Before they were arrested last year, Alabama doctors John Couch and Xiulu Ruan were prized customers of Insys Therapeutics Inc., maker of a powerful and highly addictive type of synthetic opioid known as fentanyl.
Drs. Couch and Ruan prescribed a combined $4.9 million of the painkiller, called Subsys, to Medicare patients in 2013 and 2014, among the most of any doctors in the U.S., federal data show.
Insys, based in Chandler, Ariz., went to unusual lengths to keep these high-prescribing doctors happy.
By 1987, Dr. Kapoor had gained control of LyphoMed Inc., after investing just $50,000 of his own money to acquire the company. The company attracted protests after acquiring a decades-old drug being used to treat AIDS and quadrupling its price to $100 per dose, which activists called price-gouging. Dr. Kapoor made more than $100 million when he sold the company in 1990 to a predecessor of Astellas Pharma Inc.
Insys paid its sales representatives base salaries of $40,000, well below the industry average, but offered them the chance to make many multiples more in sales commissions.