Wall Street, bribery and an opioid epidemic –

June 18, 2020 – Seven of the Insys executives and employees on trial were found guilty of masterminding and participating in a scheme to bribe doctors to prescribe the drug. Kapoor was sentenced to five and a half years on charges that included racketeering conspiracy. Michael Babich, Insys’ former chief executive, and Alec Burlakoff, former vice-president of sales, co-operated with prosecutors and received two and a half, and 26 months, respectively. 

Insys was a flagrant flouter of the rules. Founded in 2002, it started clinical trials for its under-the-tongue fentanyl spray in 2007. Subsys won regulatory approval in 2012, more than a decade into the opioid crisis, when overdose deaths were already rising and after other pharma companies had been fined for mismarketing opioids. The company used tactics familiar in the US pharmaceutical industry — but took them across the line into illegality. Many drugmakers pay speakers’ fees to doctors, with the understanding that they will recommend their product to peers at educational events — but Insys made it clear that they expected more prescriptions in return for their money. Sometimes it abandoned the pretence of such events completely. Subsys was approved for “breakthrough” bursts of pain in cancer patients already tolerant to opioids, yet the majority of prescriptions were for patients, like Fuller, who did not even have cancer. It is legal and common for doctors in the US to prescribe drugs “off label” or for uses they are not approved for. But it is illegal for pharmaceutical companies to market their medicines for these other uses.

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