Insys founder John N. Kapoor, center, leaves the John Joseph Moakley United States Courthouse in Boston on May 2, 2019.

Five former executives from one of the companies at the heart of the nationwide opioid epidemic were convicted in federal court Thursday.

A federal jury in the US District Court for the District of Massachusetts found the executives of Insys Therapeutics – founder John Kapoor and executives Richard Simon, Sunrise Lee, Joseph Rowan and Michael Gurry – guilty on RICO conspiracy charges. Two other former executives, Michael Babich and Alec Burlakoff, had previously pleaded guilty. Kapoor was arrested in October 2017, while the others were arrested in December 2016.

According to the indictment, the executives of Chandler, Arizona-based Insys conspired to get doctors in various states, many of whom operated pain clinics, to prescribe Subsys, a fentanyl-based spray, in exchange for bribes and kickbacks. Subsys has Food and Drug Administration approval for breakthrough cancer pain, but the doctors were mostly prescribing the drug off-label for patients who did not have cancer. Although it is legal for doctors to prescribe drugs for any use, as long as it is within the parameters of medical ethics and there is a scientific basis, drugmakers are forbidden from marketing their products for off-label uses.

Insys launched Subsys in March 2012, but the executives quickly became dissatisfied with its sales and, starting in May 2012, devised a plan whereby they used pharmacy data to identify doctors who prescribed a high volume of rapid-onset opioids. They then provided speaker fees, honoraria for marketing events, food and entertainment, administrative support and fees in exchange for the doctors prescribing the drug. Between May 2012 and December 2015, sales of Subsys went from $3.7 million during the first nine months of 2012 to $329.5 million for fiscal year 2015.

The convictions “mark the first successful prosecution of top pharmaceutical executives for crimes related to the illicit marketing and prescribing of opioids,” US Attorney Andrew Lelling said in a statement. “Just as we would street-level drug dealers, we will hold pharmaceutical executives responsible for fueling the opioid epidemic by recklessly and illegally distributing these drugs, especially while conspiring to commit racketeering along the way.”

Other companies blamed for the opioid epidemic have fallen on hard times as well, as lawsuits related to their aggressive marketing of highly addictive opioid painkillers pile up. In March, Reuters reported that Purdue Pharma, the maker of the long-acting oxycodone drug OxyContin, was exploring a Chapter 11 bankruptcy filing as it faced about 2,000 lawsuits related to the drug. In response, the philanthropic efforts of the Sackler family that owns Purdue have come under scrutiny.

Photo: Jonathan Wiggs/The Boston Globe, via Getty Images

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