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Opioid Executive Guilty Verdict Means Other Pharma Execs Could Be Charged with Racketeering

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A book with fentanyl described and test tubes on a table illustrating pharmaceutical company creating fentanyl-based drugs

Insys Therapeutics’ founder was convicted of racketeering conspiracy related to fentanyl-based Subsys. Fentanyl is one of the leading causes of drug overdose deaths in the U.S., but effective fentanyl detox treatment is available.
BEVERLY HILLS, Calif., May 3, 2019 — Former billionaire and Insys Therapeutics founder John Kapoor was found guilty of racketeering conspiracy by a Boston jury on May 2, 2019. According to NPR, he’s among the highest-ranking pharmaceutical executives to face trial related to the opioid epidemic.
The verdict is a major win for federal prosecutors and lays the foundation for holding more drug company executives responsible for their roles in the opioid crisis. The federal government now has a successful case to show how a pharmaceutical company’s illegal methods of increasing sales can resemble and be prosecuted as organized crime.
Kapoor and his co-defendants faced federal charges of running a nationwide bribery scheme. The scheme included paying doctors to prescribe their opioid medication, Subsys, and having staff lie to insurance companies to get it covered, reported NPR.
Subsys is a fentanyl sublingual spray medication. According to the company website, it is prescribed in doses of 100 mcg to 1600 mcg with as many as 120 unit doses per container. A container of 800 mcg Subsys with 30 units can cost over $6,700, according to Drugs.com.

Criminal Tactics Used by Kapoor’s Pharmaceutical Company

NPR reported that Insys sought out doctors who allegedly already had a track record of prescribing opioids liberally. The company reportedly bribed the doctors to prescribe Subsys under the guise of paying the doctors to participate in the company’s “speakers program.” The company paid doctors whether they attended the program or not as long as they wrote many prescriptions for Subsys. At the pharmaceutical executive’s trial, prosecutors alleged that these doctors prescribed the medication to patients who did not need it.
The second half of the scheme covered in the trial involved the Insys company call center. The drug company’s employees allegedly pretended to work for the doctors’ offices and lied about patient diagnoses to ensure the prescriptions were covered.
The Arizona-based company’s future is in jeopardy in light of financial, legal, and management problems. In August 2018, the company reached a deal with the U.S. Justice Department to pay $150 million over five years, and potentially another $75 million, to resolve the department’s investigation into claims the company had paid doctors to prescribe Subsys.
With this latest legal win, federal prosecutors have a model for winning a criminal case against an opioid executive. Other cases are already being pursued. On April 23, for example, prosecutors charged Rochester Drug Co-Operative — one of the 10 largest pharmaceutical distributors in the U.S. — with conspiracy to distribute oxycodone and fentanyl for nonmedical reasons and conspiracy to defraud the U.S. The company’s former CEO, Laurence Doud, and former chief of compliance, William Peitruszewski, were charged with willfully failing to file suspicious order reports to the Drug Enforcement Administration, reported NPR.
State and local governments are pursuing similar litigation, according to the Associated Press. For example, in April, New York’s state sued the Sackler family of Purdue Pharma, the company that created OxyContin.

More Regulations Are Needed to Stop Ongoing Unethical, Aggressive Drug Sales Tactics

Although paying doctors to write prescriptions is illegal, NPR’s reporting noted that paying physicians to promote a product is still a common, legal practice in the pharmaceutical industry. Similarly, off-label prescribing by doctors is legal and common; however, drug sales representatives are not supposed to advocate for off-label uses.
These practices, along with aggressive drug marketing tactics, are legal. They also can be considered unethical. Such methods have contributed to fueling the opioid epidemic. More government regulation of drug companies’ marketing and interactions with doctors could help end the opioid crisis.

Fentanyl Is One of the Leading Causes of Drug Overdose Deaths

Fentanyl is a synthetic opioid that is stronger than morphine and heroin. It is designed to decrease physical pain as well as a person’s emotional response to pain. Insys Therapeutics’ drug Subsys, for example, is a fentanyl-based prescription pain medicine used to manage pain in cancer patients.
The Subsys warning information includes the risk of life-threatening respiratory depression; addiction, abuse, and misuse; adverse reactions such as vomiting; and more. Numerous negative side effects and drug interactions can occur.
Fentanyl’s potency and addictiveness make it one of the most dangerous opioids available. “Among the more than 70,200 drug overdose deaths estimated in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs, with more than 28,400 overdose deaths,” according to the National Institute on Drug Abuse and Centers for Disease Control and Prevention.

Non-Opioid Fentanyl Detox Treatment Is Available

People struggling with opioid use disorder can benefit from medical detoxification treatments that do not involve replacing opioids. Medical detox provider Waismann Method®, one of the originators of rapid opiate detoxification, offers fentanyl detox in a private accredited hospital. Medical detoxification is tailored to each patient’s unique needs, and full treatment typically lasts seven to 10 days.
This inpatient fentanyl detox is performed by Waismann Method®’s quadruple board-certified medical doctor in a private room at a JCAHO-accredited hospital. Because fentanyl is such a strong opioid, withdrawal without proper medical management can be intense and dangerous, potentially resulting in respiratory failure. However, when detoxing in a full-service hospital, patient risk is greatly reduced, and medication is available to manage withdrawal symptoms, discomfort, and cravings.
Waismann Method® has one of the highest opioid detox success rates in the U.S. Its medical director has successfully treated thousands of patients suffering from opioid use disorder.
This kind of superior medical support is key to helping people get free from an overpowering drug like fentanyl. Whether a patient has developed a dependence on a fentanyl-based prescription drug, abused a prescription painkiller, or uses an illicit form of fentanyl, medical detox can provide a means to get off the drug successfully.
About the Waismann Method® Experts
Clare Waismann, certified addiction treatment counselor, is the founder of Waismann Method® Advanced Treatment of Opiate Dependence and Domus Retreat. As an addiction treatment specialist with over 21 years’ experience, Waismann has served as an advocate for patients suffering from opioid use disorder and mental illness, working to provide the public with the proper education to eliminate the stigma associated with both conditions. Waismann, her team, and Waismann Method® have been featured in The New York Times, USA Today, Fox News, Vogue Magazine, WIRED Magazine, and many other media outlets worldwide.
Dr. Michael H. Lowenstein, M.D., serves as the medical director for Waismann Method®. He is a quadruple board-certified physician. His board certifications include anesthesiology, addiction, medicine, and pain management. Dr. Lowenstein is recognized by the international community as a leader in opiate detoxification and has provided cutting-edge medical treatment for patients suffering from opioid use disorder for over two decades. Dr. Lowenstein enhances detoxification protocols to offer medical treatment for additional substances more safely and effectively. Our commitment to our patients’ well-being is as strong now as it was 20 years ago when Waismann Method® was founded.

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