A billionaire pharmaceutical CEO faces up to 20 years in prison after being found guilty of a bribery and kickback scheme to get doctors to prescribe addictive painkillers to people who didn’t need them.
It is the first conviction of a high-profile pharmaceutical executive related to the opioid crisis plaguing the nation.
The case revealed details of the efforts by John Kapoor and his company, Insys Therapeutics, to get doctors to over-prescribe opioids, including giving them lap dances, producing a rap video glamorizing higher doses of the drugs, and rewarding salespeople for selling higher-dose medications.
A federal judge found Kapoor and four former executives guilty Thursday of racketeering for its methods of getting physicians to prescribe Subsys, a highly potent fentanyl spray used to treat cancer patients, to cancer-free patients who did not need it.
“Today’s convictions mark the first successful prosecution of top pharmaceutical executives for crimes related to the illicit marketing and prescribing of opioids,” said U.S Attorney Andrew Lelling. “Just as we would street-level drug dealers, we will hold pharmaceutical executives responsible for fueling the opioid epidemic by recklessly and illegally distributing these drugs.”
A Boston jury deliberated for 15 days and issued five guilty verdicts for racketeering conspiracy charges.
Insys executives and sales representatives went to unorthodox measures to attract prospective prescribers. Two Insys sales representatives made a music video in 2015 to show at a national sales meeting illustrating a method used to increase dosages, called titration. As the two men dance around a person in a Subsys dispenser costume, they say “I love titrations, and it’s not a problem. I got new patients, and I got a lot of them.”
Insys sales representatives also lured doctors in by giving them lap dances. Holly Brown, a former Insys sales representative in Chicago, testified that her boss, a former exotic dancer, gave a doctor a lap dance to persuade him to prescribe more of the fentanyl spray.
The 10-week trial revealed Insys Therapeutics’ strategies for recruiting doctors and manipulating insurers to cover a high volume of Subsys prescriptions. Subsys becomes more expensive as the dosage climbs, but patients are more prone to becoming dependent, as it is 100 times more potent than morphine.
Former sales representatives said their bonuses were directly tied to the dosages prescribed. With a higher prescribed dose, the sales representative would get a higher bonus payment. Representatives also had to justify to their supervisor why some doses were lower than they would have liked within 24 hours.
Doctors who prescribed Subsys practice in many states including Alabama, Florida, Illinois, Connecticut, and more. A physician in Alabama tied to the case was sentenced in 2017 for 20 years.
The other executives found guilty were Richard Simon, former national director of sales, former regional sales directors Sunrise Lee and Joseph Rowan, and Michael Gurry, former vice president of managed markets.
After the verdicts were issued, Beth Wilkinson, a lawyer for Dr. Kapoor, said, “Four weeks of jury deliberations confirm that this was far from an open-and-shut case,” and that Kapoor’s legal team “will continue the fight to clear Dr. Kapoor’s name.”
