Netflix’s Dark Comedy ‘Pain Hustlers’ Inspired by Real-life Story of Indian American Entrepreneur John Nath Kapoor

The dark comedy “Pain Hustlers,” which began streaming on Netflix this week, follows a small company promoting fentanyl addiction in unsuspecting patients. It draws inspiration from the real-life story of John Nath Kapoor, the founder of Insys Therapeutics, a Chandler, Arizona-based pharmaceutical company. Andy Garcia plays the eccentric Jack Neel, a character based on Kapoor. 

Also starring Chris Evans, Emily Blunt, and Catherine O’Hara, and directed by David Yates, the film premiered at the Toronto International Film Festival last month. Blunt plays a single mother who takes a job at a pharmaceutical start-up with questionable sales methods. She is recruited into the company’s pharmaceutical sales by Pete (Chris Evans). Within months, she significantly propels market penetration of the drug Lonafen (the fictional name of Subsys).

Garcia’s character in the film invents a fast-acting fentanyl spray for cancer patients like his late wife. In real life, Kapoor promoted Subsys, a fentanyl-based pain medication. Although it was based on “a generic drug, Insys attached a spray delivery system to it that allowed them to promote it as a premium product,” according to Elle magazine. 

Kapoor was sentenced in January 2020 for orchestrating a scheme to bribe practitioners to prescribe Subsys, often when medically unnecessary. The 78-year-old was released in June this year, after only serving two years in prison. In August, he was ordered to pay back $6 million in legal fees due to an unsuccessful criminal defense paid for by Insys, a Reuters report said. 

The genesis of the film began with “a 2018 investigative article by Evan Hughes for the New York Times Magazine about Insys,” the Elle report said. Hughes eventually wrote a book, “Pain Hustlers: Crime and Punishment at an Opioid Startup,” on which the film is based. The original names in the film  are changed  — the company name, Insys, was changed to “Zana,” and the drug name, Subsys, was changed to “Lonafen.”

Although Kapoor was the highest-ranking pharmaceutical boss to be sentenced amidst the opioid crisis, his sentence was much less than the 15 years the U.S. government sought.

Who is John Kapoor?

Born around 1942 in Punjab, Kapoor led a modest life, he told Forbes in an October 2016 report. He later moved to Mumbai to study at the Institute of Chemical Technology (formerly UDCT). 

He was the first in his family to attend college. After earning a degree in pharmacy, he headed to America under a scholarship from the University of Buffalo. He obtained a doctorate in medicinal chemistry in 1972 and quickly landed a job at Invenex Pharmaceutical. “In India, they teach you how to work in a factory,” he told Forbes. “They don’t teach you how to work in a drugstore.”

He took LyphoMed public, but he was involved in a scandal where poor production standards led to several deaths, a Forbes report said. He founded Insys in 1990 and soon realized that developing a spray delivery system for a drug and marketing it as a premium product could bring huge profits. He privately funded Insys to develop Subsys. It was approved to help cancer patients suffering from immense pain, “but it contained Fentanyl, which made Subsys approximately 100 times more potent than morphine and 50 times more potent than heroin, according to the National Institute on Drug Abuse. 

Kapoor hired, or authorized the hiring of, several top executives who became co-conspirators in the criminal scheme to bribe practitioners, the Department of Justice said in a Jan. 23, 2020 press release. He was convicted in May 2019 by a federal jury of racketeering conspiracy along with four other Insys executives. They were accused of “bribing practitioners into prescribing Subsys, even when it might not be medically necessary to patients,” the DOJ said. 

In 2012, Kapoor authorized the use of “speaker programs” purportedly intended to increase brand awareness of Subsys through peer-to-peer educational lunches and dinners, the DOJ said. However, the programs were used as a vehicle to pay bribes and kickbacks to targeted practitioners in exchange for increased Subsys prescriptions and increased dosage. Kapoor insisted that profits generated should double the amount of money spent paying doctors. Practitioners who failed to meet satisfactory prescribing requirements were ousted from the speaker program. 

Kapoor also approved bribing doctors that he knew abusively prescribed opioids. Although Kapoor was the highest-ranking pharmaceutical boss to be sentenced amidst the opioid crisis, his sentence was much less than the 15 years the U.S. government sought. Kapoor’s incarceration was delayed due to COVID-19, but he was eventually housed at FPC Duluth, a minimum security federal prison camp with an original release date of Dec. 11, 2024. He was, however, released in June this year, after only serving two years in prison.