Opening statements began Monday in the trial of a one -time billionaire drug maker who prosecutors charge with running an elaborate kickback scheme. John Kapoor is accused of turning Insys Therapeutics into a “criminal enterprise” to line his pockets. Kapoor's lawyer says the 75-year-old only wanted to help people in excruciating pain, like his wife who suffered from breast cancer. WGBH News reporter Gabrielle Emanuel was at the federal courthouse in Boston today. She spoke with WGBH All Things Considered anchor Barbara Howard about today’s opening statements. This transcript has been edited for clarity.
Barbara Howard: So let's just start out with the basics of the trial. John Kapoor and four other top executives are faced with racketeering conspiracy charges. Tell me about that.
Gabrielle Emanuel: Yes. So John Kapoor founded a pharmaceutical company known as Insys Therapeutics that's actually still in operation. The company developed and marketed a fentanyl-based medication approved for cancer patients with severe pain. Now, prosecutors say the company paid doctors to write lots of prescriptions for this potent opioid, often to people who didn't even have cancer. They also say the company misled insurers. Prosecutors say this was a big, nationwide kickback scheme that lasted between 2012 and 2015, and that the company put millions of dollars toward it and some individual doctors were paid upwards of $200,000. The bribes were allegedly disguised as speaker fees. Now, Kapoor and the four other top executives and managers have all pleaded not guilty, although it is worth noting that two top executives have pleaded guilty and are cooperating with prosecutors.
Howard: Okay, so at this point, what our Kapoor’s defense attorneys saying?
Emanuel: So today, as I was sitting in opening statements, there were three main arguments they were making. First, they told this very compelling story about John Kapoor. He came up from nothing in India and became a billionaire here in the U.S. They talked about his late wife, who was diagnosed with breast cancer, and they said that experience motivated him to develop this pain medication and put his own money toward it. Second, they said any illegal activity should be blamed on a vice president at Insys who has already pleaded guilty. They said Kapoor himself knew nothing about it. Their third argument is that it's unfair to link this one opioid medication to the broader national drug crisis. They point out that prescriptions for their drug, Subsys, constitutes a very small percentage of all opioid prescriptions.
Howard: Well this trial must have some rather larger implications — are there any?
Emanuel: Yeah, definitely. Doctors and pharmaceutical companies have been widely blamed for fueling the opioid epidemic. Massachusetts Attorney General Maura Healey is suing one of those companies. And the argument is that in pursuit of profits, they pushed doctors to prescribe opioids even when they were not entirely necessary and while knowing just how addictive they are. It is true that a lot of people who are addicted to opioids were first exposed to them through a physician's prescription. Now this trial is something the federal government can point to and say they are holding drug companies accountable for this crisis. Now, it's worth remembering that the charges against Kapoor and the other executives were made on the same day when President Trump declared the opioid crisis to be a public health emergency.
Howard: Well Insys is based in Arizona, so why is the case being tried here in Boston?
Emanuel: This is a federal criminal case, and the alleged bribery played out all across the country. The federal government decided to try the case here likely because the U.S. attorneys in Boston have a reputation for being very good at litigating these complex health care cases. But nothing is a guarantee. They've gone for the top man here at this pharmaceutical company, and those cases can be harder to prove because there's often less incriminating evidence for those at the top since they weren't the ones implementing the scheme. So we will really have to wait and see. The judge on this case has booked up to 14 weeks for this trial.
Howard: And you're gonna be covering it?
Emanuel: Yeah, I will be.
Howard: That's WGBH Radio's Gabrielle Emanuel. She's been covering the opening statements today in the trial of John Kapoor of Insys Therapeutics. He's accused of running an elaborate opioid kickback scheme. This is WGBH’s All Things Considered.