John N Kapoor, the 74-year old founder of Insys Pharma, has been legally charged over his involvement in driving a "nationwide conspiracy" to illegally distribute fentanyl, a potent opioid painkiller intended for specific cancer patients and one of the main offender’s in the US’ current crisis over the drug class.

Kapoor has been accused on a number of bases – including Rackateer Influenced and Corrupt Organisation, conspiracy and wire fraud – for pushing the unnecessary prescription of Subsys, his company’s sublingual fentanyl spray, through collusion with medical professionals and pharmacies, in addition to defrauding insurance companies for payment of the drug. This included kickbacks and bribes such as gifts and meals for the doctors prescribing it.  

As William Weinreb, acting United States Attorney for the District of Massachusetts remarked: "In the midst of a nationwide opioid epidemic that has reached crisis proportions, Mr. Kapoor and his company stand accused of bribing doctors to overprescribe a potent opioid and committing fraud on insurance companies solely for profit."

As a result, Insys is now under investigation for the off-label marketing of Subsys. Six former executives and managers of the company had already been charged for the same crimes, conspiring to bribe doctors into unnecessarily prescribing the drug, and the firm has already shelled out millions to settle existing lawsuits on this basis.

"As alleged, Insys executives improperly influenced health care providers to prescribe a powerful opioid for patients who did not need it, and without complying with FDA requirements, thus putting patients at risk and contributing to the current opioid crisis," said Mark A McCormack, Special Agent in Charge of the FDA Office of Criminal Investigations’ Metro Washington Field Office.

Senator Claire McCaskill, who is in charge of the new investigation, added:  "This company has repeatedly gotten away with fines that amounted to a slap on the wrist for actions that helped fuel a nationwide epidemic that’s claimed hundreds of thousands of American lives. Anyone, including top executives, who potentially violated criminal law should be aggressively prosecuted."