Subsys won regulatory approval in 2012, more than a decade into the opioid crisis, when overdose deaths were already rising and after other pharma companies had been fined for mismarketing opioids. Founded in 2002, it started clinical trials for its under-the-tongue fentanyl spray in 2007. Insys was a flagrant flouter of the rules. We also interviewed prosecutors, short sellers and the reporters who exposed the scheme. In a joint investigation between the FT and the PBS series Frontline, we spoke to several former employees about life inside Insys, including Burlakoff, the former vice-president of sales, who we questioned under prosecutors’ supervision. Sarah Fuller died aged 32, after having been prescribed opioids for fibromyalgia and neck and back injuries © Fuller family One town in West Virginia had 3,200 residents, but was receiving enough opioids for them to take 6,500 pills each over 10 years. But in some regions, the abuse became brazen. At first, marketers convinced some physicians that opioids were not as addictive as previously thought. Many people hooked on illegal opioids start on painkillers prescribed by doctors. Fuller’s family is one of many still suffering from losing a loved one. There have been 750,000 overdose deaths since the crisis began in 1999, according to the Centers for Disease Control and Prevention, and about two-thirds involved an opioid. “At least now, they’ll have to think, maybe they’ll go to jail for this.” “Normally, they just get a slap on the wrist and have to pay a penalty, which was easily made up by selling more opioids,” she says. But she hopes the sheer fact of people going to prison will deter other drugmakers, which may have previously accepted fines as a cost of doing business. Michael Babich, Insys’ former chief executive, and Alec Burlakoff, former vice-president of sales, co-operated with prosecutors and received two and a half, and 26 months, respectively.įuller calls the sentences “a disgrace”, believing they should have been far longer. Kapoor was sentenced to five and a half years on charges that included racketeering conspiracy. Seven of the Insys executives and employees on trial were found guilty of masterminding and participating in a scheme to bribe doctors to prescribe the drug. “They are no different from mobsters,” she said. Clutching her speech, the 62-year-old mother from New Jersey stood outside the court in Boston this January and accused John Kapoor, the Insys founder, and his colleagues of a “greed and fraud” that took Sarah away when she was just 32. Now, four years later, executives from Insys, the maker of Subsys, had become the first pharmaceutical bosses to be handed prison time for their role in America’s opioid epidemic. Admitted to hospital for hyper-sedation, physicians recommended she stop using the spray - but her doctor continued to prescribe it. With an Insys sales representative in the room, she was put back on opioids including Subsys - and within 20 days, her dose of the spray was tripled. After she recovered from the addiction, she visited a new doctor. The former nursing assistant had first become addicted to opioids when she was prescribed them for fibromyalgia and neck and back injuries. We had to have her cremated because there was no way they could have made it so that she was recognisable,” Deborah recalls in an interview. “It was not a vision I would wish on anyone. The next morning, Sarah’s fiancé found her dead, keeled over on her face. The day before her death, mother and daughter had chatted about her upcoming wedding.

In March 2016, her daughter Sarah died from an overdose of drugs that included Subsys: a tiny yet potent spray containing fentanyl, an opioid 50 to 100 times stronger than morphine. This story is outside the FT’s paywall (you do not need a subscription to access it) so it can be shared freely.ĭeborah Fuller had just heard the sentences that were the closest she would get to justice. Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.

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