How A Drug Startup Screwed Patients, Doctors, And Insurers

Do you think justice was done when the Insys founder went to prison? Think again.

Janice Harayda
6 min readMay 4, 2022


The liquid-spray painkiller Subsys / Credit: Insys Therapeutics

You might think no drug company has screwed people more egregiously than the notorious Purdue Pharma.

What could be worse than an outfit that saw three of its executives convicted of criminal charges related to its flagship product, OxyContin? And that helped to drive the opioid crisis that’s killed millions?

Try Insys Therapeutics and its founder, John Kapoor. While all of Purdue’s guilty parties avoided jail, Kapoor began serving a five-and-a-half year sentence at a federal prison in Duluth last year after he and four other company executives were convicted of racketeering charges.

John Kapoor, founder of Insys, in 2020 / Credit: Wikimedia Commons

Took doctors to strip clubs

The Insys scams involved paying bribes and kickbacks to doctors who prescribed its fast-acting painkiller Subsys, a liquid-spray form of fentanyl, for unauthorized uses. The bribes included cash and favors such as taking doctors to strip clubs, and the illegal conduct wasn’t limited to the top brass at what was once a high-flying startup.

More than two dozen Insys executives, doctors, and sales reps were convicted of crimes related to Subsys, a drug linked to hundreds of deaths.

Those verdicts don’t mean justice has been done for the patients and others victimized by the startup. Insys declared bankruptcy in 2019, and the settlement called for it to forfeit tens of millions in assets.

But the company owes much of that money to health insurers who paid for Subsys, Evan Hughes writes in his recent The Hard Sell: Crime and Punishment at an Opioid Startup: “The most patients will get from that pot is a refund of their co-pays.”

Worse, Insys might have gotten away with its crimes if insiders hadn’t become whistleblowers and sparked an investigation by the U.S. Department of Justice.



Janice Harayda

Critic, novelist, award-winning journalist. Former book editor of the Plain Dealer and book columnist for Glamour. Words in NYT, WSJ, and other major media.