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Federal prosecutors in Boston have rested their case against John Kapoor, an opioid entrepreneur and a onetime billionaire. Kapoor is the founder of Insys Therapeutics. He and four of his colleagues are accused of racketeering, a charge that's often used to prosecute organized crime. If convicted, they could face many years in prison. Gabriella Emmanuelle of member station WGBH reports.
GABRIELLE EMANUEL, BYLINE: Two months ago, Paul Lara saw a letter from his doctor to his insurance company. Next to his doctor's signature...
PAUL LARA: It says, does this patient have cancer? He marked yes.
EMANUEL: Only one problem - Paul Lara has never had cancer. A commercial fisherman in Texas, Lara was badly injured on the job. In 2013, his doctor prescribed him an opioid called Subsys. It's 100 times stronger than morphine. The medication is only approved for cancer patients in severe pain.
LARA: I was shocked. I was really, really shocked.
EMANUEL: Federal prosecutors believe Paul Lara was a victim in a complex scheme by Insys therapeutics to bribe doctors and lie to insurance companies. Over the past two months, the government laid out its case, and Lara testified. The prosecutors claim Insys set up a phony speakers program; often no one showed up for the lectures, but the doctors got paid big money.
LARA: But they wouldn't get paid unless they were giving out medication, the Subsys medication.
EMANUEL: And the government alleges one doctor even received a lap dance from a sales rep. For sales reps, the higher the dose prescribed, the higher the bonus they took home. Two sales reps even made a music video about ratcheting up a patient's dose, a process called titration.
(SOUNDBITE OF SONG, "GOOD BY CHOICE")
Z REAL AND A BEAN: (Singing) I love titrations. Yeah, that's not a problem. And I got new patients, and I got a lot of them.
EMANUEL: But having patients wasn't enough; they needed the insurance companies to foot the bill. One month's supply of Subsys can cost tens of thousands of dollars. So prosecutors allege Insys set up a call center where drug company representatives posed as doctor's assistants. The jury heard a recording of a call.
(SOUNDBITE OF ARCHIVED RECORDING)
KIMBERLY: This is Kimberly (ph) calling with Dr. Lewis' (ph) office.
UNIDENTIFIED PERSON: Hi, Kimberly. What is your title there?
KIMBERLY: I'm a PA specialist.
EMANUEL: Prosecutors say employees like Kimberly had one job - say whatever's necessary to get the medication covered, including fabricating a cancer diagnosis. The federal government has painted a picture of Insys executives who put profits over patients' lives. Now it's the defense attorneys turn to present their arguments.
BRAD BAILEY: I suspect one of their principal focuses is to say, wait a second. It may look bad, but folks, this is not a crime, and this is government overreach once again.
EMANUEL: Brad Bailey is a criminal defense attorney in Boston and a former federal prosecutor. Lawyers on both sides of the trial are barred from doing interviews. Bailey is not involved, but he's been following this case closely. His guess is that Kapoor's lawyers will argue that the sales techniques are commonly used.
BAILEY: This is what you have to do to break into the market.
EMANUEL: As for the alleged illegal activities, Bailey predicts Kapoor's lawyers will argue he had no knowledge of the schemes, and it was all orchestrated by three former employees who have already pleaded guilty. Insys Therapeutics says defending itself in court cases is costing so much money it may not survive.
BAILEY: And there's no doubt this entire prosecution is meant to have a deterrent impact and tell other companies, hey, you've got to start taking responsibility for this health crisis.
EMANUEL: Brad Bailey says the federal government also wants the American people to feel like someone is being held accountable for the opioid epidemic. For NPR News, I'm Gabrielle Emanuel, in Boston.
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