For some people, working in pharma is a privilege; a chance to improve people’s lives by contributing to the spread of better, safer drugs. That was not the case with John Kapoor, the founder of the successful Insys Therapeutics.
According to federal prosecutors, Kapoor went as far as paying doctors millions of dollars nationwide so they would prescribe his company’s highly addictive painkillers, in order to boost sales. An affluent man, largely thanks to Insys’ good performance, Kapoor was accused by Assistant U.S. Attorney David Lazarus of turning his business into a criminal organization, “from top to bottom.”
When addressing jurors, and TV cameras, in Boston last January, the Asst. Attorney focused specifically on Kapoor’s main motivation, the one that led him to ruin many American lives by making patients addicted to dangerous opioids. “This is not a complicated case,” he said, “It’s a case about greed — about greed and its consequences — and what happens when you put profits over people.”
Although many people have been prosecuted in connection with the rampant opioid crisis, never before has the head of an involved drug company faced a jury. The New Yorker famously reported on the company making the most money off opioids in the country, whose philanthropic owners (the Sackler family) haven’t suffered as much as a scratch from our justice system. Hopefully, Kapoor’s example will send a message that a sleek corporate office in Manhattan and an army of lawyers are no longer protection enough against the arm of the law.
Insys Therapeutics is based in Chandler, Arizona. Its drug Subsys, which contains the synthetic opioid fentanyl, is meant to treat acute pain in cancer patients. Kapoor, who is 75, is not the only person standing trial, he is joined by a handful of his former employees.
Prosecutors allege that Kapoor and his co-conspirators came up with bogus speaking fees to cover up massive bribes and kickbacks paid to doctors all over the country. Drugs like Subsys should only be prescribed in cases where nothing else will work, because they are highly addictive and can create new health problems for patients. But Kapoor’s “friendly” doctors were prescribing it left and right, for years, in exchange for a fat check, the Assistant U.S. Attorney claims.
In their opening statement, Kapoor’s defense did not deny that the company was paying doctors handsomely to speak about the benefits of Subsys, arguing that this is a common practice in pharma. They tried to present the defendant as someone who was solely motivated by an urge to help people deal with chronic pain. They had a card up their sleeve: Kapoor’s wife suffered from breast cancer, so the man knows how unbearable the pain can be. “He did not want that to happen to anyone else,” one of his attorneys told the jury.
But no matter how many tear-jerking stories the defense might come up with, the fact is some of Kapoor’s former associates have caved; they are cooperating with the prosecution, after pleading guilty in exchange for leniency. One of the key witnesses is the company’s former sales executive, Alec Burlakoff.
If they are found guilty of racketeering conspiracy, Kapoor and his co-defendants could go to prison for up to 20 years. This is not the first time corporate greed has put Insys in dire circumstances. In 2018, the company agreed to a $150 million settlement in a federal case over inappropriate sales.
This may all sound like a lot of numbers and cold facts. But that is not the case for the patients who were, unbeknownst to them, turned into opioid addicts by greedy doctors and a corrupt company, patients who later had to experience shocking withdrawal symptoms when they stopped taking the drug.
Prosecutors allege that Insys specifically looked for doctors running “pill mills,” who could be easily corrupted. They knew people might suffer and die, but they didn’t care. This is what usually follows when greed is the driving force behind a corporation’s actions: death and destruction. In fact, whenever doctors increased Subsys doses for patients, putting their lives at risk, Kapoor and Insys rewarded them with large bonuses. According to Asst. U.S. Attorney Lazarus, Kapoor wanted, “success at all costs,” and the law wasn’t going to stop him. The trial is expected to last three months.