Appeals Court Affirms All Convictions of Insys Executives

Today, the First Circuit affirmed all of the convictions of the executives of Insys, the manufacturer of a highly-addictive sublingual fentanyl spray that the FDA had approved only to treat breakthrough cancer pain. Congratulations to Assistant United States Attorneys Nat Yeager and David Lazarus for successfully leading perhaps the most important pharma prosecution of this century. Here are two sentences from the first paragraph of this 141-page decision: “The facts of this mammoth case, as supportably found by the jury, tell a chilling tale of suffering that did not need to happen. It involves a group of pharmaceutical executives who chose to shunt medical necessity to one side and shamelessly proceeded to exploit the sickest and most vulnerable among us — all in an effort to fatten the bottom line and pad their own pockets.” The court went on to observe that the jury reasonably concluded that the lead defendant, John Kapoor, Insys’s founder, “relentlessly pursued pill mill doctors, pressured health-care practitioners to increase dosages regardless of medical need (through financial incentives and upfront prescription commitments), knew of and encouraged certain physicians’ illegitimate prescribing habits, and — facing regulatory scrutiny for the burgeoning sales generated through these tactics — tried to hide the true state of affairs by cutting out the middleman.”