Riverfront Times, July 15, 2020

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THE LEDE

PHOTO BY THEO WELLING

“In general, [I’m here because of] the injustices, all the injustices that are happening inside the country. A lot of people really don’t stand on it or speak on it but just post about it and don’t do anything about it. So this is taking a step of action.”

— CARRINGTON REED, PHOTOGRAPHED WITH HIS GIRLFRIEND ARIANNA BAKER AT A PROTEST DOWNTOWN ON JULY 8

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How to make $6 billion

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ntil a few weeks ago, I’d never heard of a prescription drug called Acthar. Most people haven’t, unless they’re one of the (thankfully rare) parents desperately searching for some way to keep their baby from suffering infantile spasms, a nightmare of seizures repeated sometimes more than hundred times a day.

But frequent RFT contributor Ryan Krull was already digging into the medication’s history, tracing it from humble beginnings to pharmaceutical cash cow — landing on the doorstep of two of St. Louis’ biggest companies. The numbers are staggering, as you probably noticed on that eye-popping cover by art director Evan Sult. But the backstory of how a substance extracted from pig glands went from $40 a vial to more than $40,000 is every bit as fascinating. It won’t make you feel better about our health care system, but it will give you a window into how extreme profits are made.

— Doyle Murphy, editor in chief

TABLE OF CONTENTS CAN’T

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Publisher Chris Keating Editor in Chief Doyle Murphy

E D I T O R I A L Digital Editor Jaime Lees Hero In A Hot Dog Suit Daniel Hill Contributors Trenton Almgren-Davis, Cheryl Baehr, Eric Berger, Jeannette Cooperman, Thomas Crone, Mike Fitzgerald, Judy Lucas, Noah MacMillan, Andy Paulissen, Justin Poole, Christian Schaeffer, Chris Ward, Theo Welling, Danny Wicentowski, Nyara Williams, Ymani Wince Columnist Ray Hartmann A R T

& P R O D U C T I O N Art Director Evan Sult Editorial Layout Haimanti Germain Production Manager Haimanti Germain M U L T I M E D I A A D V E R T I S I N G Advertising Director Colin Bell Senior Account Executive Cathleen Criswell Account Managers Emily Fear, Jennifer Samuel Multimedia Account Executive Jackie Mundy

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C I R C U L A T I O N Circulation Manager Kevin G. Powers

Bill Poppers Outrageous price hikes on lifesaving medications beg the question: Are two of St. Louis’ biggest corporations fleecing America?

Cover design by

EVAN SULT

E U C L I D M E D I A G R O U P Chief Executive Officer Andrew Zelman Chief Operating Officers Chris Keating, Michael Wagner VP of Digital Services Stacy Volhein www.euclidmediagroup.com N A T I O N A L A D V E R T I S I N G VMG Advertising 1-888-278-9866, vmgadvertising.com S U B S C R I P T I O N S Send address changes to Riverfront Times, 308 N. 21st Street, Suite 300, St. Louis, MO 63103. Domestic subscriptions may be purchased for $78/6 months (MO add $4.74 sales tax) and $156/year (MO add $9.48 sales tax) for first class. Allow 6-10 days for standard delivery. www.riverfronttimes.com The Riverfront Times is published weekly

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INSIDE The Lede Hartmann News Feature Short Orders Culture Savage Love

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General information: 314-754-5966 Founded by Ray Hartmann in 1977

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HARTMANN The Most Ominous Man in Town Michael Neidorff has a lot of complaints about St. Louis — and plenty of leverage

BY RAY HARTMANN

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entene CEO Michael Neidorff is the most powerful person in St. Louis today. He is also its most ominous with respect to the longterm future.

Neidorff has built Centene into an unbelievable juggernaut, grossing more than $100 billion in annual revenues and — by his account to Forbes Magazine — now serving “1 in every 15 Americans” as a

national provider of governmentsponsored health care, including Obamacare.

Neidorff’s company is by leaps and bounds the largest publicly traded one in St. Louis. Just as important, it is growing exponentially, owing in no small part to Neidorff’s genius in acquisitions and his ability to leverage government largesse through the exercise of political power.

From St. Louis’ perspective, people should be concerned about a confluence of factors. ne, for whatever reason, Neidorff has apparently developed a very low opinion of St. Louis. Two, he is a man who cannot be trusted not to act on that opinion. And three, abundantly superior alternatives await his company all over the nation.

Neidorff who moved to St. Louis in , made his first dramatic appearance on the local stage this month with a brief, but enormously impactful media tour in which he trashed this region like no one

before him. Had it been for a truly constructive purpose, I’d have applauded, but it was intended more to rationalize than resolve.

It was raw and, frankly, appalling. I say that as someone who agreed with almost all of what Neidorff had to say about the fact that this region is in trouble owing to deep-rooted problems for which no solution is in sight.

Yes, as Neidorff observed, St. Louis is wracked by a tragic crime problem and an image as a crime capital that is worse than the problem itself. Yes, the region’s companies are constrained by its failure to develop a high-performance workforce, in part because of Missouri’s bottom-feeder support for education.

Yes, St. Louis’s infrastructure is abysmal with its underutilized airport and a light-rail system that people are afraid to ride. Yes, Missouri’s failure to expand Medicaid coverage has sorely impacted the region, including his own company, which has as its base business Med-

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icaid management for state governments. inally, and significantly, eidorff dropped this hint: Even after 35 years in town, he purports to resent the insular nature of the social and business elite in St. Louis. Referring to Charlotte, North Carolina, which he has just announced a $1 billion investment in a new Centene headquarters, Neidorff observed on KMOX that “no one asks where you went to high school there.”

So, what’s appalling about what Neidorff had to say? Plenty.

Neidorff’s presumed “wake up” call to St. Louis was a thinly veiled threat from a serial practitioner of that tactic. He has repeatedly threatened to move his Clayton headquarters if he didn’t get what he wanted. In the early 2000s, he was embroiled in an ugly battle to acquire property that ended in the use of eminent domain, all the while threatening to leave if he didn’t prevail.

Then there was that brief shining

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moment in 2007 when then-Mayor Francis Slay proudly announced he had persuaded Neidorff to move to Ballpark Village, only to have Neidorff mysteriously change his mind seven months later. It was all shrouded in customary secrecy.

It’s unknown how many other times Neidorff has leveraged his enormous power over Clayton and St. Louis County, where his headquarters investment has been supported by at least $175 million in public funding that we know of.

Sorry if I have trouble understanding why the intersection of Hanley and Forsyth requires public subsidy, but so be it. Neidorff’s not having attended high school here didn’t prevent that from happening.

Neidorff chose to unload his media tirade at the precise moment Centene was exploding onto the scene in Charlotte with a mammoth project that just happened to be supported by as much as $460 million in corporate welfare “incentives.” What a pleasant coincidence.

But St. Louis’ leader didn’t just let the timing send a chill through the local business and political communities. No, Neidorff contrasted shattered St. Louis to the mecca of Charlotte, a shining city on the hill where skilled and educated workforce prospects abound and race relations are improving, where young people flock in droves for a better life and a brighter future for raising their families and retiring in paradise, in his telling.

Is there truth in Charlotte having a better climate for business than St. Louis? Sure. Would Neidorff be so effusive were it not for the nearly half a billion in “incentives” coming his company’s way? Maybe not so much.

Meanwhile, back here in hell, Neidorff provided St. Louis no constructive road map or strategy, no plan of action, aside from the lowhanging fruit — vital as it is — of expanding Medicaid coverage in Missouri. The Seer of Centene just muttered about how we should ork together, vaguely, indefinitely, to emerge from the slime of our pathetic existence.

And, if not, of course, Centene might just be forced to leave town for Charlotte, Neidorff told KMOX. At 79, he’s likely just a few years from retirement. It would probably be the next CEO who would move it, I’m guessing.

The worst of Neidorff’s rant was what he didn’t say. He failed to accept a molecule of responsibility for where St. Louis is today, either

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as a presumed leader in the community, or as part of the elitist business community that seems to have fallen out of his favor as well.

This is a man who has demanded hundreds of millions in unneeded public assistance to expand business enterprises and then whines about the deficiencies of the school districts and other public entities pillaged in the process. Neidorff is hardly alone in that in St. Louis or nationally, but he ranks as a master practitioner of this nonsense.

Let’s see, how could one be more insufferable? Oh, I know. How about making a big show out of your philanthropy on behalf of policing, education and other local needs that have been suffering because so many local companies like yours have allowed those to atrophy in the name of tax avoidance?

Public companies like Centene argue that they have fiduciary duties to their shareholders to grab every penny of public assistance available in fealty to that sacred mission of cutting taxes in the localities and states where they operate. Really?

Then why spend untold millions in those very communities on self-aggrandizing lavish suites at sporting events, cultural institutions and the like?

Neidorff is spot on about the insularity of the elites, but that omits an important detail: He’s not exactly an outsider. He was a long-standing member of Civic Progress, the group of 30 or so top companies that has long fancied itself as the guardians of St. Louis. In the fallout of his media tour, the St. Louis Post-Dispatch dropped the bombshell that Centene left the group in the past year.

Civic Progress is a shell of its former self, when it was a room full of men of great station who had built, or inherited, revered companies.

Now there are a lot of branch managers in the room. But Centene’s departure is ominous, as the organization would still seem its natural platform from which to work if saving St. Louis was its true priority.

Neidorff and Centene have done wondrous things in St. Louis, from a $25 million investment in Ferguson to all the other philanthropy. But if Neidorff is serious about saving this region, he and his erstwhile Civic Progress pals should make one more small expenditure.

They need to install some mirrors. n Ray Hartmann founded the Riverfront Times in 1977. Contact him at rhartmann@sbcglobal.net or catch him on St. Louis In the Know With Ray Hartmann and Jay Kanzler from 9 to 11 p.m.

Monday thru Friday on KTRS (550 AM).

NEWS Protesters Kicked Out of City Hall Encampment Written by

DOYLE MURPHY

S Multiple Kirkwood High School alumni say they were abused by former teachers. | DOYLE MURPHY

Kirkwood High Sex Abuse Allegations Written by

CHERYL BAEHR Trigger Warning: The following story includes accounts of sexual abuse, which may be upsetting to some readers.

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exual assault allegations against multiple former Kirkwood High School teachers exploded last week in alumni social media groups.

It began with a Facebook post on July 7, prompting several former Kirkwood High School students to come forward to share their stories of abuse, some describing events that date back to the early 1980s.

In the original post, Katie Pappageorge set off the chain of events that has led multiple survivors to speak out about grooming, manipulation, abuse and assault they say they suffered at the hands of at least three different faculty members. The Riverfront Times is withholding the names of the former educators because no charges have been filed. e would normally withhold the names of sexual abuse victims as well, but Pappageorge and two other women interviewed for this

story have given the RFT permission to publish their names and share details of their allegations.

In her account, Pappageorge describes long-running abuse by a drama teacher, beginning during her freshman year when she was just twelve years old (she skipped two grades of elementary school).

The abuse continued into her junior year, until the teacher quietly resigned at the beginning of the second semester, she says in an interview. Pappageorge posted the allegations to the Kirkwood High School Alumni Facebook page. An administrator of the page deleted the post shortly after it went live, but it has since been restored.

Pappageorge says that she decided to write the post after trying for two years to take action against her abuser, first by reaching out to his current employers and eventually to police. However, as she explains, she is not necessarily interested in seeing her abuser go to prison; she wants to see the Kirkwood community held accountable for what she sees as turning a blind eye to the suffering she and other students endured.

“I don’t even want to see this man in jail,” Pappageorge says. “I would like the Kirkwood community to show accountability. I was a shy kid, and no one knew I was being abused. There are people like me out there, and I want to give them validation and the ability to not feel alone.”

Pappageorge describes a harrowing tale of abuse that began near the beginning of her freshman year at Kirkwood High School. After auditioning for a play, she began in-

t. Louis police and maintenance workers cleared a protest camp in front of City Hall early Friday morning, and then again on Sunday. Arriving shortly before 4 a.m. Friday, dozens of bike officers moved in and ordered people to leave. Police Captain Renee Kriesmann, who commands the 4th District, says people left peacefully.

“This is an important building — it’s a building that runs our city government,” Kriesmann says. “Getting it reopened and back to normal was important to everybody.”

Protesters calling for Mayor Lyda Krewson’s resignation had been camped in front of City Hall for nearly two days, bringing in tents and even some furniture. Krewson has been a target of protests for more than two weeks. During a June 26 briefing on Facebook Live, the mayor broadcast the names and addresses of advocates for defunding the city’s police department.

The video was later deleted, but backlash against the doxxing was swift and has included protests outside her home in the Central West End. On the first night of the Occupy City Hall STL camp, police say a city tow truck driver was hit with the barrel of an

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assault-style rifle while trying to tow a vehicle from the scene early Thursday morning. A suspect, twenty-year-old D’Aundre Fitzpatrick, has been charged with assault and unlawful use of a weapon.

Protesters had planned to stay in front of City Hall until Krewson resigned. They painted in massive block letters “LYDA RESIGN” on Tucker Boulevard. Several dozen people had filled the camp, although a smaller number stayed overnight Thursday into Friday.

Street medics had set up tents, stocked with basic supplies and water at the south end of the encampment. Video posted by a group associated with the medics, MARCH St. Louis, showed police officers photographing people trying to pack up what they could before police confiscated the rest.

Kriesmann says the City Hall grounds are considered a city park, and police were enforcing a curfew that forbids people from staying overnight in parks.

By 5:45 a.m. Friday, all the tents had been removed, and dozens of bike cops pedaled away from City Hall. A small number of police officers remained to block off commuter traffic on Tucker while city workers with pressure washers and brushes scrubbed the LYDA RESIGN painting off the street.

Protesters returned Friday night and stayed through the weekend, until police forced them out on Sunday. The St. Louis Post-Dispatch reported that seven people were arrested and two officers were injured.

There are now has metal barricades around City Hall. n

A City of St. Louis worker scrubs “LYDA RESIGN” off of Tucker Boulevard. | DOYLE MURPHY

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SEXUAL ASSAULT Continued from pg 9

teracting closely with her abuser, the school’s drama teacher, under the auspices of a mentor-mentee relationship, she says.

She felt uncomfortable following the audition and a strange callback involving several other girls who were similarly shy, but she did not think much of it until her mentorship involved rehearsing romantic scenes one on one with the teacher. Eventually, this escalated to touching, kissing and ultimately a sexual relationship that lasted more than two years, she charges.

“I was very confused,” Pappageorge says. “I thought I was in love with this man. He’d completely isolated me. This whole time, I thought I was participating in drama, but the only person who knew about it was him. Then all of a sudden he was gone. It was all kinds of chaos and humiliating.”

Another former student, Kate Hurster Espinosa, says she was abused by the same teacher, during roughly the same period in the 1990s. Fourteen years old at the time of her first encounter, she recalls feeling taken aback by his inappropriate behavior, but she says she was unsure how to process it.

“I can look back on it now and say, ‘Oh, that wasn’t OK,’ but I was fourteen years old and a freshman,” Hurster Espinosa says in an interview. “It was shocking, but no one acted like it was wrong, and I figured this as ho things were done because I’d never done a play before. I was the youngest person in the room and the one

Stenger Croney Pleads for Release from Prison Written by

DOYLE MURPHY

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he man who bribed former St. Louis County Executive Steve Stenger wants out of federal prison. He says the coronavirus puts him at risk.

At the time of the filing, John Rallo was little more than two weeks into his seventeen-month sentence after pleading guilty a year ago to three counts of theft of honest services/bribery. Since his plea, he has been diagnosed with thyroid cancer and has had surgery to remove his thyroid, his attorney writes in a court filing.

In a May 21 letter to the warden of the

with the least amount of power.”

Hurster Espinosa details a progression of incidents that included inappropriate touching and kissing. She says she also witnessed the teacher abuse at least two other female students as well.

“His abuse was preying on the insecurities and vulnerabilities of young people who were desperate for guidance and mentorship,” Hurster Espinosa says.

Other former students have shared their accounts about the teacher on social media, but recent posts on the alumni page have also included allegations against other former Kirkwood faculty. At least two other teachers have been implicated in Facebook posts, including a marchingband director identified by alumna Parmela Plein.

“It started almost immediately during freshman year and continued all the way until junior year hen it stopped because I figured out it wasn’t normal,” Plein says.

“Earlier on, I thought that maybe this was how adults acted and it was normal, but once I realized it wasn’t, I dropped out of all music activities. Then, I was retaliated against when I asked for a letter of recommendation to get into a music program and he refused to give me that.”

Like Pappageorge and Hurster Espinosa, Plein describes ongoing abuse that started out slowly with hugging and touching. She says it eventually escalated to inappropriate touching and her abuser showing her pornography and condoms. Although Pappageorge, Hurster Espinosa, Plein and many of the others who have posted on Facebook did not report their federal penitentiary in Marion, Illinois, the 54-year-old Rallo asked to be allowed to serve his sentence on home confinement because his health is failing.

“As such, I am among those with the highest risk of death or serious illness from COVID-19,” he writes. “Yet, as an incarcerated person, it is impossible for me to follow the CDC’s recommendations to protect myself and others from exposure to this highly transmissible disease.”

With no decision from the warden, Rallo reported as required on June 22 to Marion. His attorneys write that he has been in solitary confinement, because another inmate in his cellblock has tested positive for COVID-19. Across the Bureau of Prisons, more than 1,500 federal inmates and 164 staffers had contracted the virus, and at least nineteen had died as of late June, according to the filing.

Normally, Rallo would have to serve 90 percent of his sentence before he would be considered for home confine-

abuse to school administrators at the time, they remain critical of then-principal Franklin McCallie for what they see as a failure to see the obvious.

“They got a new drama teacher who took me to John Dean [the drama department head] and McCallie after [my teacher] resigned and I was upset and crying that I wasn’t on the drama list,” Pappageorge says. “Whatever they said to me, it was extremely euphemistic. I didn’t hear the words ‘abuse’ or ‘sexual assault.’ They said he’d resigned and left them in a bad place, and they felt bad for me because they didn’t want it to ruin my drama career. They didn’t counsel me or offer me anything. It was extremely silencing. I did not get the impression that I was there to talk about sexual assault.”

The Riverfront Times’ attempts to reach McCallie have been unsuccessful, but the former principal released a lengthy statement on Facebook (posted in full on our website, riverfronttimes.com.) He writes that there was a teacher in the 0s that the district fired as a result of allegations of sexual abuse, but the statement leaves a number of questions. It’s not clear if it is the same teacher referenced by Pappageorge and Hurster Espinosa, and McCallie doesn’t say whether the administration contacted police. He says that the teacher wasn’t prosecuted because parents of victims didn’t want to press charges.

Pappageorge says that in 2017 she started to come to terms with the extent of abuse. Once she did, she began to take action, contacting her former teacher’s current employers in 20 . o ever, the

Businessman John Rallo in May 2019 leaving federal court in St. Louis. | DOYLE MURPHY ment, but a provision in the CARES Act, passed by Congress to blunt the fallout of the coronavirus, and guidance from U.S. Attorney General William Barr have instructed the Bureau of Prisons to con-

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pieces really began falling into place for her when she connected with Hurster Espinosa and another survivor in 2019. Together, the three of them contacted police, hoping to see their abuser held to account for his actions.

At that time, Pappageorge anonymously posted an account of her experiences to the Kirkwood High School Alumni Facebook page, only to have it deleted within 30 minutes. That experience mirrors the one from last week, when her post was erased from the site. But this time, it reappeared after members of the Facebook group expressed outrage at seeing her silenced.

“I’ve spent a lot of time thinking about what I want to happen here because of all of the frustrations and the roadblocks we’ve gotten,” Pappageorge says. “I’m not interested in punishing him. I don’t want him to be around young people because I think he is a danger. But to me, the ideal outcome is not charges in a criminal sense, but a complete overhaul of Kirkwood as an institution and similar institutions like this to do something that values survivors.”

In a statement, the school district says it “takes these allegations very seriously” and asks anyone with information about abuse to report it online at www. kirkwoodschools.org/report or by contacting school human resource administrators: Dr. Howard ields -2 - 00, ext.

0 , ho ard.fields kirk oodschools.org or indi elson 2 - 00, ext. 0 , cindi.nelson kirkwoodschools.org.)

The statement says, “We also encourage you to contact the local police department.” n sider home confinement as a way to protect inmates from getting sick.

Probably the most high-profile example of that was former Trump attorney Michael Cohen, who was released to home confinement in May for fear of contracting COVID-19. However, Cohen is now back in prison after allegedly violating the terms of his release.

Rallo was a St. Louis businessman who opened an insurance company, following a stint as a nightclub operator.

He bribed Stenger for years with campaign donations in return for county contracts and real estate deals. A federal probe eventually took down Stenger and two of his top lieutenants — ex-chief of staff Bill Miller and former St. Louis Economic Development Partnership CEO Sheila Sweeney — along with Rallo.

In arguing for the release of Rallo, his attorneys point out that his conviction didn’t involve violence and he had no prior criminal history. n

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obert Stanley calls his son Payton “a multimillion-dollar man.”

Before Payton was even born he had a stroke in his mother’s womb during the third trimester. At two months old, he began having seizures, at times more than 100 in a day. He’s had a portion of his brain removed. oday, at age five, he re uires a speciali ed breathing treatment and cannot walk. The family makes regular trips from their home in Vinita, Oklahoma, to Memphis’ LeBonheur Children’s Hospital, which is widely recognized for its pediatric neurology and epileptology care. Stanley has worked two jobs so that Payton’s mother Stephanie can stay home full time. ayton re uires 0 medications every day, many of which cost, in Stanley’s words, an “extremely stupid” amount of money.

I called Stanley last month to talk about the cost of one medicine in particular. Acthar is an injectable drug manufactured by St. Louisbased Mallinckrodt Pharmaceuticals and used to treat infantile spasms. Payton was on it for

$50,000 vials. And about a year after Stanley first heard of Acthar, it also came to the attention of Larry Morrissey, then the mayor Rockford, Illinois. Like Stanley, Morrissey couldn’t believe the price. Unlike Stanley, Morrissey’s city actually had to pay.

Rockford is a city of about 150,000 people, 90 miles west of Chicago. Like a lot of Midwestern cities, it has suffered from crime, depopulation and an image problem, occasionally ranking high on those dubiously researched “Worst Places to Live” articles. Morrissey, a Democrat, was elected on an agenda of cost saving and infrastructure improvements. One of those cost-saving initiatives as to find out exactly how much the city, which funds its own health plan for municipal workers, was spending on health care. In 2016, the auditors noticed something unusual: The previous year, the city had spent nearly half a million dollars on a drug called Acthar. Only two people on the city’s health plan took the injectable drug, and between them they took a total of just nine vials. That came out to more than $54,000 a vial.

“These are funds that could have been directed to public infrastructure, economic

ment on pending litigation.

U.S. Magistrate Judge Iain D. Johnston, who is handling the early portion of the Rockford case, wrote in a pre-trial opinion, “The issues at stake in these cases are large ... [T]he potential amount in controversy is extraordinary.

The cases contain racketeering and antitrust claims, which, if successful, could lead to huge damage awards. In today’s legal vernacular, these are ‘bet the company’ cases.”

FROM A PIG’S GLAND TO A $6 BILLION COMPANY Acthar is the brand name for the naturally occurring adrenocorticotropic hormone (ACTH). In the 1940s, physician Philip Hench and chemist Edward Kendall discovered it could be extracted from the pituitary gland of a pig (usually after the rest of the pig had been butchered for meat) and injected into a human. ACTH causes humans to create more cortisone, hich reduces inflammation, and for decades Hench and Kendall’s discovery worked wonders for people who suffered from rheumatoid arthritis. The two men later

Are two of St. Louis’ biggest corporations fleecing America for millions?

By Ryan Krull

eight months in 2015. Disappointed with the pediatric care they found in Oklahoma, where doctors had misdiagnosed Payton, the family had made their first trip to e onheur. he doctors there diagnosed Payton with infantile spasms and prescribed Acthar. And despite the litany of high-cost medications that have been prescribed to Payton over the years, the sticker shock that came with Acthar still sticks in Stanley’s memory.

“I heard about the price when I went to go pick up the medicine. I asked the representative that night, ‘How much is this stuff?’”

The representative’s answer: “Fifty-thousand dollars a vial.”

“I about had a heart attack,” Stanley told me.

A standard Acthar treatment lasts a month and re uires t o to three vials. ayton ended up being on the drug for eight weeks.

Fortunately, the family’s insurance covered the treatment, though it ended up being ineffective for Payton, who had to eventually have a portion of his brain removed in order to treat the seizures. At least they hadn’t been bankrupted by Acthar.

However, someone had to pay for those

development or crime reduction,” Rockford spokesperson Laura Maher says. “[Half a million is e uivalent to approximately five police o cers annually.

In the year 2000, a vial of Acthar sold for just $40. The two-decades-long story of how this drug saw its price increase from $40 to $54,000 is riddled with allegations of kickbacks, sketchy marketing and a “murky alliance” between a drug manufacturer and America s biggest pharmacy benefit manager.

Key to the story are two of St. Louis’ biggest corporations.

In 20 , ockford filed a la suit against the drug’s manufacturer, St. Louis-based Mallinckrodt, and the drug’s sole distributor, Express cripts, hich also has its head uarters in t.

Louis. Rockford’s suit accuses the two companies of colluding to artificially raise the price of the drug. It also accuses Mallinckrodt of essentially paying doctors to prescribe Acthar even when cheaper, more suitable drugs were available.

The RFT reached out to Mallinckrodt and Express Scripts for comment. Representatives of both entities replied that they cannot com-

Express Scripts is the sole distributor of Acthar, a prescription drug manufactured by Mallinckrodt. That puts the St. Louis companies at the center of a controversy over the drug’s mind-boggling price increase, from $40 a vial to more than $50,000. | DOYLE MURPHY

won a Nobel Prize in Physiology or Medicine for their work.

But as decades passed, advances in medicine led to other anti-inflammatory therapies, such as Prednisone, which can be manufactured cheaply and don’t come with the inevitable trace impurities that are extracted from a pig’s gland along with ACTH. By the 1990s, ACTH was no longer the preferred treatment for anything except infantile spasms, or IS, a form of epilepsy that is as rare as it is serious.

Pediatric neurologist Jim Wheless told me that there are about 2,000 new cases of IS a year. “If these kids are not treated timely with effective medication, then almost all of them ill go on to have significant mental impairment,” he said.

Wheless added that when it comes to treating IS, there are really only two FDA-approved medications, and of those two Acthar has been clearly sho n to be superior, ith an e cacy rate of about 90 percent.

“If it was your child or your grandchild and I’m sitting across the table saying, ‘Gosh, if we don’t jump on this and treat this effectively, the child is probably going to have significant mental challenges the rest of their life. There’s only two medicines, and this one works better —

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what do you want to do?’” Wheless said. “You can guess what most families are going to opt for.”

Wheless added, “Now, what if I tell you that the ideal medication is so expensive you have to mortgage your house? Or that you can’t have a house?”

But a single vial of Acthar didn’t always cost more than a down payment on a starter home.

In the 1990s, Acthar was a product of Aventis Pharmaceuticals, the only company producing ACTH of any kind. At that time, a vial of Acthar from Aventis cost about $40, and the low incidence of infantile spasms combined with the low price meant that Aventis lost money on the drug. They tried to stop producing it in the 1990s, but pediatricians intervened, saying that without Acthar parents whose children suffered infantile spasms would be without an important treatment.

In 2001, Aventis sold Acthar to California-based Questcor for just $100,000, making Questcor the only source for the first-line drug against infantile spasms. The company used this monopoly to essentially set its own price. Right after acquisition, Questcor raised the price of Acthar from $40 a vial to close to $800 a vial. The price grew steadily from there. By 2007, insurance companies and Medicare were paying nearly $2,000 a vial.

But that was just the beginning.

In 2007, Don Bailey became CEO of Questcor. Over the next thirteen years, the “one-drug company” turned that one drug into a $6 billion business. uring the first year of ailey s leadership, Questcor struck a deal with Express Scripts, making the St. Louis-based pharmacy benefits manager the sole distributor of Acthar.

Over 80 million people get their medications through Express Scripts, a buying volume that gives the company considerable power to negotiate lower prices from drug companies. The company regularly posts revenues of more than $100 billion a year.

However, Rockford’s suit alleges, because of the exclusive distribution deal Express Scripts inked with Questcor, the e-pharmacy had no incentive to negotiate for a lower price and therefore did not do so.

In the months following the Questcor deal with Express Scripts, the price of Acthar went from $2,000 a vial to more than $29,000 a vial.

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Robert and Stephanie Stanley with their “multi-millionaire man” Payton. | FAMILY PHOTO Eric Liebler was a senior vice president at Questcor around the time of the Express Scripts deal.

Though he wasn’t involved in the deal with the e-pharmacy, he was privy to the company’s conversations about dramatically increasing the price of Acthar. He told me that prior to the deal the company drafted two plans for how it could increase the drug’s worth.

Option one was to do a lot of research on Acthar, find ne uses for it and, while doing so, raise the price gradually over several years in a way commensurate with the increased number of uses.

“Option two was, ‘Let’s just do it all at once,’” Liebler said. “You’re going to get yelled at for raising the price no matter what you do, so go from $1,500 right up to $21,000.”

Liebler says he recommended the first approach, doing it gradually. The company went with the second, dramatically raising the price in short order.

“I helped them write the press release, but then I resigned immediately,” Liebler said. “There are many companies who have played the price-increase game, but I’d never seen anything like this at this magnitude.”

By 2012, insurance companies were increasingly dubious about both the price of Acthar and its e cacy. ealth insurer Aetna reduced reimbursements for Acthar, a spokeswoman telling Reuters at the time, “The decision was based on the lack of clinical evidence that the drug is more effective than existing steroids.”

In the wake of Aetna’s announcement, Questcor’s stock price dropped by 40 percent.

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However, good news for Questcor and their shareholders came in 2014 when St. Louis-based Mallinckrodt Pharmaceuticals paid Questcor $5.9 billion as part of a merger between the two companies. The merger raised eyebrows. At the time, Questcor was the subject of two federal whistleblower complaints, a Securities and Exchange Commission investigation related to the marketing of Acthar and an ominous 2012 New York Times article that highlighted the extreme price increase. “I have a Cadillac in my refrigerator,” says one Acthar patient quoted in that article, referring to an unused 5 ml vial.

One month after the merger, Bailey, the Questcor CEO whose tenure coincided with most of Acthar’s price increase, sold almost a quarter million shares of Mallinckrodt, worth nearly $19 million, according to stock market tracking tool Wallmine. Bailey also joined Mallinckrodt’s board of directors.

“Most of the Questcor people who stayed when I was uncomfortable, they became very rich, ungodly amounts of money,” Liebler said. “Their [stock] options were back at 40 cents, 80 cents, and they probably sold at one hundred bucks. When I write the checks for my daughter’s college, I know that would have been easier financially to stay. ut I did the right thing.”

The controversy and litigation stemming from Acthar, its pricing and marketing have only increased since Mallinckrodt’s $6 billion acquisition.

While the data supporting Acthar as an effective treatment for infan-

tile spasms is strong, the market for IS treatments is limited given the rarity of the disease. Wheless, the pediatric neurologist, said that he also believes given Acthar’s price it’s only a matter of time until alternative, cheaper treatments for IS appear on the market.

Seeking to expand the market for Acthar, Questcor and Mallinckrodt have both promoted it as a treatment for conditions other than infantile spasms, and at times these promotions have drawn accusations that the drug is being promoted in ways outside its FDA approval.

In 2016, a man named Barry Franks who had worked in sales for Questcor and later Mallinckrodt filed a la suit against the company claiming that he as fired for not selling Acthar to doctors based on uses that were not FDA approved.

Acthar is FDA approved as an additional treatment for acute flare-ups of rheumatoid arthritis, or RA, but Franks claimed salespeople were incentivized to promote the drug and encourage refills as a longterm therapy to manage RA. Express Script’s own prior authorization process stated that in treating rheumatic disorders, Acthar is only approved for “short term administration for an acute episode.”

Furthermore, Franks’ suit claimed the salaries for Mallinckrodt’s sales staff were pegged directly to their ability to push Acthar to doctors as a long-term RA treatment. In addition to base pay, salespeople took part in an “Incentive Bonus Plan” — according to Franks this was referred to within the company as the “Rheum Incentive Plan” — through which salespeople could potentially earn more than their base salary.

Meanwhile, by 2018, four years after Mallinckrodt acquired Acthar, the price of one vial reached $40,000.

In addition to what Acthar is promoted as a treatment for, there are also considerable concerns about who is doing the promotion.

SPOKES-DOCTORS Around the same time as the 2007 Express Scripts deal, Rockford’s lawsuit claims, Questcor began paying doctors to aggressively market Acthar to other doctors who were then financially compensated for prescribing Acthar to their patients.

These spokespeople/experts were called Key Opinion Leaders (KOLs), and Rockford’s lawsuit — as well as a suit brought by the Department of Justice — alleges that the money from Questcor motivated them to promote Acthar in ways unsubstantiated by empirical research.

The Rockford lawsuit, data from a ProPublica investigation and an article published in the Journal of American Medicine all indicate that Mallinckrodt continued this practice after merging with Questcor.

One of these KOLs was Maryland neurologist Ruwani Gunawardane, who according to government data in 2013 and 2014 received almost $150,000 from Questcor. From 2015 to 2018, she received $199,000 from Mallinckrodt in honoraria and for speaking, training and education.

A 2018 lawsuit brought by the Pennsylvania-based International Union of Operating Engineers Local 542 claimed, like Rockford’s suit, that their health plan paid an inflated price for Acthar. he IUOE suit also alleges that Gunawardane’s promotion of the drug to other doctors relied heavily on Acthar’s off-label uses.

According to the NIH, “The FDA prohibits the promotion of drugs and devices for off-label uses by companies.”

“These companies, and Mallinckrodt especially, have figured out that if we get a doctor to make that pitch, they think they’re not marketing in violation of the law,” said Don Haviland, the attorney representing Rockford. “That’s why they pay big money to these doctors to go out and hawk for them.”

According to the IUOE suit, Gunawardane trained other doctors to become KOLs on Acthar, including doctors who went on to prescribe Acthar to patients whose insurance was through the labor union.

Irene Greenhouse, a neurologist practicing in a suburb north of Philadelphia, is one of the doctors who the IUOE suit alleges prescribed Acthar not on the basis of it being the best treatment, but because she received money from Mallinckrodt. The suit alleges that Greenhouse prescribed one of the IUOE’s health plan members Acthar for multiple sclerosis (due to HIPAA protections the patient’s name is unknown).

The suit claims Greenhouse prescribed Acthar in lieu of drugs that would have been cheaper and more appropriate, especially given that the patient was trying to get pregnant. The warning on Acthar’s label states, “H.P.Acthar should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Furthermore, Express Scripts’ own prior authorization process stated, “Regarding MS, there is no evidence that Acthar impacts the ultimate outcome or natural history of the disease.”

The FDA has approved Acthar for flare-ups, but not for man-

agement of the chronic disease.

The IUOE suit also alleges Greenhouse went so far as to submit false information about the patient’s medication history, claiming that other medications the patient had not taken had failed to treat her MS. In 2016, Greenhouse received $37,000 in compensation from Mallinckrodt, according to ProPublica.

“When a doctor prescribes a medication like this, why isn’t it part of their Hippocratic Oath to say, ‘Oh and by the way, just so you know, this company gave me $37,000 last year’?” Haviland said.

In 2012, two Questcor employees filed histleblo er complaints in federal court detailing the system of kickbacks and other compensation that Questcor (as well as Mallinckrodt after merging with Questcor) used to boost Acthar prescriptions. The whistleblower complaints, which were unsealed in 2019, were brought

by Charles Strunck and Lisa Pratta, both of whom worked in sales for Questcor. Pratta also worked for Mallinckrodt after the merger.

Strunck and Pratta claimed that Questcor “cheated the federal government [Medicare] out of millions of dollars” through systematic kickbacks to health care providers in exchange for them promoting and prescribing Acthar.

The whistleblower complaint also claims that Questcor gave large sums of money to the nonprofit hronic isease und, hich reimbursed Acthar users for their copays. On the surface, helping users pay for their medication might seem noble, but the whistleblower suit described how doing so enabled Questcor to “cheat” the taxpayers out of millions.

Americans on Medicare often pay out of pocket for a percentage of their drug costs. If patients had to pay even 5 percent of the $40,000 price for a single vial of Acthar, many would have no choice but to go without. The whistleblower suit alleged that Questcor and later Mallinckrodt used the Chronic Disease Fund to subsidize the patients’ copays so they wouldn’t complain about the high costs, leaving Medicare and insurance companies stuck footing the remaining tens of thousands of dollars. It’s legal for a drug company to subsidize patients who have private insurance, but illegal to do so for patients on Medicare.

A ProPublica investigation found that Acthar “isn’t prescribed often, just 3,387 times in Medicare in 2012. But Part D spent an average of $41,763 per prescription, making it one of the most expensive drugs around.”

As Acthar became prescribed more liberally, the reports of adverse side effects associated with its use increased as well. In 2017, Citron Research analyzed data from the FDA’s Adverse Reporting System and found that in 2016, two years after Mallinckrodt acquired Acthar, 82 people died due to complications associated with the medication. This was up from only four deaths in 2012.

Mallinckrodt paid $100 million in a 2017 settlement to resolve Federal Trade Commission charges that the company maintained a monopoly over Acthar.

In June 2019, the Department of Justice joined the Strunck and Pratta whistleblower suits.

Mallinckrodt responded to the allegations by claiming in a statement they “pertained principally to legacy Questcor conduct.”

However, an article published in the Journal of the American Medical Association seems to push back against Mallinckrodt’s claims that the bad behavior was a “legacy” Questcor issue. The researchers who published their work in the journal investigated the way in which Acthar was prescribed in 2015, a year after Questcor merged with Mallinckrodt. hey identified 00 doctors who prescribed Acthar ten or more times over the course of that year, resulting in more than $200 million billed to Medicare (about $667,000 per doctor). More than two thirds of those so-called “frequent prescribers” received payments from Mallinckrodt that in some cases ere as high as six figures. In 2016, Mallinckrodt spent more than $8 million in payments to doctors related to Acthar, according to ProPublica.

“Not one thing has changed about Acthar since the 1950s. No improvement since it was invented, since someone took the fluid from the pituitary gland of a pig and injected it into a baby. All of a sudden the growth just ballooned in 2010, 2011. The only thing that’s different is the marketing,” Haviland said. “And the price.”

A LITANY OF LITIGATION Over the past several years, Mallinckrodt has found itself increasingly besieged by class action lawsuits, government scrutiny and activist investors hoping to make a killing in the company’s demise.

In 2017, activist investor James Chanos referred to the relationship between Mallinckrodt and Express Scripts as a “murky alliance” and, along with other investment managers, began aggressively shorting the company.

riverfronttimes.com

Chanos is best known for predicting and profiting from the collapse of Enron and, more recently, China’s Luckin Coffee.

In August 2019, health insurance company Humana sued Mallinckrodt in federal court for $700 million, calling the company’s handling of Acthar “one of the most outrageous pricegouging schemes in the history of American medicine.”

A month later, Mallinckrodt paid $15.5 million to resolve the DOJ’s and the whistleblowers’ suit.

A board of education in Maryland also filed a la suit similar to Rockford’s against Mallinckrodt and Express Scripts over the price its health plan paid for Acthar. That case ended in a judge’s dismissal “on state law grounds.”

The current price for a vial of Acthar varies depending on who you ask. Mallinckrodt company literature from 2019 lists it at $38,892 a vial. Other third party sources put the cost at $40,613.

In addition to battling these Acthar-related suits, Mallinckrodt has spent the last several years fending off an enormous classaction lawsuit over their production of generic opioids. Oxycontin manufacturer Purdue Pharma has taken the brunt of the bad press for its role in the opioid epidemic, but according to data from the Washington Post, Mallinckrodt actually produced more pills than Purdue.

In February, Mallinckrodt reached a tentative deal to pay $1.6 billion to the thousands of state and local governments seeking damages resulting from the opioid crisis. Mallinckrodt’s beleaguered stock price rose almost 40 percent following the announcement of the settlement.

Mallinckrodt and Express Scripts’ full defenses against Rockford’s allegations are still unknown. But as the parties head toward trial it is certain that this will be something of a Davidversus-Goliath contest. The two companies post annual revenues in the billions. Rockford’s total expenditures for 2019 amounted to less than $290 million.

The case is set to be in its discovery phase until at least Thanksgiving. Judge Johnston has acknowledged the disparity of resources between plaintiff and defendant, writing that “the main defendant is a large international pharmaceutical company with substantial resources” and saying in a pre-trial hearing, “The City of Rockford is barely keeping up with what they are supposed to be doing with keeping the lights on in the streets.” n

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[SIDE DISH]

Service in the Pandemic Vicia wine pro Nick Denietolis is grateful to be working a takeout window at Winslow’s Table Written by

CHERYL BAEHR

N

ick Denietolis began his food career working at Schnuck’s when he was a teenager.

Eventually, he moved up to the meat department, gaining valuable food prep experience that helped him transition to a back-of-house position in the restaurant business. From there, he moved to a server position and then became a wine professional, always moving forward in the hospitality industry. For that reason, he can’t help but see the irony in what the COVID-19 crisis has done to his career. “I started in retail, then cooking, then service, then fine-dining and eventually, I did sommelier training and got super into wine,” Denietolis says. “Now, because of the pandemic, I’ve come back full service, because I’m basically working at a grocery store.” Denietolis is half joking since the grocery store he refers to is actually Winslow’s Table (7213 Delmar Boulevard, University City; 314-725-7559), the neighborhood eatery owned by Vicia’s Michael and Tara Gallina.

Unlike a place to pick up grab-andgo Top Ramen and Cheetos, the restaurant has pivoted to a model where guests can grab local produce and goods, housemade hand sanitizer, wine, beer and ready-toeat food, all served out of a quaint pick-up window. It’s as charming a setup as one can get in the midst of a pandemic, but Denietolis cannot help but lament what was lost when dining rooms were forced to close. “What drew me to Vicia and kept me involved in that job is getting the chance to be

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Nick Denietolis still provides hospitality, even with takeout at Winslow’s Table. | ANDY PAULISSEN

really knowledgeable about not just what food is and its history, but where it’s grown and why it’s cooked a certain way,” Denietolis explains. “At Vicia, the full tasting menu is an explosion of knowledge you try to drop on everyone in regard to those aspects. We’ve taken field trips to the farms, met the cows, held the chickens; sharing those things with people in the restaurant has been a huge source of excitement in my job and something we get a lot less of when talking through a window. You don’t get to go on a ten-minute diatribe about beets when you are talking through a window.” As difficult as that transition has been, Denietolis is thankful for his job as a sommelier-turned-counter server at Winslow’s Table, considering how uncertain things have been for the service industry. He recalls how quickly everything changed: One minute, he and his teammates were getting ready for the beginning of the restaurant’s first patio season; the next, they were unemployed — something the Gallinas did to ensure their employees would be able to get unemployment and survive financially amidst the uncertainty. Denietolis took that time as an opportunity to pause. Like many of his friends, he baked, ate a ton of

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pasta, experimented with fermentation, watched too much television, biked and spent time outside — a privilege he had thanks to the comfort he had in knowing he’d eventually be called back to service. Now that he has resumed working at the restaurant, he’s thankful for the neighborhood that supports it and, in turn, the small farmers who stock its pantry. And though it happens less often than before the pandemic, Denietolis is also thankful for the opportunity to provide those little bursts of hospitality whenever he can give them. “We do the best we can to be very gracious and do different things to show that we care about the customer and their experience,” Denietolis says. “It’s a lot less walking someone through a wine list and more walking them through how to use our website to order and being accommodating with pickup times. It makes it really important to be gracious and over the top in those times we have to give people a good experience because we have less chances to do it.” Denietolis took a moment away from the window to share his thoughts on the way the pandemic has affected his job, how he’s kept busy and what gives him hope, even in these challenging times.

As a hospitality professional, what do people need to know about what you are going through?

I think it is really important to realize that, even if the virus were to go away tomorrow, the service industry will be changed forever. So many restaurants are closing for good, and I think there will be a permanent shift to more detached models of hospitality.

Many people who have built their lives on restaurant work might not feel certain about their careers for years to come. This is also threatening to small farmers for whom restaurant sales are a huge part of their model. To the people in the farm-to-table world, who are dedicated to making our food more local and sustainable as well as less corporate and extractive, these times present an immense challenge.

What do you miss most about your job?

A big draw for me at Winslow’s Table and Vicia before [COVID-19] was the chance to learn so much about the food we serve. What impresses me most about Chef Michael’s food is his knowledge of the ingredients and their sourcing. My favorite part of service is getting to talk about food. I think what’s on the menu is far less important than why it’s there, and sharing that is the really fun part of the job. Getting to talk about how the weather has affected the amount of eggs we get or showing someone a picture of the cows we get our dairy from is a real highlight. Winslow’s has pivoted from full-service to something in between a coffee shop and a neighborhood grocery store. We still have our patio, but closing the front door means we do more of our business as to-go and get less chances to interact with the guests.

What do you miss least?

Ask any restaurant person: We all have the same nightmare, some variation of getting quintuple-sat with no busser while the restaurant is somehow 86’d water. There is a certain measure of pride I take in getting through a crusher of a shift and still being able to think straight, and I think the people who are drawn to restaurant work usually thrive in high-stress, fast-paced environments. That being said, I certainly

don’t miss the chaos.

What is one thing you make sure you do every day to maintain a sense of normalcy?

Cycling has always been a big part of my life, so this has been a really great time to fall into that.

Even in the height of quarantine, you could still get on a bike without things feeling too different.

Biking is a solitary and often meditative experience, made even better by less cars being on the road.

At one particularly manic point, I did make all the broken bikes I’ve collected over the years into one Franken-bike.

What have you been stress-eating/drinking lately?

I certainly don’t think I would have made it through the months of lockdown without my pasta maker. I’m on my second sack of flour at this point. Also vermouth, like a lot of vermouth. I just finished the last of my Cocchi Rosa, but I have to shout out to Dolin

Blanc as well. It’s nothing fancy, but it’s just right on the rocks, and I must have gone through at least three bottles this year.

What are the three things you’ve made sure you don’t want to run out of, other than toilet paper?

I’ve been really into making yogurt recently. I think quarantine season turned half of my friends into fermentation experts, and I didn’t miss that boat. Fresh fruit is a must, so I’ve made sure to keep the fridge stocked with grapefruit to supplement stuff foraged or from the garden. I live down the street from Charm Me Sweet. They have all kinds of cool, weird candy there, and because part of me is still six years old, I always have a big bag of treats from there.

You have to be quarantined with three people. Who would you pick?

Frankly, I think I ended up doing pretty well with my bubble: My partner, my roommate, and

my cat Kiwi.

Once you feel comfortable going back out and about, what’s the first thing you’ll do?

I can’t wait until I can get off work and bike to South Grand to drink on the CBGB patio. It certainly doesn’t feel like summer without that place. It’ll be great to see live music again as well. My band recorded an album at the beginning of the year, and we’re hoping we’ll be able to do a release party sometime in 2020, fingers crossed.

What do you think the biggest change to the hospitality industry will be once people are allowed to return to normal activity levels?

I think we are seeing a huge shift in how people think about and treat service workers. Lockdown and essential businesses painted a pretty stark image of the difference between white-collar and service workers. There has been a lot more respect shown to cus-

tomer service people, and I hope that is something that will stick around. Look at how mainstream the “Karen” meme is now. Especially with the issue of safety, you can complain all you want, but you still have to wear the mask.

I think restaurant owners are going to have a lot less patience with people who treat staff poorly.

“The customer is always right” doesn’t give people the right to be degrading.

What is one thing that gives you hope during this crisis?

Seeing the progress the BLM movement has made gives me so much hope. Ideas that were fringe before, like defunding the police and putting the money back into communities, are now gaining mainstream traction. That a movement like this can persist not only in the face of hundreds of years of oppression, but also during a global pandemic is truly inspiring. n

[SHORT ORDERS]

Quick Draw Among the Willows blasts its way into St. Louis’ beer scene Written by

THOMAS CRONE

F

or the past few years, the Public House Brewing Company brand has been a more-seen, more-consumed name locally, as the mid-Missouri concern has steadily grown St. Louis into its largest market. With brewpubs down I-44 in both Rolla (with an intimate, hip tap house) and St. James (featuring an expansive, highway-side restaurant next to St. James Winery), it was perhaps only a matter of time for the brewery, established in 2010, to make a mark here.

That came with no small amount of emphasis in capturing attention in an already-competitive and well-represented beer scene. Over the last couple of years, the brewer shifted from a bottling line to a canning line, added a veteran sales rep with a focus on the St. Louis market, and staked its fortunes on five year-round beers. But that initial group of flagship offerings has been trimmed a bit in 2020, with a

couple other entrants making a play for permanent status in the PHBC lineup.

With spring turning into summer, a 5.4 percent ABV pilsner called Among the Willows has been PHBC’s hit of the season.

Owner and cofounder Josh Stacy says, “The beer hits on a lot of factors that made us want to move ahead. Consumer trends have been leaning into the lighter side of craft, and we have seen success with other beers such as Cream Ale. Our head brewer, Matt Burkhardt, loves this style of beer and has been chomping at the bit to release a pilsner.

“With the changes in the external market due to COVID-19, we noticed that customers started to turn to styles that they were familiar with. The plan was to release the beer [in] our variety pack and draft for the summer to see how the customers reacted, with the potential to move into a six-pack offering. With these changes we made a quick decision to make this beer available in both and let it run through the summer.”

The beer, he says, is a nod to Public House’s regional focus.

“The name ‘Among the Willows’ is an old cowboy phrase,” Stacy explains, “that means to evade the law, running from the law. The art and story behind the beer has deeper roots to the area.” A lengthy piece in the local Phelps County Focus goes into considerably deeper details on the beer’s origin story for those curious,

Amo

Among the Willows, from Public House Brewing Company, recalls the time of fugitive cowboys. | COURTESY PUBLIC HOUSE BREWING COMPANY including some words on the can’s striking, gunfighting artwork by regular PHBC designer Travis Watkins. It’s not the only beer they’re pushing in mid-2020.

“We have several products that we are excited about for the summer,” Stacy adds. “We are finishing up our run on Strawberry Cream Ale but will follow up with Peach Cream Ale [this month]. We have also just released Dry-Fly Session IPA. We have had this beer in the market before and sold it in the taproom on limited runs over the last five years. People love this beer — it is one of my all-time favorite PHBC beers, so we are very excited

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to get it back out in the market in cans and ready for the river.”

Sixers of Among the Willows are available at craft beer sellers around St. Louis. And for those longing for an afternoon of noshing and sipping under Ozark skies, the St. James facility’s beer garden is less than an hour-and-a-half drive from St. Louis and is one of the state’s best patio bars, no question. n Thomas Crone is a longtime Riverfront Times contributor. He reports on a weekly basis about new releases from local distilleries and craft breweries.

JULY 15-21, 2020

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CULTURE

Cutline goes here followed by Art Credit, in All Caps. | ART CREDIT

MOBOT Cancels 2020 Japanese Festival Written by

JAIME LEES

JOIN US AUGUST 15, 2020 1 - 6 P.M. as PrideSTL takes the celebration virtual!

National and local entertainment comes together for a professionally produced virtual festival by 201 productions and Schunk Entertainment.

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I

f the lack of baseball didn’t already tip you off, summer in St. Louis really is canceled now because the Missouri Botanical Garden (4344 Shaw Boulevard, 314-577-5100) is saying sayonara to the Japanese Festival this year as a result of the COVID-19 pandemic. his is the first time that the beloved festival has been canceled in 44 years. Held over Labor Day Weekend, the event is always one of the most popular of the season and provides authentic Japanese music, art, dance, food and entertainment.

It is also usually very crowded and it ould be di cult to socially distance with that many people in one small area.

So the festival is off this year, but the Japanese Garden is always there. And MOBOT will have ex-

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tended hours through Labor Day Weekend — last entry is at 7 p.m.

— along with extra entertainment.

From MOBOT: “The private Teahouse Island of the Japanese Garden will be open for guided public tours on Saturday, Sunday, and Monday. Normally closed to the public, visitors can see the garden’s soan, the farm hut-style teahouse, which was a gift from Missouri’s sister state of Nagano prefecture in Japan. Originally built in Japan, the teahouse was reassembled on-site

by Japanese craftsmen and dedicated during a Shinto ceremony in 1977. Visitors can also see a snow-viewing lantern, yukimidoro, a gift from St. Louis’ sister city of Suwa, Japan.”

Tickets to the Teahouse Island tour are $10 on top of the normal garden admission, and groups are limited to ten people per tour.

The garden is also planning candlelight walks and a traditional lantern ceremony, called Toro Nagashi, on Saturday and Sunday evenings in celebration of Obon, a festival when the living and dead get to hang out again. As part of the ceremony, the names of the dead are written on lanterns.

Once the lanterns are lit, they are sent to float a ay on the ater to guide the spirits back home.

Entry for the ceremony is at 7:30 p.m., and the lanterns are scheduled to launch at 8 p.m. Tickets

“The decision to cancel the Garden’s Japanese Festival was a difficult one, but necessary in light of the current situation.” are for sale online only. or the first time in more than four decades, the decision to cancel the Garden’s Japanese Festival as a di cult one, but necessary in light of the current situation,” Dave Lowry, Japanese Activities Committee Chairman, says in a news release. “The Japanese Activities Committee hopes the lantern release will be a suitable way to commemorate those who have been lost to us this year. We look forward to next year’s festival.”

Capacity for the lantern ceremony is 250 guests each night.

For more information about when and how to visit the garden, call 314-577-5100 or visit www.MOBOT.org. n

[LONG NECKS]

[ A P O C A LY P S E S O U N D T R A C K ]

Civil Life’s Stolen Giraffe Recovered in South County

Pande-Mix: An End of the World Mixtape

The brewery’s owner says they have found their lost metal animal, but the thieves are still at large Written by

DOYLE MURPHY

A

week after it was kidnapped from its south St. Louis home, Civil Life Brewing Company’s giraffe has been found.

Civil Life owner Jake Hafner tells the Riverfront Times he was alerted last Thursday morning by police who told him the sixteen-foot-tall statue had been located in south St. Louis County. The thieves, however, are still at large.

“This is just stage one,” Hafner says.

“We still have to find whoever did this.”

From what Hafner has been told by police, the crooks sold the giraffe, known as Peaches, to an unsuspecting buyer in south county. Once the man learned it was stolen, he called police. Investigators are now trying to trace the transaction back to the giraffe-nappers.

Peaches had been a fixture at the brewery, standing in the middle of a neighboring lot known as Jake’s Dinosaur Park.

It was once part of a collection of metal figures in the “park,” but when a chainlink fence came down in March, Hafner moved the smaller creatures inside.

He left the giraffe, reasoning that no one would steal a sixteen-foot-tall sculpture.

But on July 3, he arrived at Civil Life (3714 Holt Avenue) and immediately noticed Peaches had disappeared. Surveillance video from the brewery showed a white box truck pull onto the lot at 11:20 p.m. on July 2. Part of the scene was obscured by nearby shipping containers, but Peaches’ head wobbles, and then she is lowered out of view before being loaded into the back of the truck. Another angle shows the truck driving south on Holt Avenue, the too-tall giraffe’s head poking out of the back.

We reported the caper that afternoon, and media across the city and beyond soon picked up the case. Hafner’s legions of craft beer fans joined in the chase, and he’s been in full sleuthing mode ever since, fielding countless tips

BY CHRIS WARD Each week, former KDHX DJ Chris Ward examines a song from his quarantine-based playlist dealing with isolation, loneliness, hope and germs. Find them on the Spotify playlist, “Pande-Mix: An End of the World Playlist”: https://spoti.fi/2WZGTJZ.

“Shame” from White Men Are Black Men Too (2015) by Young Fathers

Peaches (photographed before the giraffenapping) is home safe. | DOYLE MURPHY in recent days. One tipster, “Bria,” forwarded a cellphone video she’d recorded the night of the high-crime heist. It shows a box truck barreling south on Interstate 55 near Butler Hill Road in south county, and a giraffe head is sticking out the back.

On social media, Hafner has kept up a steady drumbeat of warnings to the bandits.

“Imagine you are the Giraffe-nappers and all of a sudden you start to feel the pressure,” he tweeted on July 7. “Who is that in that unmarked car? Is that a detective, are they going to knock on my door?

Sweat appears on your forehead! TURN YOURSELVES IN!” On Friday Hafner made arrangements to collect Peaches from an undisclosed location, a tricky operation, given that she is a life-size metal giraffe and he doesn’t own a box truck. He’s also working on plans to keep her safe in the future.

“I don’t want the police to be running around after my giraffe again,” he says.

“I’d feel like a bad giraffe owner.”

And he’s hopeful the thieves are brought to justice soon.

He says, “No metal animal sculpture in this town is safe until we find the people who stole ours.” n

“Nothing but a barefaced lie/Is all you cunts can hold onto.”

T

hey go low, we go high my ass.

As our friends and families die en masse, one of the continuing annoyances of the Democratic party is its complete and utter lack of backbone to call Republican leaders what they really are, as often and as vulgar and as ceaselessly as possible, while instead trying to maintain some modicum of pre-internet civility. Consequently, by brute-force design, the daily 40,000-foot tidal wave of grotesque right-wing fuckery, smug trolling and crimes against humanity is still working — crashing down on the left while some lost souls still whine into a void “This is not normal!” and hyperventilate tweets into a digital paper bag.

In history class, I once learned that one of the reasons we defeated the British so handily is because they arrived on our shores with their Rules of War, and we were leaping out of trees and shit, with knives and squirrel guns and insurgency-like ambuscados. “This isn’t normal!” the British cried as they a-kept a-runnin, down the Mississippi to the Gulf of Mexico. Similarly, in public, Democrats clutch their pearls and use cow-flop phrases like “the president ought not to” and “we mustn’t”

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and “they should be ashamed” and “history will judge.” Man, come off it.

Just once, I’d love to see a rascally Claire McCaskill or Al Sharpton appear on MSNBC to discuss the GOP and quote the Scottish band Young Fathers: “Nothing but a barefaced lie/Is all you cunts can hold onto,” before Ari Melber frantically cuts to commercial (an advertisement for truck liners that are COVID-resistant). Wouldn’t that be a breath of fresh air with Terry Gross?

But, were that to happen, they’d of course be shamed — SHAMED! — by Progressive Twitter for a month for their choice of problematic words during the left’s out-of-touch, hand-bell-ringing march to utterly blow another election.

So until then, as Jim Croce lamented, we will have to say it in a song.

Young Fathers’ “Shame” (the sound of TV on the Radio, if they were soccer hooligans) lays this sentiment out nicely. The driving momentum gets under your skin immediately in just three buzzy notes over a syncopated beat that sounds harvested from one of those Hammond organs every house had in the ‘70s. To my pleasant surprise, it also shows up in an episode of the criminally un-talked-about queer Netflix comedy-drama Feel Good. What a great needle-drop song in the decade of lies to come.

“What you do to feel better? What you do to feel good?” the choir ends.

Or, more appropriately, how do you sleep at night, all of you? n

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SAVAGE LOVE UNPLUGGED

BY DAN SAVAGE Hey, Dan: My wife asked me to write to you about our situation. e’ e been arr ed or fi teen years. I am 50 years old and my wife is a decade younger. We are a heterosexual couple with kids.

I am a submissive male and I like to play with my ass using different sized dildos. I enormously enjoy being penetrated with sex toys. A few years ago I introduced the idea of a FLR — female-led relationship — to my wife and she accepted it.

We are a happy couple! My wife is more on the traditional side of sex and I respect that. We have PIV sex twice a week and I try to give her pleasure as much as I can.

Looks like everything is OK, right? But recently she complained that I have stopped ejaculating when we have sex. And it’s true: When we engage in vaginal penetration, I no longer ejaculate. I like it this way because I don’t lose my sex drive and I can continue.

But she doesn’t like it. For her my ejaculate is the “cherry on top” of the sex and my coming during sex is important for her pleasure and satisfaction. My wife thinks that I stopped ejaculating because I developed the habit of pleasuring myself with dildos and butt plugs in the shower. My wife thinks the toys are distracting me. Do you think it’s true? If that’s the case, what should we do? I love my wife but I also love my butt plugs and dildos.

Spouse Unpleased By Husband’s Un Blasts You should come in your wife.

If your wife is in charge — you proposed a “female-led relationship” and she accepted — then she gets to give the orders and you’re supposed to do what she says. (Within reason, of course.)

So when she says, “Come in me,” you should say, “How high up your vaginal canal would you like me to come?” Even if you weren’t in a female-led relationship, SUBHUB, refusing to come in your wife when you know that feeling you come inside her is important to her pleasure is a weirdly literal kind of withholding behavior — and considering how GGG your

wife has been, SUBHUB, refusing to come in her so you can “continue,” presumably without her, isn’t something a loving submissive ould do. It s something a selfish asshole does.

Your wife doubtless suspects the same thing I do: You aren’t coming in her because you’d rather blow your load in the shower. She sees you when you slip out of bed to go cram sex toys in your ass and blow your load down the drain instead of finishing in her. And if that s what you’re doing — and I’m pretty sure that’s what you’re doing — then you’re treating PIV sex with your wife as foreplay and the time you spend alone with your ass toys as the main event. If I were your ife, , I ould find that annoying too. And ho ever much you love your plugs and dildos, I would hope you love your ife more. At any rate, you aren t submissive to your plugs and dildos — you’re submissive to your wife, who isn’t made of silicone and who has needs and feelings that have to be taken into account.

At the very least, , your wife’s pleasure should be your first priority during I sex and it’s not like you can’t combine PIV with a little butt play.

You can always shove one of your beloved plugs in your ass before you have PIV sex with the wife.

And if you didn t refrain from ejaculating every single time you had PIV, SUBHUB, if it was something you were allowed to do once in a while with your wife’s permission, she might be willing to accommodate your desire every tenth time you have PIV. Hey, Dan: I am a 53-year-old guy.

Since I’ve been struggling with depression and anxiety all my life, I’ve never been in a situation where sex was a possibility. I’m really dying to know what it’s like. I’ve gotten much better over the years and the women who know me think the world of me. But they aren’t in a position to help me out. Other women seem to want someone uch ore out o n and confident than a or e er w be onfidence comes from experience and I don’t have any. My one girlfriend could not hide the fact that my inexperience offended her. Other people on blogs and such have recommended a prostitute. But that’s not really what I’m looking for. It’s

However much you love your plugs and dildos, I would hope you love your wife more. about more than sex. I want someone to care for me as I am. Is there hope for me? Or has the world just left me behind?

Very Inexperienced Relationship Guy In Need I know it’s not what you want to hear, VIRGIN, but I agree with other blogs and such: I think you should find a sex orker. ind a nice, patient woman who does sex work and be completely upfront about why you’re seeing her: You’re so painfully self-conscious about your sexual inexperience that you find it hard to date. It may take some searching, VIRGIN, but there are sex workers who want to help their clients grow and heal. “Many people have the stereotypical misconception that all sex workers are disconnected, uncaring and only there for the money,” said Ruby Ryder, a sex worker and sex educator. “While money is indeed a part of it, many of us understand that human beings need touch, connection and acceptance. We provide an opportunity for clients to be vulnerable, hether it s fulfilling their kinky fantasies or simply having sex.”

And hile the relationship you have with a sex worker you might see regularly for a year or two is certainly transactional, VIRGIN, it’s still a relationship and about more than sex.

I’m not suggesting you see sex workers exclusively for the rest of your life (even if I’m not not suggesting that either), VIRGIN. I’m only suggesting you see a sex orker to find out hat sex is like, gain a little self-confidence and maybe feel a little more hopeful for your future.

Ruby Ryder is on Twitter @ Ruby_Ryder and online at www. peggingparadise.com.

Hey, Dan: I’m a longtime reader

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who’s never had a question that your archives couldn’t answer.

But there is something I wanted to share with you and your readers! My wife and I have incorporated virtual reality (VR) goggles into our sex life with great success, Dan, and they could be the answer to a range of questions that you get at the column. They’re so useful, in fact, that your failure to mention them is starting to look like a glaring omission! Because let’s say someone writes in who wants to open their relationship or explore a cuckold fantasy (like one of last week’s letter writers!) but they’re worried about the emotions involved, potential STIs, or COVID-19? VR goggles! While the offerings for female POV VR porn is pretty paltry I’ve never seen my wife come harder than she did with me inside her and a pair of goggles on her face giving her the perspective of a man getting fucked by a beautiful trans woman. I love the idea that this turns her on and I actually think she looks hot with goggles on! Besides the cost of a subscription to a VR porn site, the financ a barr er s rea rett low — most people can use their smartphone and a $20 headset to get started, which is much cheaper than seeing a sex worker and much less time consuming than engineering a consenting affair. And there’s no risk of STIs or COVID-19!

Just wanted you to consider VR as a possibly overlooked tool for your otherwise always-outstanding advice in the future!

Very Recent Purchase Optimizes Reality Nicely Thank you for writing in, VRPORN, and you’re right: VR porn sounds like a great way for an adventurous monogamous couple to have a little virtual variety — whether that couple is monogamous by choice or monogamous for the duration of this stupid pandemic. In addition to the technology, of course, you’ll need a partner who not only knows you fantasize about other people (like they do, like everybody does), but who’s also excited about helping you explore those fantasies. Thanks again for sharing, VRPORN! Check out Dan’s podcast at www.savagelovecast.com mail@savagelove.net @FakeDanSavage on Twitter

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