On Thursday, a Boston jury found that John Kapoor, founder of pharmaceutical company Insys, as well as four high-ranking executives at the company guilty of racketeering on the grounds that they had conspired to boost sales of one of its fentanyl-based medications.
After deliberating for 15 hours, the jury found that the five individuals had bribed doctors to prescribe Subsys, an under-the-tongue fentanyl spray approved to treat patients with cancer. A synthetic opioid that is 50 to 100 times more potent than morphine, fentanyl is highly addictive and dangerous; nearly half of the opioid-related deaths in the United States in 2016 were due to fentanyl overdose, according to the National Institute on Drug Abuse.
The jury found that the Insys executives bribed medical providers with lap dances to encourage them to prescribe the drug, as well as paying doctors to give talks at phony marketing events promoting the drug. The jury also found that they deliberately misled insurers about patients’ need for the drug as a way to boost its sales.
Founded in 1990, the Arizona-based Insys Therapeutics was once a leading pharmaceutical firm, at one point generating more than $300 million in sales. Prosecutors alleged during the trial that from 2012 to 2015, the company launched an aggressive strategy to target doctors and bribe them to recommend the drug to patients.
According to testimony from former sales reps, Insys’ bonus system was contingent on the dosages of the fentanyl-based medication prescribed; if a doctor prescribed his patients a low dose, the sales representatives would have to explain it to their supervisors within a 24-hour period. At one point, the company even produced a rap video encouraging sales representatives to push titration, or increasing doses, on medical providers, which was introduced as evidence during the trial. The 2015 video contains the lyric: “I love titrations, and it’s not a problem/I got new patients and I got a lot of ’em.”
The Insys case is part of a larger effort on behalf of the United States government to hold pharmaceutical executives accountable for contributing to the opioid epidemic, which has taken hundreds of thousands of lives in the United States over the past few years. Most recently, the state attorneys general of New York and Massachusetts have filed suit against a number of opioid manufacturers as well as the Sacklers, the family that owns the pharmaceutical company Purdue Pharmaceuticals, which introduced the powerful opioid Oxycontin to the market in 1996 and is alleged to have been instrumental in contributing to the opioid epidemic.