insys, was changed to “Zana,” and the drug name, Subsys, was changed to “Lonafen.” (Both of these names are made up, although Lonafen does sound quite similar to a pill used to treat diarrhea, Lomofen.) All the people’s names were changed, too. Insys Therapeutics founder John Kapoor became Zana founder Jack Neel (played by Andy García). Chris Evans’s character, Pete Brenner, seems to be a combination of real-life Insys CEO Michael Babich and real-life Insys VP of Sales, Alec Burlakoff. It was Burlakoff who sang a rap about Subsys alongside an employee in a pill capsule costume. (Yes, that’s real.)

Liza’s mother, played by Catherine O’Hara, appears to be inspired by a real-life New Jersey sales rep named Susan Beisler, whose overly friendly emails to the founder Kapoor about the bribes given to doctors for speaker programs were a key part of one of the pending lawsuits against him. Meanwhile, Emily Blunt’s character, Liza Drake, is entirely made up.

In an interview for the Pain Hustlers press notes, director David Yates said, “With the exception of Liza, they’re all kind of loosely based on existing characters from that pharma world. But we gave Wells license to create his own unique version of people. They’re inspired by, I would suggest, rather than biographical per se.”

Who is Liza Drake from Pain Hustlers?

Liza Drake is a fictional character of a fictional pharmaceutical company, though she was inspired by the real-life executives of Insys Therapeutics. As Yates said in that same interview, “Liza was our invention, a single mum with a daughter struggling with health issues, a dreamer, undervalued but incredibly capable.” We should have known that a drug executive with a guilty conscious had to be made up.

That said if you read Evan Hughes’s 2018 New York Times Magazine article that preceded his book, you get the sense that screenwriter Wells Tower was at least partially inspired by Tracy Krane, a young female Insys sales rep, who was taken under the wing of then-sales manager, Alec Burlakoff (who partially inspired the Chris Evans character). Burlakoff was later promoted to VP of Sales—the same position later given to Liza Drake in the movie.

That said, Liza Drake’s backstory, including her past as a stripper and her daughter with epilepsy, was entirely made up for the movie.

In other words, while Pain Hustlers may be an entertaining movie, it’s not an accurate retelling of what happened with the true story of Insys Therapeutics. (A company that is still operating to this day!) If you want to actually hold those crooks accountable, you’d do well to read Hughes’s New York Times Magazine article and book.