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Some opioid executives are finally going to prison

A rare moment of serious accountability for an American corporation.

John Kapoor, founder and former CEO of Insys, goes to trial in Boston on January 29, 2019.
John Kapoor, founder and former CEO of Insys, goes to trial in Boston on January 29, 2019.
Craig F. Walker/The Boston Globe via Getty Images

A federal court has sentenced former executives of Insys, including founder and ex-CEO John Kapoor, to years in prison for their role in irresponsibly marketing the painkiller Subsys and perpetuating the opioid epidemic.

On Thursday, US District Judge Allison Burroughs sentenced Kapoor to five-and-a-half years in prison — less than the 15 years requested by prosecutors but more than the one year requested by his defense. The other executives previously received sentences between one and three years.

The executives were previously found guilty of criminal racketeering — the kind of charge under the Racketeer Influenced and Corrupt Organizations Act that’s typically used to shut down the mob and drug trafficking organizations.

Throughout the trial, prosecutors detailed Insys’s far-reaching efforts to sell as much of its potent opioid painkiller, Subsys, as possible, beyond its approved use for cancer pain. According to the New York Times, prosecutors accused the company of paying off doctors for, say, fake educational talks, so they’d prescribe the drug widely. It also misled and lied to insurance companies so they would pay for the medication. The company even hired a stripper, Sunrise Lee, as a sales executive, and a former employee said she saw Lee give a doctor a lap dance to get him to prescribe more of the opioid.

At one point, Insys also produced a rap video for Subsys. (One of the lines in the song is that they’re “always compliant like we supposed to be.” Apparently not.) An executive who dressed up as a bottle of the addictive painkiller in the video, Alec Burlakoff, was among the sentenced.

Insys previously admitted to the kickback scheme and agreed to pay $225 million, then filed for bankruptcy shortly after, NPR reported.

It’s not the first time an opioid company has been found guilty of criminal charges. In 2007, Purdue Pharma, the maker of OxyContin, and three of its top executives paid more than $630 million in federal fines for misleading marketing. The three executives were also criminally convicted, each sentenced to three years probation and 400 hours of community service.

Other companies involved in the opioid business, such as Rochester Drug Cooperative, have also recently faced criminal charges. Opioid manufacturers and distributors more broadly face thousands of lawsuits for their role in perpetuating the current drug overdose crisis by irresponsibly marketing painkillers.

What’s unique about the Insys case, though, is the outcome of prison time. Activists and experts have long argued that prison time is necessary to really hold opioid companies and their executives accountable for their role in the drug overdose epidemic.

“If [Purdue’s owners] have the perception — and it’s the correct perception — that ‘people like us just don’t go to jail, we just don’t, so the worst that’s going to happen is you take some reputational stings and you’ll have to write a check,’ that seems like a recipe for nurturing criminality,” Keith Humphreys, a drug policy expert at Stanford University, previously told me.

Since the 1990s, roughly 400,000 people have died from opioid overdoses — either on painkillers themselves, or in many cases heroin or illicit fentanyl through a drug addiction that began with painkillers. Pharmaceutical companies were at the forefront of causing the crisis with aggressive marketing that pushed doctors to prescribe more painkillers, putting the drugs not just in the hands of patients but also of friends and family of patients, teens who took the drugs from their parents’ medicine cabinets, and people who bought excess pills from the black market.

Insys arrived somewhat late to the game, with Subsys coming to the market in 2012. In this way, it benefited from the previous misconduct of opioid companies that had done a lot of the groundwork in expanding prescriptions for opioids.

Studies have linked marketing for opioids to more prescriptions and overdose deaths.

“You can go to prison for accidentally killing one person with your car. That’s the minimum standard,” Rick Claypool, a research director at Public Citizen, previously told me. “The idea that you can run a company and cause societal-level devastation and walk away from that relatively unscathed is mind-boggling.”

For more on the case for prosecuting opioid executives, read Vox’s full story.

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