On Day 13 of deliberations in Insys trial, here are 5 things you should know about the case

Insys founder John N. Kapoor is one of five people on trial for allegedly pushing opioids to patients who didn’t need them.
Pat Greenhouse/Globe Staff
Insys founder John N. Kapoor is one of five people on trial for allegedly pushing opioids to patients who didn’t need them.

Jurors weighing the fate of five former drug company executives facing federal racketeering charges in Boston finished their 13th day of deliberations Tuesday at the John Joseph Moakley United States Courthouse.

The five former officials at Insys Therapeutics are charged with participating in a racketeering conspiracy by allegedly bribing medical practitioners to prescribe a powerful fentanyl product to patients who shouldn’t have gotten it.

It’s believed to be the first criminal trial of pharmaceutical executives who marketed an opioid painkiller since the nation’s opioid epidemic began.


Here are five things you should know about the landmark case:

What did these pharma

bosses allegedly do?

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Subsys, an addictive under-the-tongue spray, was approved by federal regulators in 2012 for severe cancer-related pain. But prosecutors say Insys founder John N. Kapoor and the other defendants conspired to pay doctors to prescribe it to patients without cancer. The remaining defendants are Michael Gurry, Insys’s former vice president of managed markets; Richard Simon, former national sales director; and Sunrise Lee and Joseph Rowan, former regional sales directors.

The five allegedly funneled millions of dollars in bribes and kickbacks to key practitioners to get them to prescribe the fentanyl product Subsys. The drug went on the market in 2012, supposedly to treat cancer-related pain, and was competing against at least four other fentanyl products.

What happened at trial?

A lot. Memorable moments included the airing of a 2015 company promotional video that depicted Insys salesmen clad in sunglasses and hoodies dancing next to a giant spray bottle of the drug firm’s opioid product.

“Insys Therapeutics, that is our name,” the associates sang. “We’re raising the bar and we’re changing the game. To be great it takes a decision, to be better than the competition.”


About three minutes into the rap video, a purple-and-white Subsys bottle with a label marked 1,600 micrograms — the maximum dosage for the under-the-tongue spray — appears in a playground where the salesmen are rapping. The bottle then joins the duo, who go by the names Z Real and A Bean.

The refrain in the song — inspired by the rapper A$AP Rocky — is, “I love titration, yeah that’s not a problem. I got new patients, and I got a lot of ’em.” Titration refers to adjusting the dosage of a drug.

There was also testimony from Holly Brown, a former Insys sales representative, who told jurors about one night in October 2012 at a club in Chicago called the Underground.

Brown said she had gone there with Lee and a doctor named Paul Madison, who had become one of Insys’s most valuable physicians, prescribing Subsys regularly to his patients, none of whom had cancer.

The group had been drinking heavily, and Brown testified that she turned around at one point to see Lee, a former exotic dancer, straddling Madison.


“She was sitting on his lap and kind of bouncing around,” Brown said. His hands were on her chest, she testified.

“Do you feel like you were getting a message about what tactics to use to market this product?” Assistant US Attorney Fred Wyshak asked.

The defense objected before she could answer.

What kind of money are we talking about?

Big money. Prosecutors said Kapoor, a one-time billionaire, was desperate for Subsys to succeed after the Food and Drug Administration approved it in 2012 for cancer patients.

Kapoor had invested $59 million in the Chandler, Ariz., company from trusts that he controlled and wanted to recoup his investment.

Kapoor and his codefendants paid unscrupulous physicians millions of dollars in bribes to prescribe a powerful opioid painkiller to patients who shouldn’t have gotten it — and sometimes got addicted — in a scheme of “brazen audacity,” said Assistant US Attorney K. Nathaniel Yeager during his closing argument in early April.

He said the under-the-tongue fentanyl spray was approved specifically for severe cancer pain, but eight practitioners who took more than $1.1 million in bribes sometimes prescribed it for neck injuries, neurological conditions, and other forms of pain.

Kapoor’s lawyer countered that the Insys founder genuinely thought Subsys was a game-changing opioid and wanted it widely prescribed because he saw his wife suffer horrific pain before she died of metastatic breast cancer in 2005.

What happens if they are convicted? And what if the jury can’t reach a verdict?

If convicted of racketeering conspiracy, they each could be sentenced to up to 20 years in prison. If the jury ultimately fails to reach a verdict, a mistrial would be declared and prosecutors in US Attorney Andrew E. Lelling’s office would have to decide whether to try the case again.

Speaking of Lelling, what does this mean for him?

Even though the case against the Insys executives was initially brought by Lelling’s predecessor, a verdict would once again thrust the current US attorney in Massachusetts into the spotlight, following a string of recent high-profile cases that Lelling’s team has brought in US District Court. Lelling last week stunned the local legal establishment when he announced obstruction charges against a state court judge for allegedly helping an undocumented immigrant evade ICE custody inside her courthouse.

In March, Lelling’s office brought charges against 50 people in connection with the nationwide college admissions cheating scandal that alternately outraged and fascinated the public with details of wealthy parents, including Hollywood stars and captains of industry, allegedly paying bribes to help their children get into fancy schools, or to facilitate cheating on their kids’ SAT and ACT exams.

Lelling’s office is also handling the closely watched case against Louis D. Coleman III, a Providence man accused of kidnapping Jassy Correia off a Boston street and causing the death of the young mother, whose body was found in a suitcase in his vehicle in Delaware.

If convicted, Coleman could face the death penalty, but prosecutors haven’t yet said whether they’ll seek capital punishment.

Maria Cramer and Jonathan Saltzman of the Globe staff contributed to this report. Travis Andersen can be reached at Follow him on Twitter @TAGlobe.