Extremely Wicked, Shockingly Evil and Vile casts Zac Efron — former star of the High School Musical franchise — as serial killer Ted Bundy.
Say you’re a filmmaker and you want to make a movie about Ted Bundy, arguably the most notorious serial killer of the 20th century. It’s a normal impulse to have. The guy’s an irresistible figure to storytellers: pure misogynistic evil who disguised himself for a decade under swashbuckling charm. Sure, maybe it’s not the most original idea (again: “most notorious serial killer of the 20th century”), but Bundy existed, he killed somewhere between 30 and 100 young women, and people should remember that. So now, how do you tell them?
Well, you could choose to go the way of so many other serial killer films and dwell on the lurid details of the murders. You might feel an urge to follow Bundy as he assaults, strangles and brutalizes his victims, leading hard into the voyeurism under the guise of just trying to understand this monster.
Or you could go the route of director Joe Berlinger and star/executive producer Zac Efron in Extremely Wicked, Shockingly Evil and Vile, their surprisingly smart and challenging new take on the Bundy story. The film might take its title from the description of Bundy offered by the judge at his sentencing verdict, but it doesn’t actually focus on his crimes. Until the film’s very end, the only violent act of Bundy’s we witness onscreen is when he punches a police officer to escape a traffic stop.
Instead, Bundy’s charisma, his manipulative nature and his bad-boy good looks get the bulk of attention, as the film wants us to understand how those closest to him could have ignored everything else he was. Netflix releases the movie this Friday on their service, where it will nestle in the algorithm alongside the docu-series Conversations With a Killer: The Ted Bundy Tapes, also directed by Berlinger (he made the projects simultaneously). But Extremely Wicked may disappoint murder-heads: It’s really a reckoning with the strange, erotic pull awful men like Bundy hold on our culture.
The film is able to get away with this reading because it’s based on the memoir of Bundy’s girlfriend Liz (Lily Collins) and follows her perspective. A Seattle single mom, Liz meets Ted (Efron) in a bar; over the next several years, while knowing him only as a law student, she allows him to share her home and play with her young daughter. Bodies keep piling up, the local paper prints a sketch of Ted’s face, and detectives start showing up at Liz’s door, but she’s still willing to believe his explanations, even entertain marrying him, motivated by what the film insinuates is a peculiar cocktail of loneliness, self-pity and alcoholism.
Bundy is really a shrewd role for Efron, he of the pronounced eyebrows, beefcake abs and Disney Channel grin. It takes a guy like him, a former teen idol who hasn’t totally shed his boyish qualities, to embody the kind of peculiar hold Bundy had on his partners. Does the film “romanticize” an abhorrent man by allowing Efron to play him as a great lover who’ll make his girlfriend’s breakfast in the morning? Yes, a little bit, but being a romantic was what allowed Bundy to get away with his evil actions for so long. And that’s the side of him most worth interrogating in fiction, certainly more so than the well-established brutality of his crimes.
The film’s “romantic” qualities become crucial in its second half, when Bundy stops being Liz’s boyfriend and becomes America’s. Berlinger uses the media circus of his Florida trial, held just one month after the Supreme Court authorized the use of cameras inside the courtroom, to demonstrate the funhouse spectacle of Bundy’s raw charisma. That gets turned up to 11 once Bundy dismisses his attorneys and represents himself, to the delight of the many young women whom we see flock to the trial and hang on his every word. Those include Carole Ann Boone (Kaya Scodelario from the Maze Runner series), an old flame of Bundy’s who joins his defense efforts and will eventually marry him while on the witness stand of his trial and father his child while he sits on death row.
These two distinct sections of the film — the first half from Liz’s perspective, followed by the trial where she’s not present — try to point to the same conclusion, but they don’t totally gel together. Evil can manipulate a public in an entirely different way from how it manipulates people in private. Fry Day, Laura Moss’ razor-sharp short film set among the crowd that gathered to watch Bundy’s execution, was able to parse this difference with more subtlety and menace than Berlinger is able to manage.
But Extremely Wicked is doing something clever nonetheless, maybe best exemplified by a scene of Bundy escaping the courthouse in broad daylight. It’s shot with a boisterous kind of thrill, like the famous scene of Hitchcock’s Strangers on a Train where we actually root for the evil psychopath to pull a cigarette lighter out of a storm drain. Perspective can be a slippery thing, and hindsight will not save us. Is that guy you see onscreen good or bad, if all you see is him, and not the horrible things you know he has done?
Seth Rogen and Charlize Theron get their rom-com on in Long Shot.
There are two fantasies at play in Long Shot, a political rom-com about a scruffy, unemployed journalist and his unlikely relationship with the glamorous Secretary of State who used to be his babysitter. The first is more or less the same formula its star, Seth Rogen, rode to stardom over a decade ago in Knocked Up, in which he played the unfortunate half of a one-night stand that leads to pregnancy and a deeper commitment to a more attractive, responsible, career-oriented woman. The second is about persuading a politician not to behave like a politician and expecting the public to reward her for it. Of the two, the latter seems less plausible.
It is not, however, unprecedented, at least in the movies. Long Shot is more or less a gender-swapped revival of The American President, a mid-’90s touchstone with Michael Douglas and Annette Bening that also wished for Douglas’ Bill Clinton type to stop relentlessly triangulating and embrace the values that led him into office in the first place. (Its writer, Aaron Sorkin, would continue this West Wing wishcasting a few years later on television with The West Wing.) Both films even share the same pet issue, the environment, though the realities of climate change then and now make for a fascinating study in contrasts. Love and idealism become closely intertwined: “Mr. President,” Bening famously tells Douglas when he lets her down, “you got bigger problems than losing me. You just lost my vote.”
For the most part, Long Shot benefits from thinking of politics as a backdrop to raunchy, star-crossed romance rather than the other way around. It’s confused and naïve — and about three years too late — about how presidential campaigns are waged, but Rogen and his co-star, Charlize Theron, are seasoned professionals in comedy and they spark off each other extremely well. The film may not know much about the ins-and-outs of international coalition building or realpolitik, but it’s more than comfortable exchanging loose talk about pop culture and orgasms, or sticking Rogen in a funny-looking traditional Swedish suit. And that’s enough.
Adding a teal windbreaker and cargo pants to his unkempt-slob repertoire, Rogen stars as Fred Flarsky, a journalist who loses his job when Parker Wembley (Andy Serkis), a Rupert Murdoch stand-in, buys out his Brooklyn-based alt-weekly. When he and his best buddy Lance (O’Shea Jackson Jr.) hit the town to drink it off, Fred bumps into Secretary of State Charlotte Field (Theron), who happened to babysit him when he was 13 and she was a 16-year-old running for student council. After the vain president (Bob Odenkirk) signals that he won’t seek a second term, Charlotte and her consultants start ramping up her own presidential bid. But concerns about her lack of warmth and humor as a candidate lead to an out-of-the-box idea: What if she hires her old neighbor Fred to punch up her speeches?
Long Shot makes the hard work of selling its mismatched pair look easy, mostly through late-night work sessions that weave into nostalgia and inside jokes, but also through Fred reminding Charlotte of the idealism that he’s seen in her since she was a teenager. That’s The American President playbook, only it’s the man who’s treated to the glamour of state dinners and discreetly arranged hook-ups and the woman who’s forced to confront how damaging such a relationship might be to her agenda and her approval ratings. And just as Fred and Charlotte try to keep their dalliances under wraps, the film itself wants to have as much fun as possible before facing its own tough political realities. The possible future president gets blasted on liquor and Molly, then deals with a hostage crisis. Good times.
When it finally squares up to the poor optics of Charlotte dating a flame-throwing, drug-using journalist with little regard for fashion or hygiene, the film chooses a cake-and-eat-it-too approach that may be the easiest way out, but also the most insulting to the audience’s intelligence. To be charitable, Long Shot reflects the widely held hope that politicians are better off being themselves than allowing poll numbers and consultants to buff out the rough edges. But there’s a reason why politicians like Charlotte are forced to compromise, especially when they’re women and have to wriggle through the narrower parameters of what the media and the public consider an acceptable profile. The film knows that, but denies it when convenient.
An anti-government protester calls for help as she and another woman help a fellow demonstrator who has been overcome by tear gas during clashes with security forces, in Caracas, Venezuela, on Wednesday.
Venezuela’s top court issued an arrest warrant Thursday for Leopoldo López, a prominent opposition figure who appeared at a key rally Tuesday next to Juan Guaidó, leader of the movement against President Nicolás Maduro.
After Guaidó appeal to the military to revolt, López, who had escaped house arrest after two years, sought refuge along with his family at the Spanish embassy in Caracas.
Guaidó is regrouping amid signs that his U.S.-backed campaign to oust Maduro is losing momentum.
Meanwhile, Maduro led a military parade through Caracas Thursday morning, thanking the troops for refusing to revolt against his government.
Guaidó’s push to remove Maduro triggered demonstrations and violent clashes this week, with at least four deaths reported around the country.
Dozens were injured in Wednesday’s demonstrations in Caracas, as Maduro’s military forces fired rubber bullets, water cannons and tear gas into crowds. The Venezuelan Observatory of Social Conflict reports that a 27-year-old woman and 16-year-old boy were killed as a result of the skirmishes in the capital.
Following reports of the woman’s death Guaidó posted a tweet, pledging to work to hold the perpetrators responsible. “This has to stop and the killers will have to take responsibility for their crimes,” he wrote.
An anti-government protester is carried away after he was affected by tear gas launched by security forces, outside La Carlota airbase during clashes between the two sides in Caracas, Venezuela, on Wednesday.
Guaidó, recognized by the U.S. and more than 50 other nations as Venezuela’s legitimate interim leader, had hoped millions of Venezuelans would mobilize against Maduro during his country’s May Day holiday, but only thousands showed up.
Some of those in the streets wore cloth face masks or gas masks and carried homemade shields.
“I saw people breaking rocks used to throw at Maduro’s security forces,” NPR’s Philip Reeves told Morning Edition, adding that the overall tenor of the demonstrations has shifted significantly since they began in January. “The people who are on the front line, taking on the security forces, they’re a small minority. But it means the protests have changed in character and there’s a growing threat of wider violence.”
Opposition leader Juan Guaidó shows gratitude to supporters during a rally in Caracas, Venezuela, on Wednesday. Guaidó called for Venezuelans to fill streets around the country Wednesday to demand President Nicolas Maduro’s ouster.
Carolina Briceno, a teacher who attended a rally on the eastern side of the city, said she had been shot with a rubber bullet that tore through her T-shirt.
“I had to run because I [felt] the bullets on my back and my T-shirt has holes in it,” she told Reeves in Caracas. Briceno said she’s been participating in protests for 20 years, “but this was the first day that I was very, very scared.”
Guaidó is calling for a general strike, with government employees leading the way. But as Reeves reports, in a country plagued by years of economic strife, that may be a risk his supporters are not willing to take.
Fear, fatigue and confusion are spreading among Guaidó’s supporters even as he has declared the movement is in the final phase of seizing government and military control from Maduro.
“Guaidó supporters are disappointed,” Reeves said. “They really thought this week was going to be the moment, and it wasn’t.”
A detained anti-government protester is driven away on a motorcycle by National Police during clashes between protesters and security forces in Caracas on Wednesday.
There were reports Wednesday that Maduro was on the brink of fleeing Venezuela to Cuba, but he’s dismissed that idea as a complete fabrication. He accuses Guaidó and the U.S. of attempting to stage a coup.
Hatred and lies can never destroy the discipline and patriotism of soldiers fighting for a socialist nation, Maduro, who is backed by Russia and China, said in tweet.
Maduro’s supporters held their own May Day rallies on Wednesday, which also served as anti-Guaidó and anti-U.S. demonstrations.
Meanwhile, international leaders are calling for both sides to show more restraint in the confrontations.
Stéphane Dujarric, spokesman for the United Nations Secretary-General António Guterres, said the U.N. is “closely following” the events in Venezuela and is concerned about the reports of injuries and casualties.
“And the secretary general reiterates his call to all sides to exercise maximum restraint and warn against the use of lethal force against peaceful demonstrators,” he said.
Protesters carry posters depicting Julian Assange outside Westminster Magistrates Court in London on Thursday where the WikiLeaks founder appeared by video link from prison for an extradition hearing.
Julian Assange has vowed to fight extradition to the United States, in what could become a long and complicated legal battle.
At a court in London, Judge Michael Snow told Assange Thursday that he could consent to being extradited to the United States, as his supporters gathered inside and outside the courtroom, chanting and holding signs demanding his freedom.
“I do not wish to surrender myself for extradition for doing journalism that has won many awards and protected many people,” Assange told the court from prison through a video link, according to media reports.
The founder of WikiLeaks was arrested in April. The Ecuadorian Embassy in London essentially evicted the 47-year-old after giving him nearly seven years of refuge. Assange was seen being pulled out of the embassy doors and into a police vehicle. And so began a new era for the controversial figure.
The U.S. government swiftly charged Assange with conspiring to hack a Pentagon computer by helping former Army intelligence analyst Chelsea Manning crack a password.
In what the U.S. Justice Department recently called “one of the largest compromises of classified information in the history of the United States,” Assange is accused of helping Manning access thousands of documents and communications on the wars in Iraq and Afghanistan, as well as diplomatic cables and briefs on Guantanamo Bay detainees. WikiLeaks published many of those documents in 2010 and 2011.
Thursday’s extradition hearing followed a court appearance Wednesday in which a court sentenced Assange to 50 weeks in prison for jumping bail. That judge described Assange’s actions as a deliberate effort to postpone justice. Assange had been wanted in Sweden for questioning over sexual assault allegations, which he has denied.
Ben Brandon, the lawyer representing the U.S. government, told the court on Thursday that Assange could face a maximum prison sentence of five years if he is convicted, according to media reports. Investigators based their allegations on exchanges between Assange and Manning in chatroom communications, Brandon said.
Two more hearings were reportedly scheduled for May 30 and June 12, after Assange’s lawyers receive the full contents of the U.S. extradition request. The judge predicted the case will take “many months.”
Prosecutors in Sweden have left open the possibility of resuming an investigation into rape allegations against Assange, a move that could force British officials to weigh competing extradition requests from both countries.
“If Sweden were to make a competing extradition request then the home secretary here might choose to give that priority and that could mean that there is at best a delay to the U.S. extradition request,” Bradshaw said.
Bradshaw added that Assange’s lawyers have already expressed concern over whether he could receive a fair trial in the United States. They may argue that the extradition request was made for a political purpose or on impermissible grounds, she said.
London was not the only place where Assange’s supporters congregated. They also gathered in front of the U.S. Embassy in Berlin. There, one devotee read a statement written by former National Security Agency contractor Edward Snowden who leaked classified information.
“It is not just one man who stands in jeopardy but the future of the free press,” the document quoted Snowden saying.
Chinese dissident artist Ai Weiwei told NPR that he was “very disappointed” by the U.S. position.
Alex Morgan, right, celebrates with Lindsey Horan and Megan Rapinoe after scoring her 100th international goal on April 4 in Colorado. The three will represent the U.S. at the Women’s World Cup next month in France.
Michael Ciaglo/Getty Images
Michael Ciaglo/Getty Images
U.S. soccer coach Jill Ellis has named the 23 players who will play for the women’s national team in the 2019 Women’s World Cup in France next month. The U.S. team will look to defend its championship from the last tournament in 2015, when it defeated Japan in the final.
The roster includes many of the stars who have previously played in high-profile international competition. Leading the way is Carli Lloyd, who scored six goals at the 2015 tournament and will now return for her fourth Women’s World Cup. Alex Morgan, Megan Rapinoe, Tobin Heath, and Becky Sauerbrunn will head to their third World Cup tournaments.
🗣 BACK FOR FOUR
— U.S. Soccer WNT (@USWNT) May 2, 2019
The biggest surprises on the roster are the inclusion of veteran defender Ali Krieger and midfielder Morgan Brian, who have only rarely been named to the national team in recent years. Ellis was clearly looking to add more experience to the squad with Krieger, who will play in her third Women’s World Cup. Brian was the youngest member of the 2015 squad, but she has struggled with injuries over the last two years.
In a call with reporters on Thursday, Ellis said both players are on an upward trajectory in terms of fitness, and that Krieger’s mental composure was part of the equation. “No moment is ever going to be too big for her,” Ellis explained.
This will be the first World Cup for nine of the athletes. All 23 of the players compete in the National Women’s Soccer League, the U.S. professional league.
One of the team’s fastest-rising stars is forward Mallory Pugh, who just turned 21. The team’s youngest member is Tierna Davidson, 20.
Former national team member Heather O’Reilly tweeted her approval of the lineup as the team pursues its obvious goal: “This is a squad that can certainly win the World Cup.”
The U.S. has won the tournament three times, the most of any country.
Hope Solo, the goalkeeper who made many headlines in years past, is no longer on the national team. Instead, the 2019 squad includes goalkeepers Ashlyn Harris, Alyssa Naeher and Adrianna Franch.
The tournament kicks off June 7 in Paris, as France and South Korea face off. The U.S. begins the group stage against Thailand on June 11 in Le Havre, followed by matches against Chile and Sweden, the team that eliminated the U.S. at the 2016 Olympics.
USA Roster for the 2019 FIFA Women’s World Cup
Goalkeepers: Adrianna Franch, Ashlyn Harris, Alyssa Naeher
Defenders: Abby Dahlkemper, Tierna Davidson, Crystal Dunn, Ali Krieger, Kelley O’Hara, Becky Sauerbrunn, Emily Sonnett
Midfielders: Morgan Brian, Julie Ertz, Lindsey Horan, Rose Lavelle, Allie Long, Samantha Mewis
Forwards: Tobin Heath, Carli Lloyd, Jessica McDonald, Alex Morgan, Christen Press, Mallory Pugh, Megan Rapinoe
As scientists learn more about how the complex way genes combine and work together to create human traits, the idea of “designer babies” becomes less and less likely.
Scientists continue to speak out against the prospect of producing engineered embryos that could lead to so-called designer babies.
Leaders of the American Society of Gene and Cell Therapy sent a letter on April 24 to the secretary of Health and Human Services, Alex Azar, adding their voices to the call for a moratorium on experiments that could alter the genes passed down to future generations.
This move follows a widely criticized experiment in China last year that apparently produced children with edited genomes.
The concern is largely ethical. The reality is biologists probably couldn’t produce designer babies even if they wanted to.
It turns out that the genetics underlying desirable traits such as athleticism, intelligence and beauty are so complicated it may not ever be possible to make targeted changes.
Back in the day of Gregor Mendel, the monk who modified the traits of the pea plants in his 19th century garden, it seemed that traits were based on simple elements (later dubbed “genes”). But by the 1920s, it was becoming clear that human traits involved many genes acting in concert.
Still, during the heyday of the Human Genome Project at the end of the 20th century, hopes were high that common diseases might be explained through the interaction of just a handful of genes. You may recall all those stories about scientists hunting “the gene for” various diseases. Hundreds of scientific papers purported to show strong candidates for these critical genes.
British comedian John Cleese poked fun of this idea in a video skit, where he pointed on a chart to “the gene which we scientists now know make us eat coconut ice cream after a fish dinner.”
But the scientific effort to find genes for common conditions was largely a flop (with a few notable exceptions, such as Alzheimer’s and breast cancer). For example, hundreds of studies over the years have reportedly found genes associated with schizophrenia.
“When we look at the 20 most-studied genes investigated for schizophrenia, we find basically no evidence that any of those are associated at levels greater that we’d expect due to chance,” says Matthew Keller at the University of Colorado.
His lab also looked at the early claims for genes linked to depression. Those, too, went nowhere.
“You could have done just as well by throwing a dart at the genome and saying, ‘ok we’re going to look at this gene and see if it’s associated with depression,’ ” he says.
Instead, scientists found that thousands upon thousands of genes are associated with common diseases and common traits. And most of them have just a tiny influence on the risk of a disease, often just a small fraction of a percent.
Human traits, like height, follow the same story.
Jonathan Pritchard, a Howard Hughes investigator at Stanford University, has looked into the genetics of height, which is one of the most thoroughly studied traits.
“It quickly became clear there’s huge numbers of variants that affect height,” he says. “We have estimated that it’s probably something like 100,000 variants across the genome, so most of the genome affects height by a small amount.”
A few years ago, he suggested that height and presumably other common traits are “omnigenetic,” meaning they involve all of our genes.
If that’s the case, each gene must influence many different traits. A gene linked to height might affect the basic mechanism inside many cells. So editing one gene would affect not only height but who knows what else.
He and his colleagues published a paper Thursday that reveals the nature of the variants related to complex traits like height. The genetic variation isn’t in the genes themselves (the DNA code that tell cells what proteins to produce) but in genetic elements that regulate those genes at the same time they influence other tasks.
His findings suggest our genes work as an interconnected network. It’s not a predictable machine as much as it is a flock of starlings, which wheels in the sky based on group dynamics.
That phenomenon makes our biology a challenge to understand, let alone engineer, Pritchard says.
“We find nature as it is, not really as we wish it to be,” he says a bit wistfully.
Pritchard’s concept of omnigenetics is not wholly accepted by his peers.
The logical conclusion is that genetics is “such a mush that we can’t understand it,” says Ewan Birney at the European Bioinformatics Institute. “I find that a bit depressing.”
He still holds out hope that, as we learn more about genetics, clearer mechanisms will emerge.
But in any event, there’s no question that complicated traits involve thousands of genes with multiple purposes.
“If anybody thinks we can understand how to change genomes to improve things, they don’t have an appreciation for the lack of knowledge that we have,” Birney says.
In the case of the rogue Chinese experiment, a gene that apparently protects people from infection with HIV was inserted into embryos, resulting in the birth of genetically-engineered twins. But, going back to the idea that genes all play multiple roles, it’s not clear what else this alteration has done to the children.
Birney also notes there’s a big difference between engineering a designer baby with desirable characteristics and fixing a genetic flaw.
“We’re much better at understanding when things break, and we call those genetic diseases,” Birney says.
There, gene editing could be brought to bear. A broken gene could be edited. But there are other options that carry less risk.
There is already an effective technology, called preimplantation genetic diagnosis, which allows doctors to look for these single-gene flaws in fertilized eggs and select only those that are free of the genetic disease to be implanted in the mother’s womb.
This approach is widely regarded as ethical. And the child isn’t a “designer baby,” but ends up with a natural set of genes.
You can contact NPR Science Correspondent Richard Harris at email@example.com.
NPR’s Ron Elving answers the toughest questions about our political system and government.
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After hearing this set from Americana trio The Lone Bellow, Mountain Stage host Larry Groce enthusiastically noted some similarities between the band’s set-up and that of folk performers from five decades ago. “Three people with acoustic instruments, standing around one microphone, singing great songs and putting it out on vinyl. I think I’m 15 again,” Groce said.
The set-up remains effective and powerful, including when the band covers “For What It’s Worth,” the Stephen Stills song widely associated with the Vietnam War era. The Lone Bellow released the cover in 2013 as part of a compilation of protest songs compiled by the advocacy campaign “ONE.”
This performance, recorded in Athens, Ohio on the campus of Ohio University, is book-ended by songs spanning the entirety of The Lone Bellow’s career. The trio begins with “To The Woods,” from its self-titled debut and close the set with “May You Be Well,” from its 2017 album, Walk Into a Storm, produced by Dave Cobb. There are two songs from the band’s 2018 acoustic EP The Restless, including the track and “Pink Rabbits,” a song originally written and recorded by The National.
The EP’s stripped-down sound inspired The Lone Bellow’s “Acoustic Triiio” Tour, which found the members condensing their performances to largely acoustic instruments, with captivating and dynamic vocal harmonies throughout.
Currently based in Nashville, The Lone Bellow started out in Brooklyn where Brian Elmquist, Zach Williams and Kanene Pipkin began performing together.
- “To The Woods”
- “You Don’t Love Me Like You Used To”
- “Pink Rabbits”
- “Watch Over Us”
- “For What It’s Worth”
- “The Restless”
- “May You Be Well”
Insys Therapeutics founder John Kapoor departs federal court, in Boston earlier this year.
A jury in Boston has found one-time billionaire and drug company executive John Kapoor and his four co-defendants guilty of a racketeering conspiracy. The verdict came Wednesday after 15 days of deliberation.
The federal government accused Kapoor, the founder of Insys Therapeutics, and his co-defendants of running a nationwide bribery scheme. Between 2012 and 2015, Insys allegedly paid doctors to prescribe their potent opioid medication and then lied to insurance companies to ensure the expensive fentanyl-based painkiller was covered.
Kapoor is among the highest-ranking pharmaceutical executives to face trial amid a national opioid epidemic. By pursuing this case, the federal government was seen as sending a message that it is holding drug companies accountable for their role in the epidemic.
The guilty verdict could strengthen the cases against other pharmaceutical executives implicated in the opioid crisis.
Brad Bailey, a criminal defense attorney in Boston and former federal prosecutor, who has been following this case, said the 10-week trial represented a rare instance in which the federal government used criminal charges to go after corporate executives.
“That’s always unusual. That’s always an attention grabber,” said Bailey. “The big issue is the use of racketeering charges, which had been originally designed to go after the mafia.” By charging Kapoor and his co-defendants with racketeering, Bailey said the federal government was essentially saying that the practices at Insys Therapeutics resembled organized crime.
While the criminal charges set this case apart, the schemes detailed in this trial mirror the aggressive tactics that other pharmaceutical companies have allegedly used to push the sale of opioids.
Bribes and lies, or an unknowing executive?
Calling 39 witnesses, federal prosecutors argued that Kapoor was motivated by money and willing to put patients’ lives at stake to improve his bottom line. They depicted Insys Therapeutics as a struggling company under intense pressure from Kapoor to succeed.
Prosecutors outlined a two-step approach that Insys followed to boost sales of their opioid painkiller, Subsys: first, bribe doctors and, then, lie to insurance companies.
Insys allegedly targeted doctors with a track record of liberally prescribing opioids, inviting them to participate in a “speakers program.” According to the government, doctors were paid handsomely even if nobody showed up for the lecture, but only if they wrote a lot of prescriptions for Subsys. Often, prosecutors say, this meant patients who didn’t need the medication were prescribed it anyway.
Insys then allegedly set up a call center where drug company employees pretended to be from doctor’s offices. Jurors heard phone calls in which Insys employees made-up diagnoses to ensure insurance companies covered Subsys, which can cost tens of thousands of dollars a month.
The defense attorneys for Kapoor and his five co-defendants only called a handful of witnesses. One was a patient who vouched for Subsys, saying it significantly reduce his pain after a car accident. The defense also emphasized Kapoor’s personal story, arguing that he was motivated to create Subsys only after seeing his late wife struggle with severe pain.
However, the crux of the defense’s argument was that Kapoor was unaware of the illegal schemes. They blamed several former employees, in particular Alec Burlakoff, the former vice president of sales at Insys. Burlakoff and several other former Insys executives pleaded guilty and testified for the prosecution in the hopes of getting a more lenient sentence. The defense emphasized Burlakoff’s history of lying and his hatred for Kapoor, which was captured on tape by federal investigators.
In closing arguments, defense attorneys highlighted contradictions in the testimony of several star government witnesses.
While Kapoor has been on trial in Boston’s federal courthouse, the company he founded has been facing financial troubles and management turmoil. Arizona-based Insys Therapeutics said in a statement that “there is substantial risk surrounding our ability to continue … primarily due to mounting legal costs and uncertain legal settlement exposures.”
Last year, the pharmaceutical company agreed to pay at least $150 million to end a Department of Justice investigation into the bribery and kickback scheme. The insurance company Aetna, as well as patients, shareholders and state attorneys general have also sued Insys.
On April 15, Insys replaced their CEO, Saeed Motahari, with the company’s chief financial officer, Andrew Long. Since their high point in 2015, Insys shares have tumbled. Bloomberg News reported shares had fallen 90 percent.
Brad Bailey, the former federal prosecutor, says other pharmaceutical companies may see Insys’s woes as a cautionary tale. However, some worry the trial didn’t strike at the root of the opioid crisis.
Leo Beletsky, a professor of law and health sciences at Northeastern University, says “a lot of what pharmaceutical companies did in the context of the opioid crisis that we are dealing with now was not, in fact, illegal. It was maybe unethical, but it was not illegal.”
While bribing doctors to write prescriptions and fabricating diagnoses is illegal, paying a physician to promote a product to their peers is a common practice in the pharmaceutical industry. Off-label prescribing is also legal and common, although sales representatives are not technically supposed to advocate for off-label uses of a medication.
Beletsky says by focusing on individuals and their illegal schemes, this trial overlooked broader issues, such as drug companies legally spending billions of dollars to maximize the use of their medications.
For Beletsky, the answer lies in regulation. “We need to think much more deeply about how we regulate the pharmaceutical industry and how we prevent these kinds of practices from occurring in the first place,” says Beletsky.
However, experts say, there are currently not major legislative efforts to regulate the pharmaceutical industry. For now, the pushback against marketing strategies that allegedly fueled the opioid crisis remains in the courts.