All language subtitles for American Greed s14e04 The Fall of an Opiod Mogul

In this episode of American Greed, a
billionaire CEO who preys on patients in

pain. They're drug pushers and that's
basically what they are.

Go inside the criminal scheme of John
Kapoor, whose drug company cashes in big

time on the opioid crisis.

People don't matter. Laws don't matter.
Morality doesn't matter. You care about

money.

Bribing doctors to prescribe high doses
of its addictive product.

Kapoor's team adds fuel to the deadly
epidemic.

To really throw that to the wind and to
say that profits matter more is what we

have here.

And trusting victims pay a horrible
price.

Not one day goes by that there isn't
some time during the day that you're

reminded she's gone. Kapoor becomes the
first big pharma chairman of the board

to go to jail.

And tonight his top salesman sits down
with American Breed.

To share his secrets. I'm simply telling
the truth because people deserve the

truth.

At the height of America's deadly opioid
epidemic

comes a stunning arrest.

And it's not some no -name middle
manager at a huge company or an over

-prescribing doctor.

No, this arrest is at the very top.

The founder and chairman of the board of
a major pharmaceutical company, Incest

Therapeutics. John Kapoor is charged
with conspiring to bribe doctors to push

his addictive and potentially deadly
drug, substance.

It's a stunning turn for a man who seems
to embody the American dream.

He was a guy who was looking to build
things and was willing to push very hard

to do it. An immigrant from India who'd
come to the United States with almost

nothing, Kapoor has built a fortune over
decades in the drug business.

I mean, he succeeded in an industry that
has seen more than its fair share of

failures.

And with the help of photo ops like
this, he's also built a reputation as a

philanthropist. After donating more than
$10 million to the University of

Buffalo, his alma mater, Kapoor gets his
name on a building in return, a coveted

symbol of success.

It's really good to be back here today
to participate in what I consider a

milestone day in the history of School
of Pharmacy.

But in truth, John Kapoor's long career
has been shattered by controversy.

In 1987, Kapoor is running an Illinois
-based company called Lifomed that

markets its products as the best.

One is an infection -fighting drug
called Pentamidine.

At the time, the AIDS epidemic is
ravaging communities across the country.

It's a deadly disease which has been
spreading unchecked. Tens of thousands

infected Americans are dying.

Many are suffering from a type of
pneumonia known as PCP.

In the 80s, 75 % of people who were
diagnosed with HIV AIDS

had PCP. And it was one way that people
with AIDS were dying.

There is a desperate need for treatment.

And the most effective drug available is
John Kapoor's pentamidine.

And so in the crisis of the epidemic,
Kapoor sees dollar signs.

Claiming unforeseen expenses, he jacked
up the price of the drug by 300%. We

saw that as price gouging, which I can't
imagine any other term to use for it.

And we were outraged.

Chicago's AIDS activists are primed for
protest.

And they take to the highway, straight
out to Life -O -Med's headquarters.

We had a huge banner that said, Death -O
-Med.

Get it? Life -O -Med?

Death -O -Med.

We set up a graveyard on the lawn of
Life -O -Med, laid

down, and did a diet.

The controversy puts Kapoor's name into
national news stories.

But he is largely untouched by the
crisis.

Later, he sells Life of Med and
reportedly clears $100 million in the

And for Gene Crocker, Kapoor's price
hike of pentamidine will always be

infuriating.

Many, many people died.

Many, many people struggled to get those
medications.

I mean, if that's not greed, if that is
not an immoral act, I don't know what

is.

Over the next two decades, John Kapoor
invests in multiple drug companies, and

the millions add up.

At age 68, he is a wealthy man and
living in Arizona.

But he is not here to retire.

On the contrary, he has founded a
company, Insys Therapeutics.

And in 2012, he is about to launch a new
product, just in time for a new

epidemic.

The opioid epidemic.

Again, thousands of people are sick and
dying. But this time, the cause is not a

virus. But the latest front in the war
on drugs turns out it's your medicine

cabinet.

Without a doubt, the start of the
epidemic rests with prescription drugs.

It was the really appalling sales tactic
that pharmaceutical companies...

used to widely promote their products.
And that really led to the massive

overuse of opioids in the population.

And into this epidemic of addiction
caused by prescription drugs, Kapoor

introduces his own highly addictive
prescription drug.

Made from fentanyl, a drug 50 to 100
times more powerful than morphine, it's

called subsus.

Kapoor's company promotes the drug in
videos like this as an under -the

spray, approved by the FDA for cancer
patients.

It's a rapid -onset opioid designed to
treat cancer patients who are already on

an around -the -clock opioid.

It's not rocket science. It's a
dangerous drug.

Kapoor has paid for the development of
sepsis himself.

Close to $60 million of his own money is
on the line.

The drug hits the market in March 2012,
but the sales are not good enough for

Kapoor. Kapoor is really unhappy. He
calls it the worst effing pharmaceutical

launch in the history of
pharmaceuticals.

Eager to make his drug quickly
profitable, Kapoor looks for a VP of

for success, and he finds him in an
experienced drug salesman, Alec

Berlikoff is laser -focused on making
money.

And lots of it motivated, he says, by a
traumatic childhood experience.

When we grew up in Long Island, New
York, and my dad came to us and said,

out of money.

We got to go. We got to move to Florida.

I got to start all over again.

That's what I'm afraid of. And I
promised myself I would never allow that

happen.

And so he signs on with the billionaire
entrepreneur, John Kapoor.

I thought this was the opportunity of a
lifetime.

That anyone would want to be in my shoes
and be able to take orders from a man

who made money.

Next, meet the Incess sales team.

This was the kind of person that they
wanted in the company. Someone who would

willingly use her sexuality to sell.

More than 10 years into America's opioid
epidemic, Ensis Therapeutics founder

John Kapoor is looking to turbocharge
sales of the company's powerful new

opioid, Subsys.

And in 2013, that high -powered sales
effort makes its way to Corpus Christi,

Texas. There, for 20 years, Paul Lara
builds a thriving business catching

shrimp. I bought a big boat.

Really big, beautiful boat.

And then I was really catching shrimp.

I thought I was going to do that the
rest of my life, without a doubt.

His daughter, Ashley, loves sharing the
life with her dad.

That was kind of my favorite Saturday
thing.

You know, we'd have a fun day sailing
and just finding all kinds of creatures

the box that came out of the waters.

One day, however, Laura makes a misstep
getting off the boat.

And I fell and I hit my neck and my
lower back.

And my life changed completely.

Seven years later, Lara is still in a
world of pain.

Oh, my pain was excruciating. I had
already had the back surgery and I was

in so much pain.

What he does not know is that his search
for relief will lead him to subsist and

that it will nearly destroy his life.

He becomes just one of many caught up in
a scheme cooked up at Incis

Therapeutics and run by the VP of Sales,
Alec Berlikoff.

I want to preface, I am not proud of
this. I'm not gloating that not a day

by where I don't regret what I did. I'm
simply telling the truth because people

deserve the truth as to what took place.

And according to Berlikoff, the truth is
that when he goes to work at Insys, he

believes John Kapoor holds his future in
his hands.

Unfortunately, I wanted to please him so
badly, and I wanted to...

I wanted to be successful so badly that
I was willing to do anything and

everything he asked.

And what Kapoor wants is to have his
fentanyl spray substance profitable

he takes into his public.

According to Berlikoff, the message is
clear.

All that matters is money.

And so when Berlikoff hires his sales
team, there is just one question.

How important is money to you?

was an interview question.

And on a scale of 1 to 10, if they
didn't answer 10, they didn't get the

Where to find the best people?

Where else?

A strip club.

That's where Berlikoff meets Sunrise
Lee, an exotic dancer who knows how to

close. After one sales meeting, she and
the doctor head to a nightclub where she

offers him something special.

A lap dance.

This was the kind of person that they
wanted in the company, someone who would

willingly use her sexuality to sell in a
way that wasn't just being a beautiful,

attractive thing to look at, but in a,
I'm giving lap dances to someone kind of

way. And they were comfortable with
that.

With the sales force coming on board,
next, the search is on for doctors.

Remember, Substance was originally
created to alleviate the pain of cancer

patients in their final days.

But that's a limited market, and John
Kapoor wants to move his drug out of

hospice and into everyday lives.

So the hunt is on for pain doctors who
will help him expand the use of

and who are willing to write
prescription after prescription of a

opioid. There were plenty of bad actors,
people who essentially served as drug

pushers, whose volumes of
prescription...

by any rational standard, made no sense.

One likely candidate is in Chicago.

When the incest rep pays a visit, she
reports by email that he runs, quote, a

very shady pill mill and only accepts
cash.

The response from incest?

Stick with him.

If they didn't run away from the pill
mills, they ran to them.

And they run with an offer.

to pay the doctors to hold meetings with
fellow doctors to discuss the benefits

of substance.

But educating doctors is not the real
purpose of the money, and that is

out in a candid conversation.

The candid conversation was, Doctor, we
are willing to pay you in the

way of a speaker fee. We really don't
care what you do or don't do. All we

about is...

The more substance you prescribe, the
more we will pay you to speak.

Are you okay with that?

The question is understood to be, are
you okay taking a bribe?

And the person approving this sales
strategy is John Kapoor.

You say, okay, if this is what this man
wants and he's a billionaire, he must

know what he's doing, then I'm going to
do it.

In any corporate criminal organization,
it's always going to come down to the

leadership at the top, right? If the
leadership has expectations for you to

ethical, then you're going to find that
the company is generally ethical. And

here, the expectations were set and
enforced by Kapoor on a daily basis, and

they were not ethical. They were the
opposite of that. They were make money,

period.

And doctors want to make money, too.

Across the country, doctors sign up for
the INSYS speaker program and start to

cash in.

Mobile, Alabama.

Saginaw, Michigan.

Summersworth, New Hampshire.

Sherwood, Arkansas.

Derby, Connecticut.

And Corpus Christi, Texas.

Their pain management doctor, Judson
Somerville, has paid for 58 subsist

speaking engagements in just over a
year.

So more than one a week.

In, you know, Laredo, Texas and Corpus
Christi, there really weren't even that

many places or doctors they could speak
to in those areas.

But who needs doctors?

Look through the records and see the so
-called speaking engagements are

expensive meals paid for by incest and
attended most often by Dr. Somerville,

his staff and the incest rep.

No one really cared.

At all. What the programs consisted of.
We hardly cared if they even took place.

The only thing that people cared about
at instance was if a check was being cut

to that position, was the physician
prescribing more of the product?

And Somerville is prescribing.

In 2013, Intis pays him over $123 ,000,
and he writes 527

subsist prescriptions, a rate of 10 each
week.

Some of those go to Paul Lara.

And when I went to Dr.

Somerville, and he said, well, I've got
just the medicine for you, you know.

Right at the start, Lara is given the
highest possible dose of subsist, 1 ,600

micrograms. of a potentially deadly
addictive narcotic to treat back pain.

And then, slowly it started to work.

Couldn't find a key, then I couldn't
find my car.

I even got lost on the way home to a
place that I've lived my entire life.

Then I started having hallucinations.

I actually was thinking that I had like
a tumor in my brain or something.

Paul Lara loses his job and is never
employed full -time again.

And later, his daughter, Ashley,
speculates on the real reason her father

given subsist.

The motives were never to heal him. The
motives were to get a kickback from the

company. And 1 ,200 miles away in
Arizona, the company knows its strategy

paying doctors is paying off.

Subsist sales are up 1 ,000%. And so the
budget for speaker fees moves

higher and higher.

And so does the number of prescriptions.

They're drug pushers in suits.

That's basically what they are. They're
drug dealers who go to a business and

wear suits and just disguise themselves
like they're doing something different

than what they are.

Next, for one patient, it's substance or
nothing.

If you don't take that, you're not with
our practice anymore.

By the spring of 2013, the goal of
making substance profitable has been

Insys Therapeutics goes public.

Biotech, cancer -type company here,
Insys Therapeutics up 400%. In the next

three years, Insys stock will soar.

And John Kapoor, its largest
shareholder, reaches a net worth of $2

We had one sole investor in the company
prior to the IPO, Dr. John Kapoor.

Kapoor had had a lot of successes.

So when someone like that comes to Wall
Street with a new idea that looks like

it can generate sales, that's something
that investors or some investors are

likely to want to put some of their
money in.

But what investors don't know is how
Kapoor is generating his profits and how

runs his company with a ruthless
micromanagerial style.

He is very controlling, unlike other.

executives who we see at that level. He
is intimately involved in the details of

Insys Therapeutics, and there is nothing
that happened at that company that

wasn't without his permission or
direction.

He is so deeply involved that he
regularly checks the performance of

doctors to make sure that the money he
is investing in bribes is paying off in

prescriptions.

Jacopo had an obsession, an obsession
with return

on investment.

everything and anything came down to,
did we get a return on investment?

Yes or no?

According to federal prosecutors, Kapoor
insists on a minimum return on

investment of two to one.

So if I spend $1 ,000 bribing you, I
expect to make $2 ,000 in sales of the

drug. And even as profits skyrocket, if
one doctor's numbers are off, there is

hell to pay.

He would get heated, he would get loud,
and he would berate the executives. And

that sort of control and that
intimidation filtered all the way down

The person often in the line of fire is
the VP of sales, Alec Berlikoff.

I would take a beatdown, a shellacking.

I mean, it would take me hours,
sometimes days.

to get over the beating that I would
take.

But it's not just the number of
prescriptions that matter to Kapoor.

He also wants prescriptions at ever
-increasing dosages for obvious reasons.

Essentially, the higher the dose, the
more addicted the person is, the more

going to need, and you've got a customer
for life.

And the way to motivate salespeople to
push doctors to increase the dose?

Money, of course.

And into sales materials show the higher
the dose, the bigger the commission.

He lived, ate and breathed return on
investment.

And if the doctors don't deliver what
Kapoor wants, then he would expect for

to fire the speaker or perhaps on a good
day, if he was feeling kind and

forgiving.

you would be asked to go to that speaker
and say, hey, if we don't see a return

on investment in the next week or two,
you will not be speaking for the company

anymore. There's no way that anyone
within that company didn't know that

were creating increased risks of people
becoming addicted.

And to really throw that to the wind and
to say that profits matter more.

is what we have here.

And anyone who wants to see how all this
plays out for people could head to

Johnson County, Kansas.

Here, the long reach of the INSYS scheme
touches a number of unsuspecting

patients.

They were as vulnerable as you could
get. They're individuals who are already

pain, who are seeking help from a
trusted source, their doctor.

In Overland Park, Kansas, a doctor at a
pain clinic is paid $220 ,000 over two

years by incis.

But that is something Mike Whitham does
not know when he is prescribed substance

for excruciating ulcer pain.

He didn't describe it as for cancer
patients.

Didn't give me any warnings about it.

It was just here, try this.

And Whitam does not know INCSIS is
incentivizing prescriptions of higher

He just knows his dose soars in four
months.

We went from 400 to 800, and then I
think I went from 800 to 1 ,200,

and then to 1 ,600. But it was all very
quickly.

Whitam says he gets to a point where he
is so drugged out he spends entire days

in bed.

But the worst is how he feels.

waiting for the next spray.

I got extremely angry.

My kids knew to not be around me when
that happened. And they called me mean

daddy.

And when he asked to make a change, it's
clear.

It's substance or nothing.

I remember one of the nurses came in and
said, what you are prescribed is what

you take, and that is it.

If you don't take that, you're not with
our practice anymore.

Carrie Ballew has the same doctor.

She suffers from back pain, and so the
doctor prescribes the fentanyl spray.

I believed everything that he said.

Followed it to a T.

But as her dose is increased, Carrie
Ballew says she is becoming addicted.

I was supposed to take it every six
hours.

And, you know, after just two or three
hours, I could feel, you know, a little

bit of shaking. Like it was time to take
it, even though it wasn't proper time.

More and more in her drug state, Carrie
Ballew withdraws from family life.

My sister, she...

Called me an addict and I got very angry
and we didn't talk for a good period of

time because I was very defensive. And,
you know, truly in my heart felt I have

to have this to survive.

But back in inches, the struggles of
people like Terry Ballew are rarely, if

ever, discussed.

It's an abstraction to people like
Kapoor. He never sees these.

To him, they're just numbers.

They're just prescriptions. They're just
dollar signs.

If anything puts the disconnect between
Insys and its patients into perspective,

it is this video made for a sales
meeting. It is about increasing doses of

medication, a process called titration.

What that video shows is the state of
mind of the people who are presenting

to the sales staff at their national
meeting. You're in the middle of an

epidemic. You've got the highest
possible dosage of this fentanyl spray

around and rapping on the screen. It
wasn't, you know, John Kapoor in a back

room, you know, pushing this out. It was
John Kapoor pushing it out. And then

the whole culture is being swallowed by
that, by that greed.

Next for John Kapoor, it seems it's
never enough.

There's no more lines to cross for
anybody who still has their brain

intact. Yet he wants them.

In 2012, when the FDA approves the sale
of Insys Therapeutics' powerful opioid,

Supsys, it is clear that the drug is to
be used for the treatment of

breakthrough pain in cancer patients.

And founder, John Kapoor, says he deeply
understands that pain.

As he tells reporter Matthew Herper in
an interview, he lost his wife, Aditha,

to the disease.

It was really a touching moment when he
talked about how, for cancer patients,

pain isn't just pain. The pain's a
really terrible thing, and people don't

appreciate the need for these drugs.

But despite his personal experience,
Kapoor markets his drug not just for

patients, but for pain patients in what
is called off -label use.

And that presents a problem for
insurance companies.

Most companies...

wanted it to be on label. A doctor can
prescribe substance for whatever they

want. They can write off -label
prescriptions, but the insurance company

have to approve it.

And if insurance companies won't pay for
it, patients can't afford it. The cost

for one month's prescription can be as
high as $19 ,000.

And so one answer is to turn pain
patients into cancer patients.

At his doctor's office, Mike Whitham
says he is asked a strange question.

Would you feel comfortable saying you
have cancer? And at that time I told

cancer is probably the only thing I
don't have.

But I don't have that and I don't feel
comfortable.

That was the last day I got a
prescription for substance.

And with patients unwilling to lie and
company profits dependent on insurance

approvals, Insys creates a call center
where its employees spin the truth.

So they would call and...

poses the doctor's office, and they
would do everything in their power to

argument in front of the insurance
company to get them to pay.

Am I speaking to a member or a provider?

I'm calling with a provider.

These recordings made by insurance
companies illustrate how the center

What is the medication you are
requesting?

This is one of the operators.

She says in a video deposition taken for
a civil case that she is trained to be

very careful with her words.

We were supposed to say we were with the
doctor's office, not from the doctor's

office.

There's a difference.

That is just one of the word games INSIS
employees play.

There are many. Using the word urgent
gets a quick response.

Patients in quite significant pain. Can
you do it via phone, but urgent?

Sure. Let me put this to urgent one
second.

And because sepsis is a spray, saying
the patient has difficulty swallowing is

very effective.

The patient, they're freaking pain and,
you know, they have the difficulty

swallowing oral medication.

Sometimes the incest operator's answers
meander from one fake diagnosis to

another. In this call, the patient first
has one kind of cancer.

The information, it looks like it is
unspecified upper limb

in that area.

But minutes later, it has evolved.

It looks like the cervical area, it
looks like that's where the location of

chronic pain syndrome is. So it's
cervical cancer.

Is that what you're saying, cervical
cancer? It's the cervical area where the

chronic pain, yes. Got it. The
prescription is approved.

which is good news for the INSA's
caller.

The pressure for success is tremendous.

Their bosses were telling them, if you
can't get it approved, I'll find

who can.

You've got to ride the gray line.

You've got to get these insurance
companies to pay. It's a game. You just

to tell them what they want to hear.

Overall, the system works well.

In just over three years, the call
operators fraudulently get approvals for

estimated $300 million worth of
prescriptions paid for by insurance

and Medicare.

But Kapoor wants even greater approval
rates.

And for Berlikoff, that is pushing the
staff too far.

They have crossed so many lines to get
this drug approved and to get it in the

hands of people that you can't fathom
asking them.

to cross another line. There's no more
lines to cross for anybody who still has

their brain halfway intact.

Yet he wants more.

And the costs paid by patients using
subsist continue to grow.

Seven years after the drug goes on sale,
the FDA has 9 ,000 adverse event

reports on subsist. And many of those
include people who died.

In January 2015, this call operator gets
approval for a 31 -year -old patient

named Sarah Fuller. Sarah suffers from
fibromyalgia and back pain. What is the

diagnosis for the patient?

As instructed by ENSYS, she crafts her
words carefully, leaving out the word

cancer in describing the need for the
drug.

The doctor is treating the patient with
breakthrough pain.

Sarah's prescription is approved for 200
micrograms. It is later increased to

600.

After more than a year on substance,
Sarah Fuller dies by a multidrug

Every time you go through a holiday, her
birthday, the day she was supposed to

be married, you know, you do everything
at a cemetery.

Not one day goes by that there isn't
some time during the day that you're

reminded she's gone.

And back at Inces, Alec Berlikoff is
beginning to realize his dream job is

becoming a nightmare.

We know we've pushed this to the brink.

None of us are feeling good about this
anymore. None of us want the extra

dollars that come along with seeing or
hearing a very

negative story. None of us want that.

But John Kapoor presses on.

asking for daily reports on the call
center's approvals.

He has one interest, which is money.
Money. And everything else doesn't

People don't matter.

Laws don't matter.

Morality doesn't matter.

He cared about money.

Next, who gets nabbed and who goes free?

And I lived for at least a year waking
up every day looking out my window for

that black man or the FBI.

In Corpus Christi in December 2013, Paul
Lara hedged to Dr. Somerville to get

his prescription renewed.

The people were standing in the halls
and they were angry.

There is big news.

The doctor's license has been
temporarily suspended.

Three of his patients overdosed and
died.

And now other doctors in the area refuse
to see Somerville's patients.

Lara has no choice.

From the highest dose of a fentanyl
painkiller, he goes off cold turkey.

I thought I was dying when I was taking
it.

I was on death's door without it.

It was like the worst flu you can
imagine times 100.

Lara has found himself in the center of
a government crackdown on opioid

prescribers, some of whom take money
from ENSYS.

Across the country, substance
prescribing doctors are being indicted,

with receiving kickbacks from incest.

The house of cards has fallen. But
Kapoor appears unfazed.

To a guy like Kapoor, this was
collateral damage.

It was just, find me another doctor.

Find me another doctor in that area who
can...

Prescribe my product.

In fact, Kapoor appears so confident
that he will not be indicted in the

He sits down with Forbes magazine
reporter Matthew Herper in October 2016.

He was a very calm, cheerful man. He
smiled a lot. He was very

unperturbed by the allegations.

Kapoor describes his surprise at doctors
that over -prescribe and suggests

that... Something happened in the field
he didn't know about.

He said it wasn't his responsibility.

You know, he said, I'm an investor.

I don't handle what goes on day to day.

When there's a problem, I'm here to fix
things.

He spoke as if he wasn't really involved
in the day to day decision making.

What is surprising about this interview
is that Kapoor knows that his company is

under federal investigation.

Three years before the interview, Insys
is served subpoenas from the Department

of Justice.

But there is little real change in how
the company operates.

They continue to bribe doctors. They
continue to lie to insurers. They

to encourage doctors to write higher
doses.

The reason Kapoor is not worried may be
that executives of pharmaceutical

companies charged with illegal marketing
are typically required to just pay a

fine.

It was just assumed as an acceptable
cost of promoting sales.

And while Kapoor apparently believes he
is not in danger of prosecution,

Alec Berlikoff makes a different
assumption, that he's next.

I mean, I was ahead of sales.

I did everything they asked me to do.

How could I not be arrested?

And in December 2016, he gets the
answer.

For at least a year, waking up every day
looking out my window to that

black man or the FBI or whomever.

And one day it came. I looked out the
window, saw a lot of vehicles.

Something didn't look right. Something
didn't feel right.

And, you know, within an hour, I was
being taken away out of my house in

He's not alone.

On that day, five other incest
executives are arrested and indicted on

of fraud.

But not John Kapoor.

My take is he did throw me and everyone
else to the wolves. He just kept

throwing us.

Feeding, feeding, feeding.

Here, take this guy. Take this guy. Take
this guy. What else do you need? What

else do you want? Just don't take me.

Next. Why does one crook rat on another?

Because I had enough.

Enough of the lies and the bull.

Of all the distinctions that John Kapoor
earned through his long career, there

is one he likely never sees coming.

Look, he's done nothing wrong. His
charges are serious and we intend to

them vigorously.

In October 2017, he is arrested and
charged with leading a conspiracy to

doctors. He is now the first chairman of
the board of a pharmaceutical company

to be criminally charged for his role in
the opioid epidemic.

And why is John Kapoor the one who gets
hit?

One big reason is Alec Berlikoff, who
steps up and gives the prosecutors just

what they need.

You need an insider.

There is nothing like having somebody
who's sitting there at the table with

other bad guys talking about the crimes
that they're about to commit.

Berlikoff pleads guilty to charges of
bribing doctors and defrauding health

insurers.

And I don't want to live with those
secrets in my in my mind or my heart or

soul any longer.

That's my decision.

That's why I pled guilty.

That's why I gave up the opportunity to
go to trial.

I did all of that because I had enough,
enough of the lies and the bull.

The trial of the instance team begins in
Boston in January 2019.

Among those who testify for the
government is one doctor who admits he

his patient's safety for money.

And I remember him testifying about
having a patient who had a mental

such they thought they were in pain, but
they really weren't. But he gave that

person substance anyway.

And then there is also the testimony of
victims, like Paul Lara, who watches

John Kapoor while he tells his own story
on the witness stand.

Everybody thinks I'm crazy for saying
this. I actually feel sorry for the man.

And this man knew people were dying and
just kept on putting that money in his

pocket. Donating places, having his name
and his wife's name put on buildings.

The amount of greed that this man had is
just unbelievable.

Kapoor's defense attorney argues that
the blame belongs to Alec Berlikoff,

who... cut a lot of side deals on his
own.

Berlikoff says the deals he made with
doctors were all approved and paid for

Kapoor. I'm guilty.

I did all this.

But none of this happens without the
approval, without the

say -so, without the direction, without
the dollars.

We're talking about millions of dollars
being paid to doctors.

That's not my money.

It's not my call.

After a 10 -week trial, Kapoor is
convicted of racketeering conspiracy and

sentenced to five and a half years in
prison.

I hope that the message being sent here
is that the government is going to go

after the people in the boardroom.

You know, it's not just going to be the
bad doctors anymore.

Following Kapoor's conviction, the
University of Buffalo removes the name

Kapoor on its pharmacy building.

And his multiple billions, they're gone.

Inches stock plummets at the news of his
arrest.

The company declares bankruptcy in 2019.

He's still a wealthy man, but in terms
of the money that he has, he's lost

literally billions as a result of the
greed and the arrogance.

Through his attorney, Kapoor declines
American Greed's request for comment.

Alec Berlikoff is sentenced to two years
and two months.

And as he heads to prison, he looks back
on his plan to avoid his father's

experience.

Work for a man like Kapoor, I would
never have to tell my kids, we don't

any money.

Well, guess what?

That's exactly what I tell my kids every
day.

We lost everything.

We have nothing.

But what we have is love.

We have...

our relationships, and we have an
opportunity to move forward. And that's

than a lot of people have.

Of all the ways that the instance scheme
hurt its victims, some say the most

damaging is the way it destroyed their
trust in people who pretended to care

them. I didn't see a single doctor, no
doctor.

I didn't go back to the hospital. I
didn't do anything for almost two years

because I just didn't trust anybody.

It certainly made things worse when I
finally did go back to the doctor.

Because all the things I did have are
worse.

Paul Lara is grateful he survived a high
dose of a powerfully addictive

medication. In examining what happened
to them all, his daughter Ashley speaks

for many victims who can't believe that
the scheme got as far as it did.

You know, there's so many lines that had
to be crossed to get to that point to

where that medication was dispensed.

Somewhere, someone should have been
looking out for the greater good, right?

Somebody should have been morally sound
enough to say, this isn't right and we

need to make it stop.

And there wasn't.