Nathan Lydell: Is He Based on a Real Corrupt Doctor?

In David Yates’ film ‘Pain Hustlers,’ the narrative dives into uncovering the outrageous involvement of pharmaceutical companies in the country’s health decline during the Opioid Crisis. Jack Neel, head of Zanna Therapeutics, introduces a new cancer breakthrough medication to the market but fails to make it marketable. That is until a desperate single mother, Liza Drake, heavily underqualified for the job, enters the office through Pete Brenner’s reference and cracks the code to selling their drug, Lonafen. However, the company and Liza’s ambitions slip through their fingers and lead to morally catastrophic results.

The professional relationship between doctors and Big Pharma companies becomes a crucial point of discussion in the film since Liza and her team exploit the same to saturate the market with their drug. In this scheme, Dr. Nathan Lydell (Brian d’Arcy James) emerges as a prominent figure, which, given the film’s ties to reality, may lead some viewers to speculate about the character’s own basis in reality. Let’s find out!

Nathan Lydell is a Combination of Insys’ Speaker Program Doctors

Although ‘Pain Hustlers’ distances itself from real-life corporations and individuals through fictionalized names and modified details, Zanna Therapeutics still retains a visible similarity to the real-life company Insys Therapeutics. Similarly, while Nathan Lydell, the doctor who champions Lonafen’s introduction to the public, is a fictional character, he seems to be inspired by several real-life doctors.

Lydell’s primary role within the narrative remains his unethical involvement with Zanna, who gives him plenty of incentive to push their drug to his patients. In fact, in Liza Drake’s pursuit of success within Zanna, a company steadily on its downfall, Lydell arrives as a beacon of hope and debuts their first Speaker Program. Like with Zanna in ‘Pain Hustlers,’ Speaker Programs were instrumental to Insys’ success within the medical industry.

Speaker Programs are usually only supposed to be a small private event wherein a doctor recruited by a pharma company may share their working experience with a certain drug to encourage others to prescribe it. However, in Insys’ case, their Speaker Programs ended up being a breeding ground for bribery schemes and Anti-Kickback Statute infringements.

Whether by the narrative’s intention or not, several doctors who participated in these Speaker Programs and unethically pushed the Insys drug, Subsys, inspired Lydell’s character. For instance, according to an anonymous former Insys rep from Florida, she often sought out doctors who seemed desperate and “power-hungry” while looking to recruit speakers for the company’s program. The representative specifically mentioned seeking”[people] that are just going through a divorce, or doctors opening up a new clinic, doctors who are procedure-heavy.”

The description seems to fit Lydell’s character to the T. Yet, another defining feature of his character comes from the doctor’s freefalling enthusiasm to prescribe Lonafen, an opioid painkiller, to the masses regardless of its moral complications. In real life, Paul Madison, an anesthesiologist and pain management specialist, was one such doctor with ties to Insys. During Insys executives’ criminal trial in federal court, sales representative Holly Brown testified about Madison’s medical practice, describing it as a “pill mill,” with prosecutors claiming Madison received $70,800 in Speaker Fee from the Pharma company.

Furthermore, Sunrise Lee, who used to work as a dancer at a strip club, was reportedly involved in Madison’s relationship with Insys. On one instance, Lee, Insys’ regional sales director, was even said to have given Madison a lap dance during one program dinner. Even though Lydell’s storyline with Liza remains inconsistent with the specifics of Madison and Lee’s real-life interactions, it’s easy to see how the latter may have inspired the former.

Lastly, the case of Gavin Awerbuch proposes another similarity to Lydell’s character within ‘Pain Hustlers.’ Awerbuch, a neurologist often described as a leading Subsys prescriber, practiced out of Michigan and reportedly received over $89,000 from Insys for the Speaker Program. Like Lydell, Awerbuch allegedly prescribed the drug to non-cancerous patients, often for no legitimate reason at all.

However, eventually, Awerbuch was arrested after prescribing Subsys for a simple back pain complaint by a patient who turned out to be an undercover cop. Thus, we can conclude that Lydell’s character comes from multiple sources and strives to present a cohesive representation of the numerous moral trespasses that medical practitioners committed for their greed in partnership with Insys Therapeutics.

Where Are These Doctors Now?

Most of the doctors who were involved in Insys’ kickback schemes saw jail time and penalties. In 2018, the authorities convicted Paul Madison, the anesthesiologist, on charges unrelated to Insys, including health care fraud, falsified statements about health care service delivery, and identity theft. However, his sentencing date continued to be postponed well after his conviction until the doctor died on Jan 22, 2022.

As for Gavin Awerbuch, the neurologist was arrested in 2014 and pleaded guilty in November 2016 to healthcare fraud and unlawful distribution of Subsys. Although the doctor could have faced much more in terms of prison time, his cooperation with the investigation against Insys helped him land only a 32-month sentence. Moreover, the court ordered Awerbuch to pay a fine of $4.1 million.

Read More: Pain Hustlers Uses a Fictional Lens to Tell a True Story