Pain Hustlers (2023)

Billionaires shouldn't exist

Chris Evans, Andy Garcia, and Emily Blunt in “Pain Hustlers”

Pain Hustlers (2023)
Directed by David Yates

I hear it often said these days that billionaires — hundreds of which are now created every year¹ — should not exist. This sentiment might refer to the notion, which I think is probably true, that no one becomes a billionaire honestly or through intelligence. Ethical compromises, on the one hand, and luck, on the other, are largely responsible. Or the sentiment might refer to the sheer moral corruption built in to the incalcuable gap between these panjandrums and ordinary people, especially the poor. It is simply wrong for so much wealth, and the influence and privilege it confers, to be in the possession of a tiny fraction of the population. This imbalance is even more galling when you consider that the ultra-wealthy get that way through a system that exploits the poorest, most vulnerable people and rapes the earth. (Not satisfied with spoiling the planet, cartoon villain Elon Musk has gone so far as to despoil the night sky.² )

“Pain Hustlers“ (in theaters now, on Netflix later) focuses on the ethical compromises and lawbreaking that are an inevitable part of what it takes to build ultra-wealth. In this story, the executives at a pharma firm enrich themselves at government expense by getting Medicare and insurance companies to pay for an addictive fentanyl drug, charging thousands of dollars for each dose. This aspect of the plot — that the money comes from government and insurance reimbursements — is kind of breezed over, but it’s key to understanding how pharma companies enrich themselves by addicting people with little money. It’s a great example of the difference between people of color dealing drugs and having the government wage war on them while white, educated drug dealers are instead called business geniuses and feted as philanthropists.

At the center of “Pain Hustlers” is Liza Drake (Emily Blunt), a single mother just getting by on stripping. When a sketchy businessman, Brenner (Chris Evans), meets her at her job and recognizes her ability to extract money from him, he jokingly offers her a job as a sales rep for his struggling pharma company. She takes him up on it, though she knows nothing about drug chemistry or medicine and doesn’t even have a high school diploma. She turns out to be ace at getting what she wants from doctors who are busy, stressed, and usually in need of the attention of a very attractive lady, but she’s not asking them for money. She’s asking them to write prescriptions for her company’s drug, a fentanyl inhaler.

Once the company recognizes her sales accomplishments, it hires dozens more women like her: single mothers whose main qualification is not attractiveness (though most of them are babes) or medical knowledge, but desperation. They’re in such bad places that they’ll embrace almost any way out, and go about their work with determined vigor.

Unfortunately, the executives aren’t satisfied with selling their product unit by unit and doctor by doctor. Greedy, they embark on schemes to kick back money to doctors willing to write the prescriptions, as well as honoraria for the docs to head “speaker programs” where newly recruited doctors are wined and dined. Sure, these practices invite corruption, but the execs trivialize the ethics concerns. Everyone does it, they say, and since they’re such small fry compared to the big pharma companies, they’ll pay the fines and just keep going. (The film is based³ on a New York Times article, and later a book, by Evan Hughes, about the real-life scandal of the company Insys.) But Liza’s conscience gets the best of her; she sees the real people whose lives are being destroyed by the drug. The former stripper whose career is based on her ability to convince people to do the wrong thing turns out to do the right thing in the end. And it costs her.

As you’d expect, the arc of the company from rags to riches involves a lot of skeevy behavior that the movie eagerly displays for comic thrills. It’s a little like The Office if that show’s paper supplies company suddenly discovered a way to addict people to liquid paper and have the government pay them thousands of dollars per tiny bottle. Imagine Dunder Mifflin’s employees behaving in embarrassingly gross fashion at a celebratory party and you understand how the film has it both ways, enjoying the thrill of watching people indulge their greed and sybaritic tastes while feeling schadenfreude at how foolish they look doing it. The scene where Brenner snorts cocaine backstage and then leads a musical number at a company party dressed as one of the company’s inhalers is only the most risable.

Emily Blunt is believable throughout, as a lap dancer, as a steely, determined mother, as a sales rep hungry to outdo the competition, and as a regretful defendant who testifies against her bosses. Andy Garcia, who is made up to resemble Francis Ford Coppola, fails at speaking in a southern accent but physically embodies the weirdly delicate yet greedy founder and chairman. Though it’s a bit by the numbers, it’s Blunt’s performance that gets you through.

1. For instance, see this Forbes article that says that more than 500 billionaires came into existence from January 2020 to April 2021.

2. https://www.cnet.com/science/spacex-starlink-satellite-launches-changing-night-sky/

3. https://time.com/6312890/pain-hustlers-true-story/