Their thinking was governed by an undeniable logic flowing downstream from the profit motive: If Cephalon already has relationships with the top customers, we need to offer them something better. If Subsys prescriptions aren’t getting reimbursed by the insurers, we need to game the system better than the competitors do. If Couch and Ruan are having trouble getting enough Subsys because their pharmacy’s distributor is trying to comply with the law, we need to find a way around the problem and make sure the doctors don’t defect to Galena. It was a thought process in which the patients barely
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