Leaders of Insys, opioid society, convicted of criminal charges

Leaders of a major opioid company, Insys Therapeutics, were convicted Thursday by a federal jury for, among other mischiefs, having bribed doctors to prescribe their fentanyl-based pain reliever – another sign that the federal government and the public are increasingly willing to hold trials. individuals and companies responsible for their role in the national opioid epidemic.

The verdict concerns company founder John Kapoor and four other executives: Richard Simon, former national sales director; Sunrise Lee, former Regional Sales Manager; Joseph Rowan, also former Regional Sales Manager; and Michael Gurry, former Vice President of Managed Markets. The executives were convicted of criminal racketeering.

Throughout the trial, prosecutors detailed Insys' extensive efforts to sell as much as possible of its powerful opioid painkiller, Subsys, beyond its approved use for cancer pain. According to the New York Times, prosecutors have accused the company of paying doctors – for false educational talks, for example – for them to widely prescribe the drug. He would also have misled and lied to insurance companies to pay for the drugs. And a former employee told that she had seen Lee, who was previously an exotic dancer, give a doctor a lap dance to make him prescribe more opioids.

At one point, Insys also produced a rap video for Subsys. (One of the song's claims is that they are "always consistent, as was supposed." Apparently not.)

After 15 days of deliberation, the federal jury recognized the five guilty leaders. The charges include the potential for jail time.

This is not the first time an opioid society has been convicted of criminal acts. 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 leaders were also sentenced to three years probation and 400 hours of public works.

Last month, federal prosecutors criminally charged a leading drug distributor, the Rochester Drug Cooperative, for its role in perpetuating the opioid crisis.

And this week, another drug distributor, McKesson Corporation, has settled $ 37 million with West Virginia in an opioid lawsuit.

The recent verdict against Insys and the charges against Rochester are part of a broader effort to hold pharmaceutical companies accountable – in the form of lawsuits, fines and charges – for their involvement in the crisis. drug-related overdose, the deadliest in the history of the United States.

Hundreds of lawsuits have now been filed against companies. Several states are pursuing individually, and Oklahoma has recently concluded another legal settlement with Purdue. A federal judge in Cleveland has grouped around 1,600 lawsuits, mostly from different levels of government, with the goal of finding a historic legal solution to the opioid epidemic.

The success of the lawsuit against Insys suggests that courts and juries are prepared to punish the companies involved.

Since 1999, more than 700,000 people have died in the United States as a result of a drug overdose, mainly because of the increase in the number of opioid-related deaths. It's comparable to the number of people currently living in big cities like Denver and Washington, DC. According to some estimates, hundreds of thousands of other people could die of opioid overdoses over the next decade.

The hope of legal action against opioid manufacturers and producers is not only to hold them accountable, which could in itself deter drug companies from misbehaving, but also from obtaining funds, in the form of fines or other legal payments that can be used to pay for the treatment of drug addiction. Drug treatment is notoriously underfunded in the United States, experts in recent years urging the federal government to invest tens of billions of dollars in the establishment of a treatment infrastructure. (For reference, a study conducted in 2017 by the Council of Economic Advisers of the White House associates a year of crisis with opioids to economic losses of 500 billion dollars.)

A settlement of $ 37 million represents only a drop of water in this basket, as are the fines and regulations that are paid by other companies (including Insys). But as companies such as Purdue, Rochester, McKesson and Insys have helped provoke and perpetuate the opioid crisis, lawyers say they should at least help cope with the aftermath of the epidemic.

How manufacturers and distributors of opioids have contributed to the epidemic of opioids

The epidemic of opioids can be understood in three waves. In the first wave, beginning in the late 1990s and early 2000s, doctors prescribed many opioid analgesics. This led to a widespread proliferation of drugs and their addictions – not only patients, but also friends and families of patients, teenagers who were taking medication in their parents' medicine cabinets and those who were buying excess pills. at the black market.

A second wave of drug overdoses took off in the 2000s, when heroin invaded the illicit drug market, traffickers and traffickers took advantage of a new population of opioid users, but lost their access to analgesics or just looking for a higher, cheaper drug. And in recent years, the United States has experienced a third wave, while illicit fentanyls offer an even more powerful, less expensive and more deadly alternative to heroin.

This is the first wave that really triggered the opioid crisis and where opioid manufacturers and distributors are coming on the scene.

Drug manufacturers have misled opioid analgesics marketed as safe and effective, with many studies linking commercialization and opioid proliferation to abuse, dependence, and overdose. Opioid manufacturers like Purdue Pharma, Endo, Teva and Insys are all accused of playing a role here.

As a group of public health experts explained in the Annual Public Health Review, companies exaggerated the benefits and safety of their products, supported advocacy groups and "educational" campaigns encouraging widespread use of opioids and urged legislators to ease access to medicines.

The result: with the increase in opioid sales, addiction and overdoses have also increased.

Annual Public Health Review

Insys arrived a little late in the game. Subsys came on the market in 2012. In this way, it took advantage of the previous misconduct of opioid companies that had worked hard to develop the number of prescriptions. # 39; opioids.

It's not just that opioids were deadly; they were nowhere as effective at treating chronic noncancer pain as companies claimed. There is very little scientific evidence that opioid analgesics can effectively treat long-term chronic pain as patients become opioid-tolerant – but there is ample evidence that prolonged use can lead to very serious complications, including increased risk of addiction, overdose, and death. In short, the risks and inconveniences outweigh the benefits for most patients with chronic pain.

With drug overdoses linked to tens of thousands of deaths each year, different levels of government, as well as private groups and individuals, are now trying to get drug companies to report on the opioid crisis. That's why the news of Thursday's verdict against Insys executives is very important: it shows that the general effort to hold these companies to account can actually produce results.

To learn more about lawsuits against opioid companies, read the Vox Explainer.