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Guns, Strippers, and Fancy Dinners: How One Opioid Company Bribed Doctors to Prescribe Fentanyl

“Would you like to get a bite to eat? Somewhere spectacular! Maybe shoot guns before?”

by Alex Lubben
May 3 2019, 4:30pm

The founder and former CEO of drug company Insys Therapeutics just became the first Big Pharma exec to be convicted for his role in pushing opioids on patients, a crime that resulted in over 900 overdose deaths.

Subsys, a fentanyl-based spray, was approved for managing pain for terminally-ill cancer patients, but with a little elbow grease and a lot of grift, Insys managed to get doctors to prescribe it to patients with a slew of other conditions. Now, CEO John Kapoor and four other Insys execs have been convicted on racketeering charges.

Some of the means that Insys used to get physicians to prescribe the opioid were, let’s just say, a little unsavory. And the people who worked for Insys seemed to revel in their own salesmanship.

Here are a few of the highlights, revealed through court documents and testimony at the trial:

Trips to the gun range and strip clubs

Insys’s southeast regional sales rep Joe Rowan peddled perks to a doctor, Bart Gatz, who, while being wined and dined by the company, prescribed 1,010 units of Subsys.

Gatz earned himself a trip out to Arizona, where Insys paid for two $500 “champagne room” sessions for him at a strip club, the lawsuit alleged.

“You show loyalty to us like no other. You need anything at all, it is done,” Rowan texted Gatz in the days following the trip. Gatz replied, “Thank you for the best weekend in years.” He then wrote 17 prescriptions for Subsys in three days, according to the court documents.

In February of 2013, Rowan texted Gatz, “Would you like to get a bite to eat? Somewhere spectacular! Maybe shoot guns before?” A few days later, they went to a shooting range, courtesy of Insys. The company also bought Gatz’s office staff Thanksgiving dinner.

Lap dance as sales tactic

A former sales rep testified that at a strip club in Chicago, an Insys executive who was previously an erotic dancer gave a lap dance to a doctor to whom she was selling Subsys.

“Do you feel like you were getting a message about what tactics to use to market this product?” one of the prosecutors asked the former sales rep. The defense objected before the former sales rep answered, according to the Boston Globe.

Lavish dinners at Kapoor’s restaurants

Kapoor would often invite pain-management doctors to dinners that were ostensibly meant to educate the docs about Subsys. But Holly Brown, a former sales rep, testified as to what they were really about.

“The idea was these weren’t really meant to be educational programs but were meant to be rewards to physicians,” she said, according to Bloomberg.

The dinners were frequently held at Roka Akor, a Chicago restaurant that Kapoor owns, Brown said.

Speaking fees at sham events

Insys also put on speaking events for their most “loyal” doctors. In just one quarter, Gatz earned $36,000 in “speaking fees” from Insys, according to the Palm Beach Post.

Gavin Awerbuch, a doctor from Michigan who was convicted of illegally distributing Subsys, testified that Insys would set up the speaking arrangements, but that he couldn’t get any doctors to show up for them.

“They were a farce really,’ Awerbuch said at the trial, according to Bloomberg.

Since he couldn’t get doctors to come, he’d invite his friends and neighbors and collect the speaking fee from Insys anyway. He racked up $130,000 over the course of 18 months.

This "fuckin’" video

Jurors in the trial were made to watch this atrocity, an internal video that court documents allege was first shown at the company’s 2015 national sales meeting.

It’s a parody of A$AP Rocky’s “Fuckin’ Problems.” “I love titrations, yeah, that’s not a problem, and I got new patients, yeah, I got a lot of ‘em,” one of the salesmen raps. “Titrations” refers to the process by which physicians gradually up a drug’s dosage.

At one point, the song dips into an interlude that appears to be a parody of “Rap God” by Eminem, who has long been open about his struggles with addiction to prescription painkillers.

Kapoor and his colleagues are each facing a maximum sentence of 20 years. He hasn’t yet said whether or not he’ll appeal.

Cover: Insys Therapeutics founder John Kapoor, center, departs federal court in Boston, Wednesday, Jan. 30, 2019. A former pharmaceutical executive accused of joining in a scheme to bribe doctors into prescribing a powerful painkiller once gave a lap dance to a doctor the company was pressuring to get his patients on the drug, her onetime colleague said Tuesday. (AP Photo/Steven Senne)