Doctors, drugmakers face legal jeopardy as battle against opioid addiction heats up

Special report: Homegrown fraud task forces promote collaboration
A number of former Insys executives and managers have also been charged in the case. (Getty/Devonyu)

The healthcare industry faces a great deal of pressure over opioid addiction, which President Donald Trump on Thursday declared a public health emergency.

But increasingly, companies that manufacture the drugs and the physicians who prescribe them are facing serious criminal charges, too. Last summer, for example, a Las Vegas doctor was sentenced to 10 years in prison for his role in a pill mill conspiracy.

And this week the Department of Justice indicted a Pittsburgh-area doctor and charged him with unlawful distribution of opioids. The indictment marks the first under an initiative using prescriber data to target physicians contributing to the opioid crisis.

Webinar This Week

Preventing Diagnostic Error in the Age of the “Digital Diagnosis”

The well-known dangers of diagnostic error are now being amplified by the growing trend that’s seeing patients and clinicians opt for free websites over vetted information. Register now to learn how to better navigate this era of digital diagnosis with an evidence-based approach.

RELATED: DOJ indicts Pittsburgh doctor with help of data analytics initiative

In yet another example, the founder and majority owner of Arizona-based Insys Therapeutics was arrested in Phoenix and charged with leading a nationwide scheme to profit off of a fentanyl-based painkiller for cancer patients. 

John N. Kapoor, who sits on the board of directors for the pharmaceutical company, was arrested Thursday and charged with conspiracy under the Racketeer Influenced and Corrupt Organizations Act (RICO), the Department of Justice announced. He also faces other felony charges, including conspiracy to commit mail and wire fraud and conspiracy to violate the Anti-Kickback Law. 

RELATED: Feds charge more than 400 in national fraud bust 

Kapoor and a slew of former Insys executives and managers, many of whom were indicted in December, allegedly bribed physicians to prescribe the potent painkiller, a fentanyl-based spray which was designed for cancer patients with intense breakthrough pain, to patients who did not have cancer, according to DOJ. 

Kapoor and the former Insys staffers also allegedly conspired to mislead and defraud insurance companies that were hesitant to cover prescriptions for the drug for non-cancer patients, according to DOJ. DOJ alleges that the group formed a "reimbursement unit" to secure prior authorization directly from payers and pharmacy benefit managers.  

Acting United States Attorney William D. Weinreb said in the announcement that Kapoor's arrest and the ongoing investigation "reflect our ongoing crisis to attack the opioid crisis from all angles." 

RELATED: 4 actions the Trump administration will take now that the opioid crisis is a national public health emergency 

"The allegations of selling a highly addictive opioid cancer pain drug to patients who did not have cancer make them no better than street-level drug dealers," Harold H. Shaw, special agent in charge of the Federal Bureau of Investigation's Boston field office, said in the announcement.

"Today's charges mark an important step in holding pharmaceutical executives responsible for their part in the opioid crisis." 

The opioid abuse epidemic has shown no signs of abating. A federal report released last month found that 11.8 million people misused opioids last year, equal to about 4.4% of the U.S. population over the age of 12. 

Suggested Articles

In June, the two health systems announced the planned merger deal that would have created one of the 15 largest nonprofit health systems in the US.

Express Scripts unveiled an expanded research lab intended to explore new ways to lower costs and improve care.

Hospitals increased prices for the two most common sources of surprise medical bills from 2012 to 2016, a new study found.