Insys sometimes targeted “mid-level” clinicians such as nurse-practitioners and physician assistants—who are less commonly hired as pharma speakers than doctors—recognizing that speaking fees would make a more meaningful impact on their income. According to Babich, Matt Napoletano knew about Alfonso’s family finances and had zeroed in on her as a potential speaker. Alfonso later acknowledged that she was driven by greed, but she added that she “had come to rely on that extra money” from the company “and needed it to live.”
