Witness: Insys boss wanted patients’ dosages boosted

A crucial prosecution witness in the racketeering trial of five former Insys Therapeutics executives told jurors Tuesday the executive chairman of the company’s board was livid about the launch of its opioid painkiller Subsys, because he felt patients were being prescribed too low a dose and eventually stopped taking the drug.

John Kapoor “called it the worst (expletive) launch in history,” said former CEO Michael Babich, who pleaded guilty last month to mail fraud and conspiracy to commit mail and wire fraud for his role in the case. “A lot of our patients starting at a low dose had a higher dropoff rate.”

In week three of the trial in U.S. District Court in Boston, Babich testified the company eventually “achieved some success with certain doctors by bribes” and by providing “false and misleading statements to insurance companies” so that they would pay for Subsys.

From 2012 to 2015, Kapoor and his co-defendants — vice president of managed markets Michael J. Gurry, director of sales Richard M. Simon, and regional sales directors Joseph A. Rowan and Sunrise Lee — conspired to pay out more than $1 million in bribes to doctors across the country to prescribe Subsys “at ever-increasing doses” and con insurance companies into paying for the fentanylbased drug, at an average monthly cost of $19,000 per patient, prosecutors allege.

The Food and Drug Administration approved Subsys in 2012 for cancer patients with “breakthrough pain,” extreme pain that strikes while a patient is already medicated with a long-acting painkiller. But prosecutors allege Insys even bribed doctors who did not have many cancer patients because Kapoor and his co-defendants wanted to expand the market to all pain patients in order to maximize profits.

In his opening statement last month, Assistant U.S. Attorney David Lazarus told the jury Lee, a former stripper, “got personal” with a doctor at a nightclub to get him to write more Subsys prescriptions.

Kapoor’s lawyer, Beth Wilkinson, argued last month that Kapoor didn’t know his employees were cutting side deals with doctors.

Alec Burlakoff, former vice president of sales, wanted “free rein,” Wilkinson said, so he tried to prevent the executive chairman from reviewing payments to doctors who wrote prescriptions for Subsys.

Like Babich, Burlakoff, who pleaded guilty in November to racketeering conspiracy, is expected to testify for the prosecution.