tonight, painkiller prison sentence. the billionaire founder of a pharmaceutalom heading behind bars. his company accused of using sex appeal, schemes, and cash to get doctors to prescribe a potentially fatal opioid. >> i have never seen such in your face, such egregious, blatant behavior. >> families picking up the pieces. >> they got away with murder. my daughter's dead because of what they did. >> i missed some of the best years in my kids' life. >> our juju chang with breaking developments. "nightline: painkillers" will be right back.

my biggest regret is my children having to suffer the anguish of seeing their daddy in and out of hospitals and struggling to regain his health. >> a battle-weary hero who says he came closest to death thanks to a doctor's prescription. >> i missed some of the best years of my kids' life. i can't get that back. >> reporter: a tormented whistle-blower who feels she's trying to make up for past sins. >> i took this job thinking i was going to be helping people.

and i was killing people. >> reporter: a small-town attorney on a crusade against big pharma. >> i do not know how they look in a mirror, i do not know how they put their head on a pillow at night. >> reporter: united against a common cause to hold one company and its executives responsible for what they say is their role in the opioid crisis. >> the former company accused of bribing doctors to prescribe an opioid. >> mr. kapoor, abc news, do you have any comment? >> reporter: after a landmark comment, john kapoor, the rags to riches founder, sentenced. >> i think it's a credit to the people who worked on this case, i can't believe we're here. >> reporter: the prosecution team talking about what this sentence means. >> it means the boardroom can be prosecuted. it means ceos and vps and people who previously have not been prosecuted in the pharmaceutical industry, it means the

department of justice is willing to pursue you, to prosecute you if you break the law. >> reporter: kapoor and other former insys executives guilty in a racketeering conspiracy, an elaborate scheme where the company coaxed doctors with money and sexual favors to prescribe subsys, a fentanyl spray for severe cancer pain, to thousands who didn't need it. >> any comment? >> reporter: prosecutors say insys put profits over people, defrauding companies. >> which medication are you talking about? >> subsys. >> reporter: prescription drugs like subsys responsible for one-third of all opioid deaths yet no company had been prosecuted in a case until now. the potential toll breathtaking, more than 7,000 deaths according to the fda adverse deaths reporting system.

people who didn't have cancer but were prescribed the death anyway. >> makes you wonder whether or not to be charged with homicide. >> reporter: jeffrey never imagined he would end up in a shelter like this for homeless veterans. when we first met him last year, he told us about his three tours of duty in iraq where he was hit by multiple ied blasts. >> the vertebrae had slipped off each other and the back was in jeopardy of sliding off and causing paralysis. >> reporter: despite injuries jeff flourished, settling in maryland. >> what did it mean to be dad? >> everything. it's the strength that you need when you don't feel anything else to give you the motivation to be the better version of yourself. >> reporter: but there were still moments when the pain was unbearable. give me a laundry list of painkillers. >> i don't think there's one i haven't been on. it could be an injury, a slip or

fall, or simply my back would flare up. i'd have to go to the emergency room to get treated. >> reporter: in 2010 he thought he found a better approach when he was introduced to a new doctor, william tam, a pain specialist in annapolis, maryland. >> this initially had come out with him saying there's this new medication i think will keep you out of the emergency room. >> reporter: that medication, subsys, a fentanyl spray 50 times more powerful than heroin. >> squeeze fingers and thumb together to spray subsys under your tongue. >> reporter: fda approved specifically for severe cancer pain. but jeff and thousands like him was prescribed the drug off label, a legal and common practice for many drugs, but tightly regulated for powerful opiates. >> this is approved for one reason only, for cancer pain. >> reporter: it didn't matter that jeff didn't have cancer pain, says a former insys employee. >> estimate what percent of the

patients you authorized actually had cancer? >> from my experience, around 10%. >> reporter: what mattered was that the patient was insured so that employees like patty nixon could make sure subsys prescriptions were paid for. >> they were asking me to lie to insurance companies about patients having cancer and cancer pain. a lot of it was word games. when the insurance company would ask the question, does the patient have cancer with breakthrough cancer pain? we would say yes, we're treating breakthrough pain. >> reporter: prosecutors say insurance fraud was just part of the scheme. dissatisfied with sales after three months on the market, insys can a speakers program, supposedly to increase brand awareness. these programs are legal and common to teach doctors about new drugs, but prosecutors argued insys conceived theirs as a front for bribes. pointing to exchanges like this. >> one of the things they do is

they identify medical providers, physicians, that are high prescribers of opioids in general. pain management doctors. >> reporter: dr. tam, the pain specialist who treated jeff, was allegedly part of the speaker series. government records show he received at least $55,000 from insys between 2013 and 2016. >> they were setting up sham speaking events. it was a means to have a fancy dinner and act like they were putting on an educational event that was legitimate. >> what happened to subsys prescriptions? >> they skyrocketed. >> reporter: and evidence shows insys routinely employed sex appeal to drive prescriptions, relying on hires like amanda. >> i didn't have a strong connection with anyone. >> reporter: a former reality show participant and "playboy" model. in a statement she said, what the story failed to mention is i hold a bachelor's degree from the university of arizona, a substitute teaching credential k-8, and was the owner operator

of a modeling talent agency. all of this information was discussed during my interview with insys. >> i have never seen such in your face, such egregious, blatant behavior. hiring drug reps that had no industry experience whatsoever, strippers. >> reporter: socializing with doctors was a corporate strategy. company email showed then vice president of sales pressuring his staff in one of his many directives. and the strategy paid off. between 2012 and 2013, the company saw more than 1,000% growth in net revenue of subsys sales, making it the darling of wall street. execs all smiles as they opened the nasdaq exchange. the following year subsys became the most widely prescribed drug of its type. by then kapoor, the soft-spoken immigrant, had become a billionaire. a few years later he joined the

"forbes" list of richest people in america. all the while hailing his drug as a win for patients and shareholders alike. >> that product that we launched three years ago today, this year will do close to $300 million. ♪ i got new patients and i got a lot of them ♪ >> reporter: these are insys sales reps rapping about their conquests, showcased at a national sales meeting in 2015. under the fentanyl costume, the vp of sales. >> whoo! >> reporter: meanwhile jeff says he was edging closer to death. my understanding is you were taking the equivalent of 5,000 percocet a day? >> yes. or the equivalent to a gram of heroin. >> reporter: jeff has filed a lawsuit against dr. tham, kapoor, and insys. the company denied that there have been more than 7,000 deaths associated with the use of subsys. insys has since paid out $225

million in government fines, declared bankruptcy, sold off subsys to another company. >> hi, daddy. >> hi, sweetheart. >> reporter: that near-death hospital visit was the breaking point, jeff says. he spent years working to get clean. >> miss you guys. >> miss you. >> reporter: dr. tham denies any wrongdoing. in response to the allegations by jeff the doctor and his attorneys told abc news they had no comment. when we come back, the moment a whistle-blower says she came clean. >> you were getting anxiety attacks, why? >> i knew what i was doing was wrong. >> hear the evidence for yourself. >> if they did not make that call, she would have never been approved for the drug.

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♪ thank you for calling envision rx. how can i help you today? >> hi, my name is gina, and i'm with the doctor's office. >> reporter: at insys therapeutics, patty nixon says lying was part of the job. >> we were instructed to say that we were calling from the physician's office that was treating that particular patient. >> even though you knew you were calling from the pharmaceutical company? >> correct. i was in a very small office in chandler, arizona, and i would call alaska and say i was from alaska. sometimes i was from hawaii, i was from wherever the patient was from and wherever the doctor was located. >> reporter: her role, she says, getting insurance companies to sign off on payments for subsys prescriptions. one part of a years-long scheme that cheated millions of dollars from insurers, including medicare.

the lies all based on a script, patty says, that insys executives had instructed her to follow, what they called the l.iesp >> you know, when the insurance company would ask the question, "does the patient have cancer with breakthrough cancer pain?" and when we would respond, we would say, "yes,ing th we breaatkthroureghre pai tn" so it -- eliminating the word "cancer." >> what's the most haunting part of it for you? >> that people would die, and knowingly or unknowingly, it doesn't matter. i was a part of it. >> she was quirky. she was really sweet. >> reporter: there is a quiet stillness in deborah fuller's home. here her daughter sarah was planning her wedding. >> she was over the moon. >> reporter: sarah was battling chronic pain after a series of

car accidents. when treatments had left her struggling with opioid addiction, they eventually turned to new jersey family physician invest convenient matalon. what did you tell her? >> i said, "sarah is addicted to painkillers. so when you deal with her chronic pain, you gotta find another avenue." >> reporter: but deborah says dr. matalon disregarded the family's plea. in january 2015, she prescribed sarah subsys, a fentanyl spray approved specifically for severe cancer pain. in an appointment that deborah says was accompanied by an insys rep. and one day later, that sales rep texting her manager about how to get dr. matalon into the insys speakers program, a front, prosecutors say, to bribe doctors for prescribing their drug. >> what is the patient's last name and date of birth? >> the last name is fuller, f-u-l-l-e-r. first name is sarah. >> this is a ledger. >> right. >> reporter: the family's

attorney, richard hollawell, says he was able to track down exactly how sarah got that fatal prescription. getting a subpoena for the phone call an insys rep made to an insurance company, who was pretending to be from the doctor's office. >> you're calling from the doctor's office, correct? >> yeah, dr. matalon's office. >> i would call it the murder weapon, the smoking gun. >> reporter: then misrepresenting her diagnosis. >> and what is the diagnosis for the patient? >> let me look here. medication intended for the management of breakthrough cancer pain. >> when i found out what it was designed for, to put these people in comfort when they're terminal. but why was sarah taking it? she didn't have cancer at all. >> if they did not make that call, she would've never been approved for the drug. this is the carton that would come to miss fuller's home. >> this looks like a drugstore. >> this box alone is really >> this is one month's supply of fentanyl? >> this is a 600 microgram spray.

>> and this is $24,000 worth of >> in this box.r: just under 15 months after sarah began taking subsys, she died. she was 32 years old. her family sued insys and dr. matalon and are negligence and wrongful death. >> sarah loved butterflies, purple. her wedding day, we all met her, her fiance, us. it was really surreal, because we should be in a church watching her walk down the aisle, then a great reception. but that's not how it happened. >> i feel like if i would have spoke up sooner, then maybe i could have saved her life. you know, i don't think people really understand what it's like

to live with this. >> reporter: patty had left insys before sarah fuller's death, consumed by guilt and regret for her role in the prescription of subsys to countless patients. she testified before a grand jury during the indictment of insys' former ceo. >> it was really scary. i had to tell the truth. i had to tell what my job was and what i did, and what i did was illegal. so that was -- that was really scary. i wasn't sure what was going to happen to me. >> and you were willing to face the consequences? >> absolutely. >> you weren't asking to get out of -- >> no. >> -- responsibility? >> no. i -- i -- i didn't -- i didn't ask for any plea deal. i'm not trying to profit from this. >> reporter: in may 2018, the new jersey board of medical examiners revoked dr. matalon's medical license. the fuller family and dr. matalon, who claimed she was

misled by sales reps about using subsys to treat sarah, reached a settlement for an undisclosed sum. kapoor and other former insys executives were convicted in federal court back in may 2019, the former ceo faced up to 15 years in prison. his defense attorney reacting to the conviction saying, "dr. kapoor is disappointed in the verdict." she said they would keep fighting to clear his name. after eight months of waiting, deborah finally arrived at a boston courtroom to learn kapoor's fate. during the sentencing hearing, several victims read impact statements, including deborah and jeff. afterwards kapoor apologized to them and their families. the judge then sentenced the former ceo to 5 1/2 years in prison. >> dr. kapoor's statement and the apology that he gave, i found that to be hollow. apologetic when you are facing

going to jail and trying to get a reduced prison sentence. >> he didn't have the courage to testify and try to justify the actions of his company. he spoke for the first time and for the judge to say, oh, i think that what i'm hearing from you, that you're a good man -- i was totally shocked by that. he's not a good man. i mean, let's be clear about that. >> reporter: for jeff and deborah, this sennce isn't >> justice i don't think can ever be served for the victims in this case, because we're all going to contend with lifelong issues. and again, those that lost their lives. so i don't know that there can ever be defined justice. >> we deserve justice and i don't think we got it. the people who died, the people whose lives were destroyed, they deserve better. they got away with murder and my daughter is dead because of what they did.

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