A new pharmaceutical business model
September 22, 2015 2:22 PM Subscribe
Martin Shkreli was a hedge fund manager who started out short-selling biotech stocks before founding Retrophin, a company with a new goal: "acquiring the rights to obsolete remedies Shkreli says can be put to new and lucrative purposes". In 2014, Retrophin hiked the price of Thiola, a drug to treat rare kidney disease, from $1.50 a pill to $15. Shkreli was ousted from Retrophin and later sued for $65 million, but returned to form Turing Pharmaceuticals, whose aim is to "buy forgotten and orphaned assets from Big Pharma—any drug that’s had weak supply or weak support." They bought the rights to market Daraprim, an obscure drug used to treat parasitic infections, and raised the price from $13.50 to $750 per pill. In response to the price rises for Daraprim, and for other vital drugs, Hillary Clinton has unveiled plans to tackle prescription drug pricing, while Bernie Sanders introduced a bill in September that would also allow Medicare to negotiate drug prices. Pharma industry blogger Derek Lowe (previously) also has some ideas about what to do about Turing. Meanwhile, Shkreli has defended his price hike and says that anyone who cannot afford the drug will not be forced to pay.
Daraprim is not under patent, but no generic versions are currently available possibly due to the small market for the product. Daraprim is under a closed distribution system, which will make it harder for a competitor to access the brand-name drug needed to test their generic version.
Daraprim is not under patent, but no generic versions are currently available possibly due to the small market for the product. Daraprim is under a closed distribution system, which will make it harder for a competitor to access the brand-name drug needed to test their generic version.
One thing is that this guy better be hiring personal security. Another thing is that I hope someone uses the techniques pioneered by US states attempting to secure execution drugs to procure samples in order to set up future generic manufacturing.
posted by rhizome at 2:26 PM on September 22, 2015 [2 favorites]
posted by rhizome at 2:26 PM on September 22, 2015 [2 favorites]
The only thing missing from this story is the villain setting fire to an orphanage while trampling puppies underfoot. What a monster.
posted by lesbiassparrow at 2:28 PM on September 22, 2015 [60 favorites]
posted by lesbiassparrow at 2:28 PM on September 22, 2015 [60 favorites]
nationalize drug pricing - which is pretty much what every other developed country in the world does.
they do? that's interesting and the first i've heard of it. can you give me a pointer? i tried googling, but got hits on nationalizing drug companies.
posted by andrewcooke at 2:31 PM on September 22, 2015
they do? that's interesting and the first i've heard of it. can you give me a pointer? i tried googling, but got hits on nationalizing drug companies.
posted by andrewcooke at 2:31 PM on September 22, 2015
I saw the video interview with this guy. He looks like he should be playing the evil preppy in a John Hughes movie or palling around with Patrick Bateman.
posted by tunewell at 2:33 PM on September 22, 2015 [37 favorites]
posted by tunewell at 2:33 PM on September 22, 2015 [37 favorites]
If anything this cartoonish mofo is proving that the for-profit model is broken (essential drugs get arbitrary price increases while research disproportionately goes towards erectile dysfunction etc). He's getting while the getting is good. Enjoy it while it lasts ya little ogre.
posted by aydeejones at 2:34 PM on September 22, 2015 [5 favorites]
posted by aydeejones at 2:34 PM on September 22, 2015 [5 favorites]
Pics of this guy look like what you get when you call Central Casting and ask for "rich youngish douchebag, the kind who gets his comeuppance. The kind with a face that screams 'punch me.'"
posted by emjaybee at 2:34 PM on September 22, 2015 [73 favorites]
posted by emjaybee at 2:34 PM on September 22, 2015 [73 favorites]
Christ, what an asshole.
posted by acb at 2:35 PM on September 22, 2015 [22 favorites]
posted by acb at 2:35 PM on September 22, 2015 [22 favorites]
No Mr. Bond, I expect you to die... of a parasitic infection!
Of course if this leads to the kind of legislation mentioned above, you could put this guy on the $100 for all I care.
posted by gwint at 2:36 PM on September 22, 2015 [1 favorite]
Of course if this leads to the kind of legislation mentioned above, you could put this guy on the $100 for all I care.
posted by gwint at 2:36 PM on September 22, 2015 [1 favorite]
He is literally a prick, poking a hole and sucking the teat of the nation's bloated healthcare industry making up 1/6th of US GDP.
posted by aydeejones at 2:37 PM on September 22, 2015
posted by aydeejones at 2:37 PM on September 22, 2015
Right, there's plenty more of these GOP presidential candidate debates to go. I'd like to see all the candidates asked what they think about the Shkreli-Daraprim case.
posted by Wordshore at 2:37 PM on September 22, 2015 [14 favorites]
posted by Wordshore at 2:37 PM on September 22, 2015 [14 favorites]
Shkreli has defended his price hike and says that anyone who cannot afford the drug will not be forced to pay. ...
Daraprim is under a closed distribution system, which will make it harder for a competitor to access the brand-name drug needed to test their generic version.
Assuming the best, I take it the plan was to sell pill batches to actual pharmaceutical companies interested in making generics, not overcharge individual patients.
posted by carsonb at 2:38 PM on September 22, 2015
Daraprim is under a closed distribution system, which will make it harder for a competitor to access the brand-name drug needed to test their generic version.
Assuming the best, I take it the plan was to sell pill batches to actual pharmaceutical companies interested in making generics, not overcharge individual patients.
posted by carsonb at 2:38 PM on September 22, 2015
This guy also owns a LoL e-sports team so PRETTY MUCH EVERYTHING ABOUT HIM IS TOP NOTCH!
posted by selfnoise at 2:38 PM on September 22, 2015 [11 favorites]
posted by selfnoise at 2:38 PM on September 22, 2015 [11 favorites]
I am legitimately curious regarding how his "if you can't pay, you won't have to" will work out. On the one hand, money grubbing fucktart. On the other, he is right in that there ARE copays and there ARE writeoffs and there ARE many, many issues with modern prescription pricing and that there ARE massive costs involved in drug research. One of the reasons that we're running out of antibiotics that work is not that they're not needed, but that they're not profitable to research and thus lower priorities for the big biotech firms.
The "one price for the uninsured, another vastly higher price for the insured" system is flat busted. Something needs to change. This, in and of itself, is not what I'd call A Positive Step at face value but the devil is in the details, and if he does make it possible for rank-and-file poor who need it to still get it, he's more Cassandra than Snidely Whiplash.
But we'll see.
posted by delfin at 2:38 PM on September 22, 2015 [1 favorite]
The "one price for the uninsured, another vastly higher price for the insured" system is flat busted. Something needs to change. This, in and of itself, is not what I'd call A Positive Step at face value but the devil is in the details, and if he does make it possible for rank-and-file poor who need it to still get it, he's more Cassandra than Snidely Whiplash.
But we'll see.
posted by delfin at 2:38 PM on September 22, 2015 [1 favorite]
@andrewcooke PHARMAC is the New Zealand agency that does this. There's concern that if TPPA is approved, that the agencies ability to negotiate prices like this will be much curtailed.
posted by maupuia at 2:38 PM on September 22, 2015 [2 favorites]
posted by maupuia at 2:38 PM on September 22, 2015 [2 favorites]
Turing Pharmaceuticals
He may be a surplus maximization algorithm trying to pass himself off as a human being, but at least he can laugh at himself.
posted by Iridic at 2:39 PM on September 22, 2015 [41 favorites]
He may be a surplus maximization algorithm trying to pass himself off as a human being, but at least he can laugh at himself.
posted by Iridic at 2:39 PM on September 22, 2015 [41 favorites]
The problem with the write offs and copay system is that we all end up subsidizing it with premiums. I'm all for my premium helping everyone who needs it. Not This Fuckin' Guy.
posted by aydeejones at 2:40 PM on September 22, 2015 [23 favorites]
posted by aydeejones at 2:40 PM on September 22, 2015 [23 favorites]
This has been a really big issue for patients with diabetes. The numbers in this piece are pretty ugly but I can tell you that sticker shock in the drugstore is worse. The price of insulin is increasing dramatically every year now and it's not like we haven't known about insulin for almost a century. People with diabetes suffer and die without insulin and nobody notices the price gouging because there's no mustache-twirling face like this Shkreli asshole to pin it on.
posted by immlass at 2:40 PM on September 22, 2015 [47 favorites]
posted by immlass at 2:40 PM on September 22, 2015 [47 favorites]
I agree that he probably realizes a generic is inevitable and he's positioning himself to make a bunch of money on other companies who need to do A-B testing. Still, it's artifical bullshit to line his pockets and we all pay for it.
posted by aydeejones at 2:42 PM on September 22, 2015 [1 favorite]
posted by aydeejones at 2:42 PM on September 22, 2015 [1 favorite]
Waiting for the Slate article telling me how this is actually a good thing.
posted by octothorpe at 2:42 PM on September 22, 2015 [21 favorites]
posted by octothorpe at 2:42 PM on September 22, 2015 [21 favorites]
Note that the 13.50 price was already a bloated price, as the people who brought it from GSK had already increased the price from about $1 to 13.50. This stuff goes on all the time, it's just that most of the companies doing it are run by somewhat more intelligent sociopaths who know that no one will notice the small vampires.
posted by tavella at 2:42 PM on September 22, 2015 [17 favorites]
posted by tavella at 2:42 PM on September 22, 2015 [17 favorites]
Pharmaceutical coverage is a big issue in Canada right now and is getting more publicity due to the upcoming Federal election.
posted by blue_beetle at 2:43 PM on September 22, 2015 [1 favorite]
posted by blue_beetle at 2:43 PM on September 22, 2015 [1 favorite]
they do? that's interesting and the first i've heard of it. can you give me a pointer? i tried googling, but got hits on nationalizing drug companies.
Here's a portal to Ontario's system.
posted by quaking fajita at 2:43 PM on September 22, 2015 [1 favorite]
Here's a portal to Ontario's system.
posted by quaking fajita at 2:43 PM on September 22, 2015 [1 favorite]
Except that, even a $20 copay can be crippling to some families in the US.
http://aspe.hhs.gov/2015-poverty-guidelines
A family of four in the US is below the poverty line if they make $24,250 a year.
http://www.nclej.org/poverty-in-the-us.php
45 million people living below poverty in 2012.
That $20 copay literally could be a meal for them. Relying on that as your moral safe ground, like this man is, is a lie.
posted by junyatwin at 2:43 PM on September 22, 2015 [10 favorites]
http://aspe.hhs.gov/2015-poverty-guidelines
A family of four in the US is below the poverty line if they make $24,250 a year.
http://www.nclej.org/poverty-in-the-us.php
45 million people living below poverty in 2012.
That $20 copay literally could be a meal for them. Relying on that as your moral safe ground, like this man is, is a lie.
posted by junyatwin at 2:43 PM on September 22, 2015 [10 favorites]
This guy is not some evil shit stain all on his own. He is the logical conclusion of decades of everyone smiling and acting disinterested as libertarianism and late-model trickle-down capitalism are touted as legitimate and reasonable political beliefs and passed on to newer generations.
posted by newdaddy at 2:44 PM on September 22, 2015 [148 favorites]
posted by newdaddy at 2:44 PM on September 22, 2015 [148 favorites]
There's a slow-motion .gif going around where you can see a micro-expression on his face as he realizes "I am the scum of society," which is then clamped down hard and a rictus grin replaces it.
This is the purest expression of capitalism, can't wait for people to come out of the woodwork to defend this.
posted by fifteen schnitzengruben is my limit at 2:45 PM on September 22, 2015 [7 favorites]
This is the purest expression of capitalism, can't wait for people to come out of the woodwork to defend this.
posted by fifteen schnitzengruben is my limit at 2:45 PM on September 22, 2015 [7 favorites]
This guy's customers, like those of all drug companies, are insurance companies and hospitals, not patients. Patients who are unfortunate enough to be paying out of pocket will get the screw, but that's how all medicine pricing is in the US: this guy is just an exhibition of the pricing defects that occur when nobody's even trying to work out the real value of any of this stuff, but rather trying to transfer money to themselves from all the others with the least risk manageable.
My guess is that this guy's company is going to switch to a price discrimination model, where he charges insurance companies one price, and the little guy a lower price (just like he'll charge Canada a third price and Namibia a fourth, etc.). Then the Insurance companies in the US will say "eh, we don't cover it, buy it yourself," and the price in fact will be lower than $750/pill
posted by Sunburnt at 2:45 PM on September 22, 2015 [4 favorites]
My guess is that this guy's company is going to switch to a price discrimination model, where he charges insurance companies one price, and the little guy a lower price (just like he'll charge Canada a third price and Namibia a fourth, etc.). Then the Insurance companies in the US will say "eh, we don't cover it, buy it yourself," and the price in fact will be lower than $750/pill
posted by Sunburnt at 2:45 PM on September 22, 2015 [4 favorites]
This fucking guy went to my high school (but appears not to have graduated); our Facebook alumni group is discussing what to do with a $1,000,000 donation he gave the school this year.
posted by nicwolff at 2:46 PM on September 22, 2015 [23 favorites]
posted by nicwolff at 2:46 PM on September 22, 2015 [23 favorites]
He also promised: “If you cannot afford the drug we will give it away for free.”
If he holds to this, fine. If not, we have our second pigfucker of the week.
posted by delfin at 2:46 PM on September 22, 2015 [2 favorites]
If he holds to this, fine. If not, we have our second pigfucker of the week.
posted by delfin at 2:46 PM on September 22, 2015 [2 favorites]
This stuff goes on all the time, it's just that most of the companies doing it are run by somewhat more intelligent sociopaths who know that no one will notice the small vampires.
So you're saying that he is actually some kind of performance artist dramatically highlighting the injustice of the system?
posted by acb at 2:47 PM on September 22, 2015 [4 favorites]
So you're saying that he is actually some kind of performance artist dramatically highlighting the injustice of the system?
posted by acb at 2:47 PM on September 22, 2015 [4 favorites]
I've spent a good portion of the past few days imagining his gruesome agonizing prolonged death and it's been quite satisfying.
ideally it will be at least 55x more gruesome and agonizing and prolonged than my friend david's was from crypto.
posted by poffin boffin at 2:47 PM on September 22, 2015 [25 favorites]
ideally it will be at least 55x more gruesome and agonizing and prolonged than my friend david's was from crypto.
posted by poffin boffin at 2:47 PM on September 22, 2015 [25 favorites]
Lawsuit: Scumbag Pill Price Gouger Stalked and Harassed Ex-Coworker's Entire Family
We still have giant pits where lions in need of feeding are allowed to congregate, right?
posted by divined by radio at 2:47 PM on September 22, 2015 [22 favorites]
We still have giant pits where lions in need of feeding are allowed to congregate, right?
posted by divined by radio at 2:47 PM on September 22, 2015 [22 favorites]
This has been a really big issue for patients with diabetes.
I don't think it has. I see the cost increases mainly being people upgrading to pens instead of syringes. It's frustrating that diabetics get cycled so they keep paying non-generic prices, but Lantus is only 10% higher than two years ago, Humalog is steady, Metformin is as cheap as ever (essential way to reduce need for the more expensive insulin, in my opinion.) There seem to be more good mail order options to get cheaper testing equipment and the rebates/etc. for drug stores' generic testing kits are always aggressive.
I don't believe we'll see biosimilars in the US any time soon, though.
posted by michaelh at 2:47 PM on September 22, 2015 [1 favorite]
I don't think it has. I see the cost increases mainly being people upgrading to pens instead of syringes. It's frustrating that diabetics get cycled so they keep paying non-generic prices, but Lantus is only 10% higher than two years ago, Humalog is steady, Metformin is as cheap as ever (essential way to reduce need for the more expensive insulin, in my opinion.) There seem to be more good mail order options to get cheaper testing equipment and the rebates/etc. for drug stores' generic testing kits are always aggressive.
I don't believe we'll see biosimilars in the US any time soon, though.
posted by michaelh at 2:47 PM on September 22, 2015 [1 favorite]
The trend of pushing pricing on drugs has really dominated the financials for their pharma companies for the last few years - as have companies like Valeant that sort of explicitly view their model as - buy, eliminate R&D, cut overheads and raise prices.
I think (hope?) this guy is the final straw that breaks the proverbial camel's back. He pushed the model too far and acted like a jerk. And he gets what every he has coming to him.
posted by JPD at 2:49 PM on September 22, 2015 [3 favorites]
I think (hope?) this guy is the final straw that breaks the proverbial camel's back. He pushed the model too far and acted like a jerk. And he gets what every he has coming to him.
posted by JPD at 2:49 PM on September 22, 2015 [3 favorites]
Actually, there is a bad change which is a change in mail order coverage for people who need CGMs, causing them to become more expensive for some kinds of insurance. Dexcom and Medtronic aren't increasing the price, though.
posted by michaelh at 2:49 PM on September 22, 2015
posted by michaelh at 2:49 PM on September 22, 2015
He pushed the model too far and acted like a jerk. And he gets what every he has coming to him.
Which is what would be nice if it happened. What will probably happen is that people will call him an asshole for a few days, then the rage will die down as people forget or are distracted by the next outrage or spectacle (except for the patients dying because they can't afford medication, but, hey, what can you do?) 18 months later, he makes the news again when he buys a major football club or something.
posted by acb at 2:52 PM on September 22, 2015 [9 favorites]
Which is what would be nice if it happened. What will probably happen is that people will call him an asshole for a few days, then the rage will die down as people forget or are distracted by the next outrage or spectacle (except for the patients dying because they can't afford medication, but, hey, what can you do?) 18 months later, he makes the news again when he buys a major football club or something.
posted by acb at 2:52 PM on September 22, 2015 [9 favorites]
Right, there's plenty more of these GOP presidential candidate debates to go. I'd like to see all the candidates asked what they think about the Shkreli-Daraprim case.
The right-wing party line on this seems to be that the REAL PROBLEM is the FDA requiring bioequivalence studies thus giving Shkreli a government-created monopoly and jacking up the free market system. So it's all the government's fault, of course.
posted by sparklemotion at 2:54 PM on September 22, 2015 [1 favorite]
The right-wing party line on this seems to be that the REAL PROBLEM is the FDA requiring bioequivalence studies thus giving Shkreli a government-created monopoly and jacking up the free market system. So it's all the government's fault, of course.
posted by sparklemotion at 2:54 PM on September 22, 2015 [1 favorite]
It's not even that he's giving away the drug for free — what about the people, the payers who can pay for it?
Hell, what about Medicare? Of course Medicare can pay for it. But that extra 10K that it's going to spend to treat each patient is another 10K that's not going towards a lifesaving surgery. Another 10K that's not going towards primary care for people who need it. And so on.
The issue isn't that some people can pay, but that we're all going to be paying for it, somehow, even if someone or some payer can afford it. And all that money that we could be spending on real healthcare, for people who truly need it — that that money's going to some piece of shit lowlife like this guy — that's the real tragedy here.
posted by un petit cadeau at 2:55 PM on September 22, 2015 [33 favorites]
Hell, what about Medicare? Of course Medicare can pay for it. But that extra 10K that it's going to spend to treat each patient is another 10K that's not going towards a lifesaving surgery. Another 10K that's not going towards primary care for people who need it. And so on.
The issue isn't that some people can pay, but that we're all going to be paying for it, somehow, even if someone or some payer can afford it. And all that money that we could be spending on real healthcare, for people who truly need it — that that money's going to some piece of shit lowlife like this guy — that's the real tragedy here.
posted by un petit cadeau at 2:55 PM on September 22, 2015 [33 favorites]
this was going to be my fpp for tomorrow but it seems like it would go pretty well right here:
What Can You Do If You Can't Afford Your HIV/AIDS Medicine?
posted by poffin boffin at 2:55 PM on September 22, 2015 [11 favorites]
What Can You Do If You Can't Afford Your HIV/AIDS Medicine?
posted by poffin boffin at 2:55 PM on September 22, 2015 [11 favorites]
Daily Beast: Martin Shkreli is Big Pharma's Biggest Asshole
More from Slate
What a chode.
posted by en forme de poire at 3:00 PM on September 22, 2015
More from Slate
What a chode.
posted by en forme de poire at 3:00 PM on September 22, 2015
One of the major factors preventing generics from popping up is the increasing use of REMS to shut out competition.
posted by grumpybear69 at 3:01 PM on September 22, 2015 [1 favorite]
posted by grumpybear69 at 3:01 PM on September 22, 2015 [1 favorite]
fifteen schnitzengruben is my limit: "There's a slow-motion .gif going around where you can see a micro-expression on his face as he realizes "I am the scum of society," which is then clamped down hard and a rictus grin replaces it."
I think we need a link.
Also, all that money (apparently) and he still can't get decent quality rhinoplasty, I guess.
posted by Joakim Ziegler at 3:02 PM on September 22, 2015 [1 favorite]
I think we need a link.
Also, all that money (apparently) and he still can't get decent quality rhinoplasty, I guess.
posted by Joakim Ziegler at 3:02 PM on September 22, 2015 [1 favorite]
A face truly in need of a fist.
posted by mephron at 3:02 PM on September 22, 2015 [4 favorites]
posted by mephron at 3:02 PM on September 22, 2015 [4 favorites]
Scum of the earth.
posted by BlackLeotardFront at 3:03 PM on September 22, 2015 [1 favorite]
posted by BlackLeotardFront at 3:03 PM on September 22, 2015 [1 favorite]
acb: "when he buys a major football club"
Well, he already owns a League of Legends team, so there's that.
posted by mhum at 3:04 PM on September 22, 2015
Well, he already owns a League of Legends team, so there's that.
posted by mhum at 3:04 PM on September 22, 2015
Further proof to validate my deeply held belief that behind everyone with more than a few million dollars is some shady immoral shit.
posted by Arbac at 3:04 PM on September 22, 2015 [3 favorites]
posted by Arbac at 3:04 PM on September 22, 2015 [3 favorites]
they do? that's interesting and the first i've heard of it. can you give me a pointer? i tried googling, but got hits on nationalizing drug companies.
IN Canada there's the Patented Medicine Prices Review Board which isn't quite nationalized pricing, but it does set maximum prices.
posted by GuyZero at 3:05 PM on September 22, 2015
IN Canada there's the Patented Medicine Prices Review Board which isn't quite nationalized pricing, but it does set maximum prices.
posted by GuyZero at 3:05 PM on September 22, 2015
This is all about profit, and the way greed has simply spiraled to fuck you, I want lots of money. Profit in healthcare has generally not been good for people who need health care. Profit has not created efficiency. Pharmaceutical companies are all chasing the big wonderdrug for heart or diabetes, which will be massively profitable. There are all sorts of promising avenues for research for drugs to treat illnesses that a small number of people need. But there's not enough profit in that.
It's the smug sense of superiority and the lack of even a shred of decency that makes me want to throw a drink in his face.
posted by theora55 at 3:07 PM on September 22, 2015 [6 favorites]
It's the smug sense of superiority and the lack of even a shred of decency that makes me want to throw a drink in his face.
posted by theora55 at 3:07 PM on September 22, 2015 [6 favorites]
Digg with the roundup: Who Is Martin Shkreli And Why Is He Price-Gouging AIDS Patients?
posted by the man of twists and turns at 3:07 PM on September 22, 2015 [1 favorite]
posted by the man of twists and turns at 3:07 PM on September 22, 2015 [1 favorite]
I see the cost increases mainly being people upgrading to pens instead of syringes.
I'm on Medicare and I spent a couple hours last year on the phone with the prescription drug plan help line, getting bumped up to higher and higher tiers of support because I couldn't believe it all cost so much after my doctor had thought insulin would be less expensive than oral medications, but for me at least the syringes would cost the exact same amount as pens.
Which makes much more sense to me now, if there are no generic-brand forms of insulin available. If it's all patented anyways the disposable plastic mechanism of the pen (which has already changed once, resetting the patent clock I'm sure) probably doesn't have much impact on the manufacturing cost.
posted by XMLicious at 3:07 PM on September 22, 2015
our Facebook alumni group is discussing what to do with a $1,000,000 donation he gave the school this year.
Infrastructure upgrades? The Martin Shkreli Septic Waste System.
posted by We had a deal, Kyle at 3:08 PM on September 22, 2015 [27 favorites]
Infrastructure upgrades? The Martin Shkreli Septic Waste System.
posted by We had a deal, Kyle at 3:08 PM on September 22, 2015 [27 favorites]
I agree that he probably realizes a generic is inevitable and he's positioning himself to make a bunch of money on other companies who need to do A-B testing. Still, it's artifical bullshit to line his pockets and we all pay for it.
I read somewhere else that companies that price-hike like this stave off generic versions by restricting the supply of their version of a drug, which then hinders the testing required to get a generic approved.
I don't know much about chemistry, but it would be really cool if someone could develop a re-configurable, small batch pharmaceutical production plant that could be used to produce rarely used drugs like this on demand. If drug makers were forced to develop and disseminate a compatible synthesis pathway as part of their patent or marketing approval, we'd have an easy option for preventing situations like this.
I can't imagine that such a machine would be unfeasible, since I recently read about a much more ambitious project to develop a machine that could also formulate synthesis pathways for novel chemicals for research purposes.
posted by cosmic.osmo at 3:11 PM on September 22, 2015 [2 favorites]
I read somewhere else that companies that price-hike like this stave off generic versions by restricting the supply of their version of a drug, which then hinders the testing required to get a generic approved.
I don't know much about chemistry, but it would be really cool if someone could develop a re-configurable, small batch pharmaceutical production plant that could be used to produce rarely used drugs like this on demand. If drug makers were forced to develop and disseminate a compatible synthesis pathway as part of their patent or marketing approval, we'd have an easy option for preventing situations like this.
I can't imagine that such a machine would be unfeasible, since I recently read about a much more ambitious project to develop a machine that could also formulate synthesis pathways for novel chemicals for research purposes.
posted by cosmic.osmo at 3:11 PM on September 22, 2015 [2 favorites]
On the other, he is right in that there ARE copays and there ARE writeoffs and there ARE many, many issues with modern prescription pricing and that there ARE massive costs involved in drug research. One of the reasons that we're running out of antibiotics that work is not that they're not needed, but that they're not profitable to research and thus lower priorities for the big biotech firms.
If only there were a way that the government could provide funding to perform that kind of valuable, potentially-life-saving biological research. That way the money for that research could come out of a broad tax base, instead of just from the pockets of patients with serious diseases and the people who care for them.
posted by en forme de poire at 3:12 PM on September 22, 2015 [61 favorites]
If only there were a way that the government could provide funding to perform that kind of valuable, potentially-life-saving biological research. That way the money for that research could come out of a broad tax base, instead of just from the pockets of patients with serious diseases and the people who care for them.
posted by en forme de poire at 3:12 PM on September 22, 2015 [61 favorites]
Now, let's not get too wild here.
posted by quaking fajita at 3:14 PM on September 22, 2015 [6 favorites]
posted by quaking fajita at 3:14 PM on September 22, 2015 [6 favorites]
I wonder how many people have died because of this little boy's games. Is his kill count above Jeffrey Dahmer's? Ted Bundy's?
posted by You Can't Tip a Buick at 3:15 PM on September 22, 2015 [4 favorites]
posted by You Can't Tip a Buick at 3:15 PM on September 22, 2015 [4 favorites]
I read this today elsewhere. One of the drugs is for toxoplasmosis, there is talk lately of microbial links to mental illness. Toxoplasmosis has been discussed a lot on the cat loving web. I wonder if the talk made the med attractive for aquisition? Then I wonder about subtle propaganda that drives old meds into the spotlight, while the new stuff funds presidential debates. On a lighter note my daughter noted a foot fungus medicine sponsored the latest Republican matchup.
posted by Oyéah at 3:18 PM on September 22, 2015 [1 favorite]
posted by Oyéah at 3:18 PM on September 22, 2015 [1 favorite]
(To be clear, delfin, I'm not trying to make fun of what you said above. I just think gouging patients and the health care system is a shitty, inequitable way to fund research and I think he's being extremely disingenuous about how this is actually somehow for patients' own good, particularly since one of his ideas about future research was apparently a fucking once-daily dosing regimen for the medication, i.e., low-hanging patent fruit.)
posted by en forme de poire at 3:20 PM on September 22, 2015 [2 favorites]
posted by en forme de poire at 3:20 PM on September 22, 2015 [2 favorites]
How can anyone possibly oppose allowing Medicare, which spends north of $50 billion dollars per year on drugs, to negotiate prices? What other organization in the entire world spends $50B without being allowed to negotiate?
posted by ssg at 3:20 PM on September 22, 2015 [29 favorites]
posted by ssg at 3:20 PM on September 22, 2015 [29 favorites]
Also in terms of setting drug prices, the NHS sets a "Pharmaceutical price regulation scheme" every 5 years it seems: Pharmaceutical price regulation scheme 2014
posted by GuyZero at 3:23 PM on September 22, 2015
posted by GuyZero at 3:23 PM on September 22, 2015
It's not just HIV patients that need this medication at times. Some of the sickest children on the planet, those unfortunate enough to be born with a primary immunodeficiency, will be susceptible to the same disease.
posted by kisch mokusch at 3:24 PM on September 22, 2015 [1 favorite]
posted by kisch mokusch at 3:24 PM on September 22, 2015 [1 favorite]
There's a very special circus sideshow in hell for this piece of slime.
posted by Thorzdad at 3:25 PM on September 22, 2015 [1 favorite]
posted by Thorzdad at 3:25 PM on September 22, 2015 [1 favorite]
More evidence about how the free market is making us the best healthcare system in the world.
posted by zombieflanders at 3:29 PM on September 22, 2015 [10 favorites]
posted by zombieflanders at 3:29 PM on September 22, 2015 [10 favorites]
He doesn't want sick people to pay. He already knows they can't.
He wants everyone else to pay via Medicare/Medicaid/InsertProgramNameHere.
Single-payer, folks. Even Donald Trump likes it! :-)
posted by Cool Papa Bell at 3:30 PM on September 22, 2015 [7 favorites]
He wants everyone else to pay via Medicare/Medicaid/InsertProgramNameHere.
Single-payer, folks. Even Donald Trump likes it! :-)
posted by Cool Papa Bell at 3:30 PM on September 22, 2015 [7 favorites]
How do you become this guy? Jesus.
posted by skybluepink at 3:33 PM on September 22, 2015 [2 favorites]
posted by skybluepink at 3:33 PM on September 22, 2015 [2 favorites]
I don't think it has. I see the cost increases mainly being people upgrading to pens instead of syringes. It's frustrating that diabetics get cycled so they keep paying non-generic prices, but Lantus is only 10% higher than two years ago, Humalog is steady, Metformin is as cheap as ever (essential way to reduce need for the more expensive insulin, in my opinion.)
I'm seeing some conflicting info about that, but anyway.
A 30 day supply of Metformin costs about $4. It sure would be nice if that was enough for me. Unfortunately I'm on Metform AND Novolog AND Levemir (my insurance company decided not to cover Lantus and force-switched me to Levemir). A 5-pen box is $420 for one and $450 for the other.
So I inject myself with $60 of stuff every day if not for insurance. Instead, copays and insurance and the deductable cost me a total of about about $12/day -- still way more than many people can afford.
And that's not counting the cost of needles, nor of lancets or test strips, nor doctor visits and blood work every 3 months.
posted by Foosnark at 3:33 PM on September 22, 2015 [3 favorites]
I'm seeing some conflicting info about that, but anyway.
A 30 day supply of Metformin costs about $4. It sure would be nice if that was enough for me. Unfortunately I'm on Metform AND Novolog AND Levemir (my insurance company decided not to cover Lantus and force-switched me to Levemir). A 5-pen box is $420 for one and $450 for the other.
So I inject myself with $60 of stuff every day if not for insurance. Instead, copays and insurance and the deductable cost me a total of about about $12/day -- still way more than many people can afford.
And that's not counting the cost of needles, nor of lancets or test strips, nor doctor visits and blood work every 3 months.
posted by Foosnark at 3:33 PM on September 22, 2015 [3 favorites]
This fucking guy went to my high school (but appears not to have graduated); our Facebook alumni group is discussing what to do with a $1,000,000 donation he gave the school this year.
How about buying up as much as you can of this drug with it and the opening up a drug dispensary for free distribution?
posted by EmpressCallipygos at 3:34 PM on September 22, 2015 [27 favorites]
How about buying up as much as you can of this drug with it and the opening up a drug dispensary for free distribution?
posted by EmpressCallipygos at 3:34 PM on September 22, 2015 [27 favorites]
"I hope nothing terrible happens to him," he lied.
posted by MrJM at 3:40 PM on September 22, 2015 [18 favorites]
posted by MrJM at 3:40 PM on September 22, 2015 [18 favorites]
How about buying up as much as you can of this drug with it and the opening up a drug dispensary for free distribution?
At $750/pill... 1333 pills will go pretty fast I'm guessing. Maybe use the money to publically shame the guy or lobby a congressman to at least consider a single payer system.
posted by sopwath at 3:41 PM on September 22, 2015 [2 favorites]
At $750/pill... 1333 pills will go pretty fast I'm guessing. Maybe use the money to publically shame the guy or lobby a congressman to at least consider a single payer system.
posted by sopwath at 3:41 PM on September 22, 2015 [2 favorites]
How about buying up as much as you can of this drug with it and the opening up a drug dispensary for free distribution?
Rather, provide the drug to a competing company that needs to get through clinical trials to set up production.
posted by The Tensor at 3:43 PM on September 22, 2015 [12 favorites]
Rather, provide the drug to a competing company that needs to get through clinical trials to set up production.
posted by The Tensor at 3:43 PM on September 22, 2015 [12 favorites]
See, guys like this really don't upset me all that much.
I mean, I get it - who he is fundamentally as a person is basically everything that is wrong with our society. I hate what he's doing as much as the next guy. But guys like this are so far outside of my tiny circles of influence that there is nothing I will ever be able to do to stop him from his nefarious acts.
But I'm a firm believer in hell - I realize this makes me in a minority here at Metafilter, but hear me out - whatever hell may be. I personally like to picture it as the fiery inferno, but it could be some kind of cosmic karma that is much different from what I picture. Whatever it is, I think it's out there and waiting for all of us in one way or another.
The way I picture it, whatever it is - it has levels, and depending on how truly evil you are, you get a corresponding level of karmic misery. So, the way I see it, this guy is getting a spot at the white-lava-hot end of the extra crispy ward.
For eternity.
Because I actually believe this it actually makes me feel bad for this guy. I pity him. I wish I could help him avoid his fate.
posted by allkindsoftime at 3:44 PM on September 22, 2015 [3 favorites]
I mean, I get it - who he is fundamentally as a person is basically everything that is wrong with our society. I hate what he's doing as much as the next guy. But guys like this are so far outside of my tiny circles of influence that there is nothing I will ever be able to do to stop him from his nefarious acts.
But I'm a firm believer in hell - I realize this makes me in a minority here at Metafilter, but hear me out - whatever hell may be. I personally like to picture it as the fiery inferno, but it could be some kind of cosmic karma that is much different from what I picture. Whatever it is, I think it's out there and waiting for all of us in one way or another.
The way I picture it, whatever it is - it has levels, and depending on how truly evil you are, you get a corresponding level of karmic misery. So, the way I see it, this guy is getting a spot at the white-lava-hot end of the extra crispy ward.
For eternity.
Because I actually believe this it actually makes me feel bad for this guy. I pity him. I wish I could help him avoid his fate.
posted by allkindsoftime at 3:44 PM on September 22, 2015 [3 favorites]
And here I am expected to feel guilty 'cause I don't go to church on Sundays any more.
posted by turbid dahlia at 3:49 PM on September 22, 2015 [2 favorites]
posted by turbid dahlia at 3:49 PM on September 22, 2015 [2 favorites]
Right, there's plenty more of these GOP presidential candidate debates to go. I'd like to see all the candidates asked what they think about the Shkreli-Daraprim case.
You really think their answers would surprise anyone? Least of all this made-for-James-Spader-to-play fuckwad?
posted by blucevalo at 3:51 PM on September 22, 2015 [1 favorite]
You really think their answers would surprise anyone? Least of all this made-for-James-Spader-to-play fuckwad?
posted by blucevalo at 3:51 PM on September 22, 2015 [1 favorite]
Right, there's plenty more of these GOP presidential candidate debates to go. I'd like to see all the candidates asked what they think about the Shkreli-Daraprim case.
"Obama!"
"That wasn't the question, Ms. Fiorina..."
"Can I just say Carly is a beautiful woman..."
"Mr. Trump, please."
"... a very beautiful woman..."
posted by Cool Papa Bell at 3:53 PM on September 22, 2015 [9 favorites]
"Obama!"
"That wasn't the question, Ms. Fiorina..."
"Can I just say Carly is a beautiful woman..."
"Mr. Trump, please."
"... a very beautiful woman..."
posted by Cool Papa Bell at 3:53 PM on September 22, 2015 [9 favorites]
There is totally a special place in Hell for people who willingly, with a smile on their faces, make life harder for people who already have shitty lives.
posted by roomthreeseventeen at 3:54 PM on September 22, 2015 [5 favorites]
posted by roomthreeseventeen at 3:54 PM on September 22, 2015 [5 favorites]
Here is that slow-motion .gif you requested
posted by fifteen schnitzengruben is my limit at 3:55 PM on September 22, 2015 [34 favorites]
posted by fifteen schnitzengruben is my limit at 3:55 PM on September 22, 2015 [34 favorites]
This issue has been around for a while and many have previously used this awful business model. Way back in 2008 I worked on this issue and it was covered here.
Note that the article finds 26 examples of drugs increasing in price by more than 100% at a time during 2007 alone.
The GAO did a follow up report finding over 400 examples over the 2000-2008 period:
His case is particularly egregious, plus the whole hedge fund bro angle gives it internet juice. But it's a fundamental and widespread practice that we've allowed to happen through our fucked up drug pricing policies. I can actually understand how someone like him just thinks 'hey this is business as usual'. Because sadly, it is.
posted by zipadee at 3:59 PM on September 22, 2015 [17 favorites]
Note that the article finds 26 examples of drugs increasing in price by more than 100% at a time during 2007 alone.
The GAO did a follow up report finding over 400 examples over the 2000-2008 period:
His case is particularly egregious, plus the whole hedge fund bro angle gives it internet juice. But it's a fundamental and widespread practice that we've allowed to happen through our fucked up drug pricing policies. I can actually understand how someone like him just thinks 'hey this is business as usual'. Because sadly, it is.
posted by zipadee at 3:59 PM on September 22, 2015 [17 favorites]
While I'd like to think this guy is simply an asshole out to hurt the poor, I doubt he even thought about that when making this decision. It's purely numbers in the business community most of the time and people suffering only matters if it hurts profits. So I guess what I'm saying is they're all assholes.
posted by downtohisturtles at 4:01 PM on September 22, 2015
posted by downtohisturtles at 4:01 PM on September 22, 2015
How do you become this guy? Jesus.
yes, the Jesus of American Civil Religion.
posted by quonsar II: smock fishpants and the temple of foon at 4:02 PM on September 22, 2015 [2 favorites]
yes, the Jesus of American Civil Religion.
posted by quonsar II: smock fishpants and the temple of foon at 4:02 PM on September 22, 2015 [2 favorites]
I'm on Medicare and I spent a couple hours last year on the phone with the prescription drug plan help line, getting bumped up to higher and higher tiers of support because I couldn't believe it all cost so much after my doctor had thought insulin would be less expensive than oral medications, but for me at least the syringes would cost the exact same amount as pens.
Which makes much more sense to me now, if there are no generic-brand forms of insulin available. If it's all patented anyways the disposable plastic mechanism of the pen (which has already changed once, resetting the patent clock I'm sure) probably doesn't have much impact on the manufacturing cost.
That sounds like the one upside of Medicare if it's the same cost for you. It's definitely not the situation for most diabetics on insurance.
Foosnark, that's rough if they force you onto a pen-only medicine. Your costs sound a little high. I could do my medications uninsured for about $15 a day and medications and testing, including CGM, would be about $30/day uninsured. I'm type 1. Hopefully you can improve your situation soon.
posted by michaelh at 4:03 PM on September 22, 2015
Which makes much more sense to me now, if there are no generic-brand forms of insulin available. If it's all patented anyways the disposable plastic mechanism of the pen (which has already changed once, resetting the patent clock I'm sure) probably doesn't have much impact on the manufacturing cost.
That sounds like the one upside of Medicare if it's the same cost for you. It's definitely not the situation for most diabetics on insurance.
Foosnark, that's rough if they force you onto a pen-only medicine. Your costs sound a little high. I could do my medications uninsured for about $15 a day and medications and testing, including CGM, would be about $30/day uninsured. I'm type 1. Hopefully you can improve your situation soon.
posted by michaelh at 4:03 PM on September 22, 2015
So this guy is contributing literally nothing to the world. If you went back in time and smothered him in his crib, nobody would notice.
I'd love to hear some conservative explain why it's a good thing he's rich.
posted by Naberius at 4:11 PM on September 22, 2015
I'd love to hear some conservative explain why it's a good thing he's rich.
posted by Naberius at 4:11 PM on September 22, 2015
SICKO: EN CUBA
also btw, with the pope coming over from there today, what would francis (anti-christcapitalist) say?
posted by kliuless at 4:12 PM on September 22, 2015 [9 favorites]
also btw, with the pope coming over from there today, what would francis (anti-
"An unfettered pursuit of money rules. The service of the common good is left behind. Once capital becomes an idol and guides people's decisions, once greed for money presides over the entire socioeconomic system, it ruins society, it condemns and enslaves men and women, it destroys human fraternity, it sets people against one another and, as we clearly see, it even puts at risk our common home... The first task is to put the economy at the service of peoples. Human beings and nature must not be at the service of money. Let us say NO to an economy of exclusion and inequality, where money rules, rather than service. That economy kills. That economy excludes. That economy destroys Mother Earth." --Pope Francis[*]oh and fwiw, sanders would allow drug imports...
"[S]ome people continue to defend trickle-down theories which assume that economic growth, encouraged by a free market, will inevitably succeed in bringing about greater justice and inclusiveness in the world. This opinion, which has never been confirmed by the facts, expresses a crude and naïve trust in the goodness of those wielding economic power and in the sacralized workings of the prevailing economic system." --Pope Francis[*]
"I recognize that globalization has helped many people to rise from poverty, but it has condemned many others to hunger. It's true that in absolute terms it grows world wealth, but it also increased the disparity and the new kinds of poverty. What I notice is that this system is maintained with the culture of waste, of which I have already spoken several times. There is a politics, sociology, and also an attitude of rejection. When at the center of the system there is not anymore man but money, when money becomes an idol, men and women are reduced and simply instruments of a social system and an economy characterized, indeed dominated by deep imbalances." --Pope Francis[*]
posted by kliuless at 4:12 PM on September 22, 2015 [9 favorites]
How do you become this guy? Jesus.
The way every other "hedge fund manager" does -- greed, lack of scruples, and skill at lying and intimidation. But he's a bit dumb and makes too much noise about it. Read the letter he sent to his former employee's wife in the Gawker article linked upthread.
The way the press keeps referring to him as an "entrepreneur" and not "a con man" is expected, but still depressing. He founded his previous "biotech startup" literally as a pump-and-dump scheme to pay back investors when his hedge fund went bust.
posted by junco at 4:21 PM on September 22, 2015 [4 favorites]
The way every other "hedge fund manager" does -- greed, lack of scruples, and skill at lying and intimidation. But he's a bit dumb and makes too much noise about it. Read the letter he sent to his former employee's wife in the Gawker article linked upthread.
The way the press keeps referring to him as an "entrepreneur" and not "a con man" is expected, but still depressing. He founded his previous "biotech startup" literally as a pump-and-dump scheme to pay back investors when his hedge fund went bust.
posted by junco at 4:21 PM on September 22, 2015 [4 favorites]
our Facebook alumni group is discussing what to do with a $1,000,000 donation he gave the school this year.
The first thought that came to my mind was convert it to quarters, hold him down, and shove each coin- wait, that would be wrong.
posted by NorthernLite at 4:28 PM on September 22, 2015 [7 favorites]
The first thought that came to my mind was convert it to quarters, hold him down, and shove each coin- wait, that would be wrong.
posted by NorthernLite at 4:28 PM on September 22, 2015 [7 favorites]
In India, multiple combinations of generic pyrimethanine are available for a price ranging from U.S. $0.05–$0.10 each (3–7 rupees).
In the UK, Daraprim is available from GSK at a cost of U.S. $20 (£13) for 30 tablets (approx. $0.66 each)
Just to reiterate: A month course in India is about $3. A month course in Britain is $20. A month course in the US is $22,500.
$22,500.
posted by Lutoslawski at 4:33 PM on September 22, 2015 [46 favorites]
In the UK, Daraprim is available from GSK at a cost of U.S. $20 (£13) for 30 tablets (approx. $0.66 each)
Just to reiterate: A month course in India is about $3. A month course in Britain is $20. A month course in the US is $22,500.
$22,500.
posted by Lutoslawski at 4:33 PM on September 22, 2015 [46 favorites]
In the UK, Daraprim is available from GSK at a cost of U.S. $20 (£13) for 30 tablets (approx. $0.66 each)
Subject to change upon ratification of TTIP.
posted by acb at 4:35 PM on September 22, 2015 [5 favorites]
Subject to change upon ratification of TTIP.
posted by acb at 4:35 PM on September 22, 2015 [5 favorites]
Some other "fun" stuff for the subset of people reading this who also care about post-hardcore/emo music:
AIDS Pill Price-Gouger Revealed as Major Investor in Geoff Rickly's Collect Records
[Interview] COLLECT RECORDS' GEOFF RICKLY ON THE LABEL'S INVOLVEMENT WITH PRICE-GOUGING PHARMA EXEC MARTIN SHKRELI
(Geoff Rickly was the lead singer of the popular post-HC group Thursday.)
No one is thrilled, obv.
posted by raihan_ at 4:37 PM on September 22, 2015 [2 favorites]
AIDS Pill Price-Gouger Revealed as Major Investor in Geoff Rickly's Collect Records
[Interview] COLLECT RECORDS' GEOFF RICKLY ON THE LABEL'S INVOLVEMENT WITH PRICE-GOUGING PHARMA EXEC MARTIN SHKRELI
(Geoff Rickly was the lead singer of the popular post-HC group Thursday.)
No one is thrilled, obv.
posted by raihan_ at 4:37 PM on September 22, 2015 [2 favorites]
This guy belongs in a cell with that oncologist in Michigan who prescribed chemotherapy to people without cancer. That or to take the $1M in quarters NorthernLite proposed, put them all in a sack, and give him a good sack-beating.
posted by Existential Dread at 4:37 PM on September 22, 2015 [7 favorites]
posted by Existential Dread at 4:37 PM on September 22, 2015 [7 favorites]
I first saw this story on the Facebook wall of the lone anti vaxxer in my friends feed, who often posts articles about the evils of "big pharma." And honestly, my first reaction, seeing the story through her, was not "christ, this CEO is an asshole" but "let me read this story first to verify that it is not anti-science outrage filter."
Now, of course, this is big news and the guy is indisputably a mustache twirling villain. But I can't help but think how he's given the anti-vaxxers and other people who inherently don't trust mainstream medicine a huge gift on a gold platter. They can point to this story and say "see, the industry is inherently corrupt and profit-driven, and that is why we don't vaccinate/choose to treat our kid's autism with dangerous chelation therapy/etc. And in this instance, they're 100 percent right, even if they're wildly off base about vaccines.
posted by ActionPopulated at 4:46 PM on September 22, 2015 [4 favorites]
Now, of course, this is big news and the guy is indisputably a mustache twirling villain. But I can't help but think how he's given the anti-vaxxers and other people who inherently don't trust mainstream medicine a huge gift on a gold platter. They can point to this story and say "see, the industry is inherently corrupt and profit-driven, and that is why we don't vaccinate/choose to treat our kid's autism with dangerous chelation therapy/etc. And in this instance, they're 100 percent right, even if they're wildly off base about vaccines.
posted by ActionPopulated at 4:46 PM on September 22, 2015 [4 favorites]
Can the human race survive capitalism? Stories like this make me wonder.
posted by Beholder at 5:04 PM on September 22, 2015 [7 favorites]
posted by Beholder at 5:04 PM on September 22, 2015 [7 favorites]
Between this and the Volkswagen story, it's been a pretty high-profile week for the Evil League of Evil.
posted by sparkletone at 5:12 PM on September 22, 2015 [15 favorites]
posted by sparkletone at 5:12 PM on September 22, 2015 [15 favorites]
He has relented (Twitter linked to spell out an angle not explored here. NYT link)
posted by rhizome at 5:23 PM on September 22, 2015
posted by rhizome at 5:23 PM on September 22, 2015
Apparently the pressure got to him. He's lowering the price, though won't say how much.
(He's still a garbage person)
posted by tocts at 5:25 PM on September 22, 2015
(He's still a garbage person)
posted by tocts at 5:25 PM on September 22, 2015
"The only thing missing from this story is the villain setting fire to an orphanage while trampling puppies underfoot. What a monster," & "If anything this cartoonish mofo is proving that the for-profit model is broken (essential drugs get arbitrary price increases while research disproportionately goes towards erectile dysfunction etc). He's getting while the getting is good. Enjoy it while it lasts ya little ogre," from lesbiassparrow and adeyjones respectively kudos.
Regarding the Metafilter entry summary: "Meanwhile, Shkreli has defended his price hike and says that anyone who cannot afford the drug will not be forced to pay." Read, we'll milk Medicare and Medicaid for all we can and raise costs for ACA as much as practicable, suckers.
When opportunity strikes, that is, a new government health care initiative, ACA, game it and take as much "legal" advantage as possible. Just the worst.
Maybe it is time for a new windfall profits tax on abusive pharma company monopoly and manipulation. Sure, take a $17 dollar med and raise the price to $750 overnight, but, with a new windfall profits tax, let's tax the differential at 99.99%. I sure wouldn't trust this guy to channel the profits back to research - let the government. If the company then quits producing the drug out of retaliation, etc., then the drug is considered abandoned and ownership goes to the government to be reassigned to interested parties. I also noted, these "innovators," are tightly controlling the distribution so companies who could possibly make a generic version cannot obtain enough to re-engineer. These innovators, you know the GOP says they're "Restoring the American Dream" calls, just cries out, for a windfall profits tax. I sure hope to hell, Twitter, Instagram, Facebook, any of the other social media companies push this. Call your Congress critter. Oh, and what's so irksome is the patents for most of these common meds have long ago expired.
I would expect a windfall profits tax would stop this kind of manipulation and speculation dead in its tracks.
Ugh...
posted by WinstonJulia at 5:40 PM on September 22, 2015 [4 favorites]
Regarding the Metafilter entry summary: "Meanwhile, Shkreli has defended his price hike and says that anyone who cannot afford the drug will not be forced to pay." Read, we'll milk Medicare and Medicaid for all we can and raise costs for ACA as much as practicable, suckers.
When opportunity strikes, that is, a new government health care initiative, ACA, game it and take as much "legal" advantage as possible. Just the worst.
Maybe it is time for a new windfall profits tax on abusive pharma company monopoly and manipulation. Sure, take a $17 dollar med and raise the price to $750 overnight, but, with a new windfall profits tax, let's tax the differential at 99.99%. I sure wouldn't trust this guy to channel the profits back to research - let the government. If the company then quits producing the drug out of retaliation, etc., then the drug is considered abandoned and ownership goes to the government to be reassigned to interested parties. I also noted, these "innovators," are tightly controlling the distribution so companies who could possibly make a generic version cannot obtain enough to re-engineer. These innovators, you know the GOP says they're "Restoring the American Dream" calls, just cries out, for a windfall profits tax. I sure hope to hell, Twitter, Instagram, Facebook, any of the other social media companies push this. Call your Congress critter. Oh, and what's so irksome is the patents for most of these common meds have long ago expired.
I would expect a windfall profits tax would stop this kind of manipulation and speculation dead in its tracks.
Ugh...
posted by WinstonJulia at 5:40 PM on September 22, 2015 [4 favorites]
Can anyone familiar with the subject point me to resources with any cogent and reasonable objections to a single-payer system in the US? What would it take tax/policy/logistics wise to pull that off? Would it just be Medicare on steroids?
posted by echocollate at 5:40 PM on September 22, 2015
posted by echocollate at 5:40 PM on September 22, 2015
Daraprim is 62 years old, well past the 20 years for a US patent. The last two links in the post hint at legal maneuvering by Turing Pharmaceuticals to prevent generics from being able to enter the market, but the "closed distribution system" link says that whole scheme has never really been tested in court.
This is a different situation from Sovaldi, the super-expensive hepatitis cure (cure!), where the fruits of illegal research into generics would still need to wait 20 years or else patent-infringment lawsuits could start flying. If enough illegally obtained Daraprim got into the right hands, ie, a rival pharmaceutical company with the will to follow through, would that be enough? Can you do a clean room design and manage to make it legally that way, since Daraprim is off-patent?
A legal method would have come through the FAST Generics Act that was proposed to Congress in 2014, which would have prevented the need to break laws in order to acquire the name-brand product, but unfortunately it failed.
--
It should be noted that Martin Shkreli was a hedge-fund manager, and is not a pharmacist or a chemist or a doctor or a scientist of any sort; you can point at Wall Street for being corrupt.
posted by fragmede at 5:43 PM on September 22, 2015 [1 favorite]
This is a different situation from Sovaldi, the super-expensive hepatitis cure (cure!), where the fruits of illegal research into generics would still need to wait 20 years or else patent-infringment lawsuits could start flying. If enough illegally obtained Daraprim got into the right hands, ie, a rival pharmaceutical company with the will to follow through, would that be enough? Can you do a clean room design and manage to make it legally that way, since Daraprim is off-patent?
A legal method would have come through the FAST Generics Act that was proposed to Congress in 2014, which would have prevented the need to break laws in order to acquire the name-brand product, but unfortunately it failed.
--
It should be noted that Martin Shkreli was a hedge-fund manager, and is not a pharmacist or a chemist or a doctor or a scientist of any sort; you can point at Wall Street for being corrupt.
posted by fragmede at 5:43 PM on September 22, 2015 [1 favorite]
I came into the thread expecting nothing but 80 comments consisting of "Christ, what an asshole." It would have been appropriate.
posted by Justinian at 5:52 PM on September 22, 2015 [2 favorites]
posted by Justinian at 5:52 PM on September 22, 2015 [2 favorites]
The licensing fee for "Christ, what an asshole" was recently increased twenty-fold, so we're having to improvise.
posted by cortex at 5:54 PM on September 22, 2015 [46 favorites]
posted by cortex at 5:54 PM on September 22, 2015 [46 favorites]
He is now the most hated person on the internet. His OK Cupid profile has been posted (I refuse to link to it) on which he says he "thinks a lot about human suffering."
posted by Obscure Reference at 5:57 PM on September 22, 2015 [2 favorites]
posted by Obscure Reference at 5:57 PM on September 22, 2015 [2 favorites]
thinks a lot about human suffering
YKINMKAYKINOK
posted by tonycpsu at 5:59 PM on September 22, 2015 [5 favorites]
YKINMKAYKINOK
posted by tonycpsu at 5:59 PM on September 22, 2015 [5 favorites]
To be fair he didn't say whether he thinks about decreasing or increasing it.
posted by Justinian at 5:59 PM on September 22, 2015 [20 favorites]
posted by Justinian at 5:59 PM on September 22, 2015 [20 favorites]
Daily Beast: Martin Shkreli is Big Pharma's Biggest Asshole
Yeah, here's the thing about that. He's not big pharma. This guy is small artisanal mom and pop phama. I'd bet pretty much everything he does is with contract organizations and no one in the front office could explain what a covalent bond was if their life depended on it. Their Switzerland location shares a parking lot with the Swiss version of Bed Bath and Beyond for God's sake.
I hope Big Pharma is paying attention to Shkreli and his loathsome ilk, because, as Lowe said, this is a huge embarrassment for the industry.
Anyone want to go in on a B corp? I know a guy who could run bioanalytics.
posted by Kid Charlemagne at 6:01 PM on September 22, 2015 [9 favorites]
Yeah, here's the thing about that. He's not big pharma. This guy is small artisanal mom and pop phama. I'd bet pretty much everything he does is with contract organizations and no one in the front office could explain what a covalent bond was if their life depended on it. Their Switzerland location shares a parking lot with the Swiss version of Bed Bath and Beyond for God's sake.
I hope Big Pharma is paying attention to Shkreli and his loathsome ilk, because, as Lowe said, this is a huge embarrassment for the industry.
Anyone want to go in on a B corp? I know a guy who could run bioanalytics.
posted by Kid Charlemagne at 6:01 PM on September 22, 2015 [9 favorites]
More evidence about how the free market is making us the best healthcare system in the world.
This is exactly the opposite of a free market. This is the government and men with guns who will haul you away and throw you in jail if you try to participate in a real free market.
Congress wrote the law that prevents Medicare from negotiating on drug prices. Congress wrote the law that will put you in jail if you try to buy drugs on the free market in foreign countries. Congress wrote the law that gives pharmaceutical companies exclusive anti-competitive monopolies on drugs for 20 years and will put you in jail if you use free market innovation and efficiency to make and sell a cheaper version. Barack Obama and Congress are attempting to pass trade laws that extend all of these restrictions to every other country in the world.
Martin Shkreli did not just wake up one morning and figure out a way to make money. He would be helpless in any attempt to do this without the full power and intimidation of the government to back him up.
This form of capitalism isn't like some immutable law of physics that can't be violated. These are deliberate, man-made rules that use government power to extract money from citizens and transfer it to the elites.
posted by JackFlash at 6:06 PM on September 22, 2015 [42 favorites]
This is exactly the opposite of a free market. This is the government and men with guns who will haul you away and throw you in jail if you try to participate in a real free market.
Congress wrote the law that prevents Medicare from negotiating on drug prices. Congress wrote the law that will put you in jail if you try to buy drugs on the free market in foreign countries. Congress wrote the law that gives pharmaceutical companies exclusive anti-competitive monopolies on drugs for 20 years and will put you in jail if you use free market innovation and efficiency to make and sell a cheaper version. Barack Obama and Congress are attempting to pass trade laws that extend all of these restrictions to every other country in the world.
Martin Shkreli did not just wake up one morning and figure out a way to make money. He would be helpless in any attempt to do this without the full power and intimidation of the government to back him up.
This form of capitalism isn't like some immutable law of physics that can't be violated. These are deliberate, man-made rules that use government power to extract money from citizens and transfer it to the elites.
posted by JackFlash at 6:06 PM on September 22, 2015 [42 favorites]
Shkreli has defended hisprice hike and says that anyone who cannot afford the drug will not be forced to pay.
...aaand anyone who still has a functioning, transplantable kidney can afford to pay. It's win/win!
posted by sexyrobot at 6:07 PM on September 22, 2015 [1 favorite]
...aaand anyone who still has a functioning, transplantable kidney can afford to pay. It's win/win!
posted by sexyrobot at 6:07 PM on September 22, 2015 [1 favorite]
It is difficult to overemphasize how vile his responses to interlocutors on his Twitter feed have been.
I think even Patrick Bateman would have recoiled from making some of his replies.
posted by winna at 6:08 PM on September 22, 2015 [1 favorite]
I think even Patrick Bateman would have recoiled from making some of his replies.
posted by winna at 6:08 PM on September 22, 2015 [1 favorite]
Can anyone familiar with the subject point me to resources with any cogent and reasonable objections to a single-payer system in the US?
There already is a single payer system for a large portion of the U.S. It's called Medicare but is forbidden by law from negotiating on drug prices thanks to Bush's 2003 law. The law also prohibits Medicare or anyone else from buying at lower prices from foreign countries.
There is another smaller single payer system. It is called the Veteran's Administration. It is not prohibited from negotiating drug prices and gets discounts of more than 40% from the prices paid by Medicare. U.S. taxpayers cough up the higher Medicare prices in their payroll taxes.
posted by JackFlash at 6:16 PM on September 22, 2015 [22 favorites]
There already is a single payer system for a large portion of the U.S. It's called Medicare but is forbidden by law from negotiating on drug prices thanks to Bush's 2003 law. The law also prohibits Medicare or anyone else from buying at lower prices from foreign countries.
There is another smaller single payer system. It is called the Veteran's Administration. It is not prohibited from negotiating drug prices and gets discounts of more than 40% from the prices paid by Medicare. U.S. taxpayers cough up the higher Medicare prices in their payroll taxes.
posted by JackFlash at 6:16 PM on September 22, 2015 [22 favorites]
This is exactly the opposite of a free market. This is the government and men with guns who will haul you away and throw you in jail if you try to participate in a real free market.
Kind of. It's protectionism and welfare for the elites. It's a true free market for everyone else.
posted by a lungful of dragon at 6:25 PM on September 22, 2015 [1 favorite]
Kind of. It's protectionism and welfare for the elites. It's a true free market for everyone else.
posted by a lungful of dragon at 6:25 PM on September 22, 2015 [1 favorite]
You are totally welcome to start doing research on your Sovaldi generic right now. You just can't do anything commercial with it until it goes off patent. This is how generic drugs are able to be on the market the day after the patent expires.
And it would be perfectly legal to purchase Daraprim for research purposes. I've run a rival's similar product in my assay back in the day to confirm something (and was smug four hours because our product was significantly cleaner than theirs was (unfortunately it was not any more effective)). Anyhow, all you'd need would be the patent as that would have the relevant information in it. Hell, wikipedia will get you there. The thing is, there's a shit ton of work between knowing how to make the stuff and scaling up to a full scale commercial launch. Just sticking to analytics (because that's where I'm a viking) you need to develop and validate about 20 different assays to show that your product is what you think it is, and doesn't contain things you don't want it to contain, lest you wind up in Marvel Comics' "What if Josef Mengele had good intentions?"
Anyhow, the thing is, whoever first made Daraprim had long since amortized the cost of all that, so rather than rolling back costs to what they were, you're going to end up having to charge a significant ammount more than they used to just to keep paying the rent. And everyone will think you're merely gouging less rather than that you just did an amazingly heroic job of bringing something to market in incredibly short order.
You better have a good legal department too, because I'm thinking The Smirk (or whatever his super villain name is) is going to come after you straight away.
posted by Kid Charlemagne at 6:28 PM on September 22, 2015 [4 favorites]
And it would be perfectly legal to purchase Daraprim for research purposes. I've run a rival's similar product in my assay back in the day to confirm something (and was smug four hours because our product was significantly cleaner than theirs was (unfortunately it was not any more effective)). Anyhow, all you'd need would be the patent as that would have the relevant information in it. Hell, wikipedia will get you there. The thing is, there's a shit ton of work between knowing how to make the stuff and scaling up to a full scale commercial launch. Just sticking to analytics (because that's where I'm a viking) you need to develop and validate about 20 different assays to show that your product is what you think it is, and doesn't contain things you don't want it to contain, lest you wind up in Marvel Comics' "What if Josef Mengele had good intentions?"
Anyhow, the thing is, whoever first made Daraprim had long since amortized the cost of all that, so rather than rolling back costs to what they were, you're going to end up having to charge a significant ammount more than they used to just to keep paying the rent. And everyone will think you're merely gouging less rather than that you just did an amazingly heroic job of bringing something to market in incredibly short order.
You better have a good legal department too, because I'm thinking The Smirk (or whatever his super villain name is) is going to come after you straight away.
posted by Kid Charlemagne at 6:28 PM on September 22, 2015 [4 favorites]
If enough illegally obtained Daraprim got into the right hands, ie, a rival pharmaceutical company with the will to follow through, would that be enough? Can you do a clean room design and manage to make it legally that way, since Daraprim is off-patent?
GMP is really strict for pharmaceuticals. Anything that's going to be used as a reference standard needs to have a legit paper trail. For a bioequivalence study, you need to compare the PK properties of your generic drug with the already-approved product. You can't just synthesize the same chemical and declare it the same, since the inactive chemicals in the product (the excipients) can influence the PK properties. You have to compare your product directly with the approved product, with the latter obtained through legal and well-documented means.
posted by dephlogisticated at 6:28 PM on September 22, 2015 [5 favorites]
GMP is really strict for pharmaceuticals. Anything that's going to be used as a reference standard needs to have a legit paper trail. For a bioequivalence study, you need to compare the PK properties of your generic drug with the already-approved product. You can't just synthesize the same chemical and declare it the same, since the inactive chemicals in the product (the excipients) can influence the PK properties. You have to compare your product directly with the approved product, with the latter obtained through legal and well-documented means.
posted by dephlogisticated at 6:28 PM on September 22, 2015 [5 favorites]
I have a story which might at first seem unrelated to this, but isn't.
I recently became aware that I kind of needed what is sometimes called *cough* OK fuck it I needed dick pills. Because getting old sucks.
So I did what the ads say and consulted with my cardiologist (who saved my life last year by roto-rootering my widowmaker artery) and gave my pharmacist a prescription for Viagra.
That shit is $40 a pill and not covered by insurance.
Now it turns out there is a story as to how Viagra (and, by extension, the other dick pills Cialis and Levitra) are priced. When they realized what they had Pfizer unleashed an unholy horde of actuaries and pollsters on the public and determined that their optimum price point, at which they would sell the most pills at the highest price to make the most money before breaking down too many of the potential buyers, was $25 a boner. Pfizer's price has ALWAYS been per boner, as you can see by the fact that 50mg and 100mg Viagra cost the same. Always have.
Of course people, especially older middle class men who can afford this shit, aren't fucking stupid and eventually all of them bought pill cutters so today it's just assumed everybody buys 100mg Viagras and those who can cut them in half, and they cost $40.
Viagra was supposed to go generic in 2012 but Pfizer spent $MILLION$ to sue for a new "use patent" on the special use of the drug as a dick pill as opposed to its generic use as a drug for any purpose, which will not expire until 2019. Despite the fact that this dodge has hardly ever worked before for anybody in the industry Pfizer got their new patent. I'm sure the fact that the $BILLION dick pill industry all falls down once any of the PDE5 inhibitors goes generic had nothing to do with this. [sarcasm tag goes here]
Canada told Pfizer to pound sand and Viagra is generic there today, so that 50 mg pill is $3, the 100 mg is $6, and they have 150mg and 200mg pills at $9 and $12 which Pfizer insists don't do anything for anybody. More lies since if Pfizer sold boners to people who need 200 mg the pill cutters would come out in force.
So how overpriced is Viagra? While I was contemplating my inability to afford it I ran across several companies selling the raw ingredient. I bought ten grams for $50. There is no prefix there. If 50 milligrams works for you, that is TWO HUNDRED DOSES, each of which Pfizer wants $40 for. Packed in gelcaps on a milligram scale the pills work just like the blue ones from the assholes. I have no reason to suspect they are adulterated since this is a well-qualified drug made for many years and any gotchas in the manufacturing are long known, and it works at the same levels as the "real thing." Automated drug factories are automated whether Pfizer owns them or not. We're long past the point when some flunkie will miss a step in a commercial operation.
But Pfizer insists to this day in trying to sell it by the boner for the price their actuaries figured men would put up with. This might not be on your outragefilter because loldickpills, but it's actually the same behavior as the OP jackal but a much more common and mainstream example of it. There are similar but less obvious examples all over the place, but dick pills are another point where the greed just nakedly emerges because they think everyone will be too embarrassed to complain.
posted by Bringer Tom at 6:47 PM on September 22, 2015 [50 favorites]
I recently became aware that I kind of needed what is sometimes called *cough* OK fuck it I needed dick pills. Because getting old sucks.
So I did what the ads say and consulted with my cardiologist (who saved my life last year by roto-rootering my widowmaker artery) and gave my pharmacist a prescription for Viagra.
That shit is $40 a pill and not covered by insurance.
Now it turns out there is a story as to how Viagra (and, by extension, the other dick pills Cialis and Levitra) are priced. When they realized what they had Pfizer unleashed an unholy horde of actuaries and pollsters on the public and determined that their optimum price point, at which they would sell the most pills at the highest price to make the most money before breaking down too many of the potential buyers, was $25 a boner. Pfizer's price has ALWAYS been per boner, as you can see by the fact that 50mg and 100mg Viagra cost the same. Always have.
Of course people, especially older middle class men who can afford this shit, aren't fucking stupid and eventually all of them bought pill cutters so today it's just assumed everybody buys 100mg Viagras and those who can cut them in half, and they cost $40.
Viagra was supposed to go generic in 2012 but Pfizer spent $MILLION$ to sue for a new "use patent" on the special use of the drug as a dick pill as opposed to its generic use as a drug for any purpose, which will not expire until 2019. Despite the fact that this dodge has hardly ever worked before for anybody in the industry Pfizer got their new patent. I'm sure the fact that the $BILLION dick pill industry all falls down once any of the PDE5 inhibitors goes generic had nothing to do with this. [sarcasm tag goes here]
Canada told Pfizer to pound sand and Viagra is generic there today, so that 50 mg pill is $3, the 100 mg is $6, and they have 150mg and 200mg pills at $9 and $12 which Pfizer insists don't do anything for anybody. More lies since if Pfizer sold boners to people who need 200 mg the pill cutters would come out in force.
So how overpriced is Viagra? While I was contemplating my inability to afford it I ran across several companies selling the raw ingredient. I bought ten grams for $50. There is no prefix there. If 50 milligrams works for you, that is TWO HUNDRED DOSES, each of which Pfizer wants $40 for. Packed in gelcaps on a milligram scale the pills work just like the blue ones from the assholes. I have no reason to suspect they are adulterated since this is a well-qualified drug made for many years and any gotchas in the manufacturing are long known, and it works at the same levels as the "real thing." Automated drug factories are automated whether Pfizer owns them or not. We're long past the point when some flunkie will miss a step in a commercial operation.
But Pfizer insists to this day in trying to sell it by the boner for the price their actuaries figured men would put up with. This might not be on your outragefilter because loldickpills, but it's actually the same behavior as the OP jackal but a much more common and mainstream example of it. There are similar but less obvious examples all over the place, but dick pills are another point where the greed just nakedly emerges because they think everyone will be too embarrassed to complain.
posted by Bringer Tom at 6:47 PM on September 22, 2015 [50 favorites]
Yeah, "free market" is not the preferred nomenclature. "Regulatory capture" would be more accurate. Like the time they dressed up as pro-environment lobbyists to get the FDA to ban generic asthma inhalers.
The DOJ has an antitrust investigation ongoing for some of the shenanigans surrounding generics -- but I'm not holding my breath, especially so close to campaign donation season.
posted by RobotVoodooPower at 6:53 PM on September 22, 2015 [4 favorites]
The DOJ has an antitrust investigation ongoing for some of the shenanigans surrounding generics -- but I'm not holding my breath, especially so close to campaign donation season.
posted by RobotVoodooPower at 6:53 PM on September 22, 2015 [4 favorites]
So you can have a patient mill with an unscrupulous doctor, the clinic "recruiting" patients, then over billing Medicare or Medicaid for services provided or not costing outrageous amounts. Now the pharma "arrangement" described here is technically legal but how does it differ in the broad sense? Oh, I get it, the hedge fund guy, who finds another "loophole," legal loophole that games the system but is not outright fraud. And the fact that the company is attempting to control distribution? How the hell does this differ from a monopolistic practice? A windfall profits tax would halt this kind of abuse dead in its tracks by dis-incentivizing the scam.
This system is rotten to the core and just a little "loophole" heavy in favor of the gamesters and scamsters. One of the latent effects is to gouge ACA by piling up pseudo-fraudulent billing costs on the system deeply overburdening the resources and needlessly driving up costs. One of the principles of ACA is cost recovery in the provision of Medicare and Medicaid services. It ain't happening with this kind of abuse and will still be difficult due to the GOP legacy of fixing the system. As Jackfish points out, Congress, read GOP, and George W Bush very specifically demanded prohibiting Medicare and Medicaid from negotiating lower drug prices.
And so it goes.
posted by WinstonJulia at 6:54 PM on September 22, 2015 [1 favorite]
This system is rotten to the core and just a little "loophole" heavy in favor of the gamesters and scamsters. One of the latent effects is to gouge ACA by piling up pseudo-fraudulent billing costs on the system deeply overburdening the resources and needlessly driving up costs. One of the principles of ACA is cost recovery in the provision of Medicare and Medicaid services. It ain't happening with this kind of abuse and will still be difficult due to the GOP legacy of fixing the system. As Jackfish points out, Congress, read GOP, and George W Bush very specifically demanded prohibiting Medicare and Medicaid from negotiating lower drug prices.
And so it goes.
posted by WinstonJulia at 6:54 PM on September 22, 2015 [1 favorite]
There is another smaller single payer system.
tricare is also single payer, but maybe not for long - "Washington policymakers will soon begin consideration of the biggest overhaul of the military health care system since Tricare replaced CHAMPUS in the early 1990s — changes that would shift millions of beneficiaries to commercial, private-sector health plans."
kickstarter is a public benefit corporation now... [1,2,3,4,5]
posted by kliuless at 7:00 PM on September 22, 2015
tricare is also single payer, but maybe not for long - "Washington policymakers will soon begin consideration of the biggest overhaul of the military health care system since Tricare replaced CHAMPUS in the early 1990s — changes that would shift millions of beneficiaries to commercial, private-sector health plans."
Currently, Tricare beneficiaries can fill a 90-day prescription for a generic medication at no cost by mail or pay $8 for a 30-day supply at a retail pharmacy. They must pay $16 for a 90-day prescription for brand names by mail and $20 for a 30-day brand-name prescription at retail pharmacies.Anyone want to go in on a B corp?
Medications not listed in Tricare's formulary run $47 for a 30-day prescription at a retail pharmacy and $46 for a 90-day prescription by mail.
Prescriptions filled at military pharmacies are available to beneficiaries at no cost.
Tricare pharmacy co-payments have become a source of contention this year during deliberations on the fiscal 2015 defense authorization bill, with Senate negotiators wanting to increase fees for brand-name prescriptions and drugs not listed in the Tricare formulary.
House lawmakers negotiating the final version of the bill remain opposed to the increases.
kickstarter is a public benefit corporation now... [1,2,3,4,5]
posted by kliuless at 7:00 PM on September 22, 2015
This is a great post, thanks. As someone with a passing interest in pharma companies, I am especially happy to discover Derek Lowe and have been reading through some of the past posts on his blog. Apparently, he made a post on Reddit a year ago about Retrophin (when Martin was CEO) buying the rights to Thiola and jacking up the price. And Martin turned up in the thread, announced himself as CEO and declared an AMA. He is also participating as recently as yesterday in the new Reddit thread on the topic we're discussing today. This heavy participation on social media by a CEO/hedge fund manager seems a little...unusual.
posted by triggerfinger at 7:07 PM on September 22, 2015 [1 favorite]
posted by triggerfinger at 7:07 PM on September 22, 2015 [1 favorite]
This is exactly the opposite of a free market. This is the government and men with guns who will haul you away and throw you in jail if you try to participate in a real free market.
The free market isn't a real thing that exists, or could even exist. It's a marketing term created to get support for pro-industry policies that nobody would support otherwise. The people who push it are the same people who get laws written that let the government redistribute wealth to the elites.
Much like the regulations passed that allowed this to happen. It's pro-industry. The only common theme here between free-market rhetoric and regulations is they both happen to be pro-industry with costs externalized to the public.
So the common issue here isn't the government, because the government is being used both ways for the benefit of ... whom? Answer that and you'll figure out who the real problem is.
posted by gehenna_lion at 7:15 PM on September 22, 2015 [13 favorites]
The free market isn't a real thing that exists, or could even exist. It's a marketing term created to get support for pro-industry policies that nobody would support otherwise. The people who push it are the same people who get laws written that let the government redistribute wealth to the elites.
Much like the regulations passed that allowed this to happen. It's pro-industry. The only common theme here between free-market rhetoric and regulations is they both happen to be pro-industry with costs externalized to the public.
So the common issue here isn't the government, because the government is being used both ways for the benefit of ... whom? Answer that and you'll figure out who the real problem is.
posted by gehenna_lion at 7:15 PM on September 22, 2015 [13 favorites]
Under current law, the Medicare prescription drug program is not allowed to negotiate prices with drug companies.
Textbook example of why every line of every law drafted and enacted in the US (or anywhere, really) should have a footnote giving the name of whoever stuck it in.
posted by IndigoJones at 7:19 PM on September 22, 2015 [3 favorites]
Textbook example of why every line of every law drafted and enacted in the US (or anywhere, really) should have a footnote giving the name of whoever stuck it in.
posted by IndigoJones at 7:19 PM on September 22, 2015 [3 favorites]
Viagra was supposed to go generic in 2012 but Pfizer spent $MILLION$ to sue for a new "use patent" on the special use of the drug as a dick pill as opposed to its generic use as a drug for any purpose, which will not expire until 2019.
The active chemical in Viagra, sildenifil, was originally designed as a drug for hypertension. The erection-promoting properties were discovered as a happy side effect during clinical testing. Pfizer filed a patent for this use in 1994 (the original patent was for its cardiovascular uses), but for reasons I've never heard explained, the patent did not officially get approved until 2002. Teva, a generic drug company, challenged this patent in court and lost (so while Pfizer did probably spend millions on this fight, they were not suing for a new patent, they were defending an existing one). The standard patent window for drugs is 17 years, which means a generic version of the drug could be sold in 2019. However, Pfizer ultimately reached a settlement with Teva that would allow them (Teva only, not other generic companies) to sell a generic version in 2017. This is also the year Cialis goes generic, so I can only presume that 2017 will be a banner year for the sale of boner pills.
posted by dephlogisticated at 7:41 PM on September 22, 2015 [3 favorites]
The active chemical in Viagra, sildenifil, was originally designed as a drug for hypertension. The erection-promoting properties were discovered as a happy side effect during clinical testing. Pfizer filed a patent for this use in 1994 (the original patent was for its cardiovascular uses), but for reasons I've never heard explained, the patent did not officially get approved until 2002. Teva, a generic drug company, challenged this patent in court and lost (so while Pfizer did probably spend millions on this fight, they were not suing for a new patent, they were defending an existing one). The standard patent window for drugs is 17 years, which means a generic version of the drug could be sold in 2019. However, Pfizer ultimately reached a settlement with Teva that would allow them (Teva only, not other generic companies) to sell a generic version in 2017. This is also the year Cialis goes generic, so I can only presume that 2017 will be a banner year for the sale of boner pills.
posted by dephlogisticated at 7:41 PM on September 22, 2015 [3 favorites]
This fucking guy went to my high school (but appears not to have graduated); our Facebook alumni group is discussing what to do with a $1,000,000 donation he gave the school this year.
Buy a pill for a deserving poor person.
posted by pjern at 8:03 PM on September 22, 2015 [4 favorites]
Buy a pill for a deserving poor person.
posted by pjern at 8:03 PM on September 22, 2015 [4 favorites]
So how overpriced is Viagra? While I was contemplating my inability to afford it I ran across several companies selling the raw ingredient. I bought ten grams for $50.
This sounds too good to be true. How do you know they didn't just sell you blue-colored flour?
posted by ymgve at 8:15 PM on September 22, 2015
This sounds too good to be true. How do you know they didn't just sell you blue-colored flour?
posted by ymgve at 8:15 PM on September 22, 2015
Viagra is highly effective. It should be very obvious if it is working. It's not the sort of thing you get confused with placebo.
I don't know what he means by "raw ingredient" though. Generic sildenafil? I've never heard anyone refer to a generic as "raw ingredient" before. The downside is ordering that is illegal, not that you might be out $50.
posted by Justinian at 8:41 PM on September 22, 2015
I don't know what he means by "raw ingredient" though. Generic sildenafil? I've never heard anyone refer to a generic as "raw ingredient" before. The downside is ordering that is illegal, not that you might be out $50.
posted by Justinian at 8:41 PM on September 22, 2015
Did anyone else read the Forbes article and notice this about Turing Pharma:
...and it is developing several therapies, including an intranasal form of the anesthetic ketamine...
So, this guy's one research project is a nose spray version of Special K?!? Ya know, the date rape drug.
Dear god, he is Adam Scott's character in Step Brothers.
posted by rock swoon has no past at 8:41 PM on September 22, 2015 [2 favorites]
...and it is developing several therapies, including an intranasal form of the anesthetic ketamine...
So, this guy's one research project is a nose spray version of Special K?!? Ya know, the date rape drug.
Dear god, he is Adam Scott's character in Step Brothers.
posted by rock swoon has no past at 8:41 PM on September 22, 2015 [2 favorites]
Pharma industry blogger Derek Lowe (previously) also has some ideas about what to do about Turing.
I'm not clicking this because I don't want to find out the answer isn't 'set him on fire'.
posted by thsmchnekllsfascists at 8:43 PM on September 22, 2015 [1 favorite]
I'm not clicking this because I don't want to find out the answer isn't 'set him on fire'.
posted by thsmchnekllsfascists at 8:43 PM on September 22, 2015 [1 favorite]
If I were him, I wouldn't be concerned about snide comments on Twitter. If I were him, I would be concerned for my own mortal soul. God is watching us.
posted by newdaddy at 8:48 PM on September 22, 2015
posted by newdaddy at 8:48 PM on September 22, 2015
Did anyone else read the Forbes article and notice this about Turing Pharma:
...and it is developing several therapies, including an intranasal form of the anesthetic ketamine...
So, this guy's one research project is a nose spray version of Special K?!? Ya know, the date rape drug.
Dear god, he is Adam Scott's character in Step Brothers.
posted by rock swoon has no past at 8:41 PM on September 22 [+] [!]
rock swoon - I can't speak to whether ketamine is actually being used for that purpose (I thought that was just rohypnol) but ketamine is an incredibly useful drug in the emergency setting for a quick acting and safe anaesthetic, so presumably a delivery method not requiring IV access would be pretty useful in trauma settings.
posted by docpops at 8:49 PM on September 22, 2015 [11 favorites]
...and it is developing several therapies, including an intranasal form of the anesthetic ketamine...
So, this guy's one research project is a nose spray version of Special K?!? Ya know, the date rape drug.
Dear god, he is Adam Scott's character in Step Brothers.
posted by rock swoon has no past at 8:41 PM on September 22 [+] [!]
rock swoon - I can't speak to whether ketamine is actually being used for that purpose (I thought that was just rohypnol) but ketamine is an incredibly useful drug in the emergency setting for a quick acting and safe anaesthetic, so presumably a delivery method not requiring IV access would be pretty useful in trauma settings.
posted by docpops at 8:49 PM on September 22, 2015 [11 favorites]
As I recall, docpops, Ketamine was one of the date rape/party drugs of the nineties. Pretty sure that's the origin of the 'K Hole.'
posted by rock swoon has no past at 9:15 PM on September 22, 2015
posted by rock swoon has no past at 9:15 PM on September 22, 2015
Pretty sure that's the origin of the 'K Hole.'
I am more than a little glad to know the meaning behind this, finally.
posted by docpops at 9:30 PM on September 22, 2015
I am more than a little glad to know the meaning behind this, finally.
posted by docpops at 9:30 PM on September 22, 2015
docpops is completely right; an intranasal form of ketamine would be super useful so it's not really fair to give somebody crap for working on it. Ketamine is great. I wish they gave me ketamine instead of whatever garbage they used on me when I had my surgeries because that stuff always makes me feel like shit later.
posted by Justinian at 9:46 PM on September 22, 2015 [1 favorite]
posted by Justinian at 9:46 PM on September 22, 2015 [1 favorite]
It's worth remembering that while some drugs are overpriced, they're also taking manufacturing space away from needed drugs that aren't deemed profitable by drug companies. Having hedge funds manage drug pricing in general seems like a really poor way for society to price medicine.
posted by sneebler at 9:50 PM on September 22, 2015
posted by sneebler at 9:50 PM on September 22, 2015
Can anyone familiar with the subject point me to resources with any cogent and reasonable objections to a single-payer system in the US?
yeah, sure. here's a link:
posted by feckless fecal fear mongering at 10:06 PM on September 22, 2015 [19 favorites]
yeah, sure. here's a link:
posted by feckless fecal fear mongering at 10:06 PM on September 22, 2015 [19 favorites]
So how overpriced is Viagra? While I was contemplating my inability to afford it I ran across several companies selling the raw ingredient. I bought ten grams for $50.
How does you check that the stuff is reliable and sufficiently chemically pure? And are there restrictions on ordering (non-psychoactive) pharmaceutical ingredients to your doorstep?
posted by sebastienbailard at 10:14 PM on September 22, 2015
How does you check that the stuff is reliable and sufficiently chemically pure? And are there restrictions on ordering (non-psychoactive) pharmaceutical ingredients to your doorstep?
posted by sebastienbailard at 10:14 PM on September 22, 2015
We should just setup a federally administered lab to manufacture these kinds of medications.
posted by humanfont at 10:17 PM on September 22, 2015 [3 favorites]
posted by humanfont at 10:17 PM on September 22, 2015 [3 favorites]
It is so nuts that this is even a real situation. It feels like Cabin in the Woods where tropes and parodies come to life.
posted by SpacemanStix at 10:32 PM on September 22, 2015 [2 favorites]
posted by SpacemanStix at 10:32 PM on September 22, 2015 [2 favorites]
As I recall, docpops, Ketamine was one of the date rape/party drugs of the nineties. Pretty sure that's the origin of the 'K Hole.'
Party/psychonaut drug, yes, which is where the term "K-Hole" comes from. Date rape - well a person under the influence of ketamine is certainly quite vulnerable but it's not the most likely thing to slip to someone undetected. Per os it's probably almost half a gram of nasty chemical-tasting powder to really knock you out. And it has plenty of legitimate medical uses.
posted by atoxyl at 11:01 PM on September 22, 2015 [2 favorites]
Party/psychonaut drug, yes, which is where the term "K-Hole" comes from. Date rape - well a person under the influence of ketamine is certainly quite vulnerable but it's not the most likely thing to slip to someone undetected. Per os it's probably almost half a gram of nasty chemical-tasting powder to really knock you out. And it has plenty of legitimate medical uses.
posted by atoxyl at 11:01 PM on September 22, 2015 [2 favorites]
Working as intended.
Including the dog and pony show hounding of this nomark.
Bread, circuses and lion feeding.
posted by fullerine at 11:12 PM on September 22, 2015
Including the dog and pony show hounding of this nomark.
Bread, circuses and lion feeding.
posted by fullerine at 11:12 PM on September 22, 2015
In that reddit thread mentioned previously, for a guy with no scientific education, this seems a remarkable claim:
I make drugs for dying kids. Every employee at Retrophin has a passion for saving lives. I've invented a few of these drugs myself. Don't believe everything you read!
posted by Rumple at 11:25 PM on September 22, 2015
I make drugs for dying kids. Every employee at Retrophin has a passion for saving lives. I've invented a few of these drugs myself. Don't believe everything you read!
posted by Rumple at 11:25 PM on September 22, 2015
Jesus, his entire reddit commenting history makes him sound like he's a douchey 17 year old.
posted by Rumple at 11:31 PM on September 22, 2015 [1 favorite]
posted by Rumple at 11:31 PM on September 22, 2015 [1 favorite]
The one that struck me on reading the NYT article yesterday (which doesn't seem to involve Shkreli's company, but it's the same sort of thing) was what happened to Doxycycline:
Doxycycline, an antibiotic, went from $20 a bottle [of 500 tablets] in October 2013 to $1,849 by April 2014, according to the two lawmakers.
Doxycycline is often used for the prevention and treatment of malaria, as an alternative to Mefloquine, which can have serious neuropsychiatric side-effects. It's on the WHO list of essential medicines. A 9,245% price increase in six months.
The US price seems to have dropped by over 50% since then, to a mere $30 for a bottle of 20 tablets ($750 for 500), but it's still ridiculous when the international price is between 1 and 2 cents a tablet.
posted by rory at 2:06 AM on September 23, 2015 [4 favorites]
Doxycycline, an antibiotic, went from $20 a bottle [of 500 tablets] in October 2013 to $1,849 by April 2014, according to the two lawmakers.
Doxycycline is often used for the prevention and treatment of malaria, as an alternative to Mefloquine, which can have serious neuropsychiatric side-effects. It's on the WHO list of essential medicines. A 9,245% price increase in six months.
The US price seems to have dropped by over 50% since then, to a mere $30 for a bottle of 20 tablets ($750 for 500), but it's still ridiculous when the international price is between 1 and 2 cents a tablet.
posted by rory at 2:06 AM on September 23, 2015 [4 favorites]
Force-feeding $1 million in quarters is just overkill, and you'd have to deal with substantial logistical concerns. At almost exactly 25 pounds per $500 box, you'd need an armored semi to transport the 50,000 pounds of non-traceable, fairly easily launder able coins. I'd suggest ordering ten boxes from your local bank (they might balk, so either ask for a weekly order for a few weeks or try another branch) and see how it goes. I expect you'll achieve the desired effect no more than seven boxes in, and you can then return the rest and use the leftover $996,500 for a hell of a pizza party.
(If you're dead-set on quarters that's understandable, but dimes have the same value/weight ratio and should make for easier insertion. Nickels and pennies would are even cheaper per pound but the thickness of nickels makes them unwieldy, and the relatively low density of modern plated zinc pennies is less than ideal. Halves and dollars are both too big and might not be easy to source in the desired quantity in your area.)
posted by clorox at 3:59 AM on September 23, 2015 [4 favorites]
(If you're dead-set on quarters that's understandable, but dimes have the same value/weight ratio and should make for easier insertion. Nickels and pennies would are even cheaper per pound but the thickness of nickels makes them unwieldy, and the relatively low density of modern plated zinc pennies is less than ideal. Halves and dollars are both too big and might not be easy to source in the desired quantity in your area.)
posted by clorox at 3:59 AM on September 23, 2015 [4 favorites]
He has a face like a slapped arse.
Bleh. Definitely cyanide. Poetic justice.
posted by RandomInconsistencies at 5:29 AM on September 23, 2015
Bleh. Definitely cyanide. Poetic justice.
posted by RandomInconsistencies at 5:29 AM on September 23, 2015
Turns out Pete Campbell is literally a vampire.
posted by Uther Bentrazor at 6:31 AM on September 23, 2015 [2 favorites]
posted by Uther Bentrazor at 6:31 AM on September 23, 2015 [2 favorites]
Like the kid with the clock, people will throw time and attention at 1 person to make sure they're helped or punished to the correct degree, but the systemic issue will be ignored.
posted by blue_beetle at 6:33 AM on September 23, 2015 [5 favorites]
posted by blue_beetle at 6:33 AM on September 23, 2015 [5 favorites]
It's not being ignored. Everyone I know who's been raging about this is also someone who is and has been for years already working on health care reform and access and costs and trying to fix our fucked-up system. Unsurprisingly, most are AIDS activists from way back.
posted by rtha at 7:17 AM on September 23, 2015 [11 favorites]
posted by rtha at 7:17 AM on September 23, 2015 [11 favorites]
Even in backing down, he's an asshole:
“I think that it makes sense to lower the price in response to the anger that was felt by people,” he told NBC News.
posted by RedOrGreen at 8:22 AM on September 23, 2015 [3 favorites]
“I think that it makes sense to lower the price in response to the anger that was felt by people,” he told NBC News.
posted by RedOrGreen at 8:22 AM on September 23, 2015 [3 favorites]
Amazing - for once someone who looks as slimy as he really is. Reprehensible reptile.
posted by the_very_hungry_caterpillar at 8:56 AM on September 23, 2015
posted by the_very_hungry_caterpillar at 8:56 AM on September 23, 2015
sio42: He... broke up with the nyt.
NYT: BRB showering with scalding water forever
posted by seyirci at 9:41 AM on September 23, 2015
NYT: BRB showering with scalding water forever
posted by seyirci at 9:41 AM on September 23, 2015
Yes.. I think this would be getting a certain amount of traction in any case because of the outrageousness of the behavior but I think one of the reasons it's really blown up has to do with the individual appearance of Martin Shkreli. If this same maneuver were being performed by a distinguished fatherly-looking man in a decent suit I personally believe an astonishing number more people would be willing to accept the handwavey explanations about why this is good for the market.
The fact that the guy in question actually looks like someone ordered up "slimy jerk" from Central Casting is part of what some people are reacting to here.
Don't get me wrong, I'm glad people are reacting. I just wish that we could count on the same outrage against those who fit our expectation of what a leading businessman should look like, because Shkreli is contemptibly venial to an almost comical extent (almost.. but it's hard to laugh when his business plan is to extort the sick and dying) but he's so, so, far from being the only one..
posted by Nerd of the North at 9:42 AM on September 23, 2015 [3 favorites]
The fact that the guy in question actually looks like someone ordered up "slimy jerk" from Central Casting is part of what some people are reacting to here.
Don't get me wrong, I'm glad people are reacting. I just wish that we could count on the same outrage against those who fit our expectation of what a leading businessman should look like, because Shkreli is contemptibly venial to an almost comical extent (almost.. but it's hard to laugh when his business plan is to extort the sick and dying) but he's so, so, far from being the only one..
posted by Nerd of the North at 9:42 AM on September 23, 2015 [3 favorites]
I think it's less about his appearance than his being determinedly douchy in public; most pharma CEOs don't tweet like a 4channer, they release bland press releases. As I said, he's a dumb sociopath, the kind that gets off on trolling people in person. The smart sociopaths -- well, the price of the drug was jacked 2,000 percent before Shkreli ever got his hands on it, and as people have noted in this thread, it was hardly the only critical drug that's gotten that treatment even this year. We've designed our medical system to reward the sort of monsters that look at a cheap, important drug and see only a system to be a gamed and money to be extracted, and could not give a shit about how many people die while they do it.
And note that it's not like Shkreli has said what the new price will be. Perhaps he'll oh so generously sell it for 'only' $100 a pill. For something that in a society that has a sane medical system is about 50 cents.
posted by tavella at 9:52 AM on September 23, 2015 [4 favorites]
And note that it's not like Shkreli has said what the new price will be. Perhaps he'll oh so generously sell it for 'only' $100 a pill. For something that in a society that has a sane medical system is about 50 cents.
posted by tavella at 9:52 AM on September 23, 2015 [4 favorites]
Yes, you're probably right that I should have written "what a business leader should look and act like" but I still think way too many people are conditioned to normally accept this kind of behavior but are rejecting Shkreli based on relatively superficial characteristics.
In a small way that makes me glad that we have Shkreli -- in arguments for years to come he can be the poster child for this egregious behavior and virtually everyone will agree that he is indefensible. That's probably the most positive thing he will ever accomplish with his life.
posted by Nerd of the North at 10:04 AM on September 23, 2015
In a small way that makes me glad that we have Shkreli -- in arguments for years to come he can be the poster child for this egregious behavior and virtually everyone will agree that he is indefensible. That's probably the most positive thing he will ever accomplish with his life.
posted by Nerd of the North at 10:04 AM on September 23, 2015
Derek Lowe: Shkreli, Turing, and PhRMA
John Carroll of FierceBiotech (who Shkreli called a “moron” on Twitter a couple of days back, prompting me to note in return that he is, after all, an indisputable world-renowned expert on morons), has an editorial that gets to the point that many of us have been trying to make about this affair. The problem is that Shkreli and Turing are acting like evil parodies of an actual drug company, rapaciously jacking up prices while all the while justifying everything as needed for R&D expenses. The fact that Turing has been doing zero R&D gets lost in all this noise, because (to a first approximation) they sound just like every other drug company when they claim that.posted by the man of twists and turns at 10:50 AM on September 23, 2015 [4 favorites]
...
By wrapping ourselves in statements of purpose and noble intentions, we in the R&D-driven part of the drug industry are doing ourselves a disservice. It leaves us unable to distinguish ourselves from obnoxious parasites, outfits like Turing that can, with a straight face, recite the same rationales. We’re going to have to be more forthcoming about how much money we spend, where it goes, and display our expensive failures to make the point that a lot of money has to come in, because a lot of money is also going out.
I think one of the reasons it's really blown up has to do with the individual appearance of Martin Shkreli
Probably the only thing missing on his face was a waxed mustache to tweak in front of the camera.
posted by a lungful of dragon at 11:45 AM on September 23, 2015
Probably the only thing missing on his face was a waxed mustache to tweak in front of the camera.
posted by a lungful of dragon at 11:45 AM on September 23, 2015
I think one of the reasons it's really blown up has to do with the individual appearance of Martin Shkreli
It would have happened regardless of what he looked like. The hilarious thing about America is that it doesn't matter what he looks like for people to make appearance a facet of criticism.
posted by rhizome at 11:50 AM on September 23, 2015 [1 favorite]
It would have happened regardless of what he looked like. The hilarious thing about America is that it doesn't matter what he looks like for people to make appearance a facet of criticism.
posted by rhizome at 11:50 AM on September 23, 2015 [1 favorite]
It would have happened regardless of what he looked like.
Probably, but I have to wonder if his comically-evil appearance and odd mannerisms have made the story easier for the media to package and sell. It seems that the media narrative has now somewhat moved on from the larger, serious phenomenon of how prescription drugs are priced, patented and made (and how all of that impacts the lives of millions of people who need them) — to generally unrelated-yet-titillating aspects of Shkeli's personal and professional life. Basically, we can go back to business as usual.
posted by a lungful of dragon at 12:14 PM on September 23, 2015 [2 favorites]
Probably, but I have to wonder if his comically-evil appearance and odd mannerisms have made the story easier for the media to package and sell. It seems that the media narrative has now somewhat moved on from the larger, serious phenomenon of how prescription drugs are priced, patented and made (and how all of that impacts the lives of millions of people who need them) — to generally unrelated-yet-titillating aspects of Shkeli's personal and professional life. Basically, we can go back to business as usual.
posted by a lungful of dragon at 12:14 PM on September 23, 2015 [2 favorites]
It would have happened regardless of what he looked like.
I hope so, but what makes Daraprim any different from any of the other, off-patent, low-volume drugs that this exact situation has already happened to, by other hedge fund managers, no less? Cycloserine, Isuprel, Nitropress, Doxycycline were all mentioned in the NYTs article, yet I have no idea what the CEOs of their respective firms looks like.
Mr. Shkreli looks aren't particularly unusual for a CEO, which is to say he looks like a rich white male. It's not his looks, then, in this case, but his willingness to engage the media, much to chagrin of his lawyers and whatever PR departments need to compensate for his actions.
On the other hand though, his inability to turn off the Internet probably lead to his decision to relent, once he realized the entire Internet hated him. If he had just shut up, signed off on the price increase, and then skipped off to a desert island for a week with no Internet, he'd probably just be conceptually evil, like a hedge fund manager that took part in the 2008 crash.
Instead, we have a face and quotes to attribute to that face; off-the-cuff twitter posts that haven't undergone a week of editing by the PR department, and another week of review by the legal department.
posted by fragmede at 1:34 PM on September 23, 2015 [1 favorite]
I hope so, but what makes Daraprim any different from any of the other, off-patent, low-volume drugs that this exact situation has already happened to, by other hedge fund managers, no less? Cycloserine, Isuprel, Nitropress, Doxycycline were all mentioned in the NYTs article, yet I have no idea what the CEOs of their respective firms looks like.
Mr. Shkreli looks aren't particularly unusual for a CEO, which is to say he looks like a rich white male. It's not his looks, then, in this case, but his willingness to engage the media, much to chagrin of his lawyers and whatever PR departments need to compensate for his actions.
On the other hand though, his inability to turn off the Internet probably lead to his decision to relent, once he realized the entire Internet hated him. If he had just shut up, signed off on the price increase, and then skipped off to a desert island for a week with no Internet, he'd probably just be conceptually evil, like a hedge fund manager that took part in the 2008 crash.
Instead, we have a face and quotes to attribute to that face; off-the-cuff twitter posts that haven't undergone a week of editing by the PR department, and another week of review by the legal department.
posted by fragmede at 1:34 PM on September 23, 2015 [1 favorite]
I have to wonder if his comically-evil appearance and odd mannerisms have made the story easier for the media to package and sell
Criticizing anybody's appearance, regardless of what it is, makes stories easier to package. It can be pretty much anything you can think of, it's all just ascribing politics to aesthetics, and there are centuries of prejudices and characterized-looks to pander to within the mainstream.
posted by rhizome at 1:41 PM on September 23, 2015
Criticizing anybody's appearance, regardless of what it is, makes stories easier to package. It can be pretty much anything you can think of, it's all just ascribing politics to aesthetics, and there are centuries of prejudices and characterized-looks to pander to within the mainstream.
posted by rhizome at 1:41 PM on September 23, 2015
My father used to work for Merck, and when I would go into one of my Liberal Rants About Medical Costs (as he'd put it), he'd tell me that the reason Merck charged what they did was to recoup the R&D costs, as well as help fund new research.
One day, I asked him if he could get me the public version of the annual report. And he did. And I went through it.
He wasn't happy when I pointed out that the ad budget was twice that of R&D that year, and the corporate dividends were twice that of marketing, so that meant that the dividends was 4x that of R&D.
posted by mephron at 1:45 PM on September 23, 2015 [14 favorites]
One day, I asked him if he could get me the public version of the annual report. And he did. And I went through it.
He wasn't happy when I pointed out that the ad budget was twice that of R&D that year, and the corporate dividends were twice that of marketing, so that meant that the dividends was 4x that of R&D.
posted by mephron at 1:45 PM on September 23, 2015 [14 favorites]
I don't understand anything about the stock market but people are saying that he maybe did this intentionally to do a short sale? (Saw this on facebook -- can't verify that it's real https://imgur.com/gNNRG7c )
posted by capnsue at 1:51 PM on September 23, 2015
posted by capnsue at 1:51 PM on September 23, 2015
I'm pretty sure a) that would be insider trading and b) the guy clearly knows easier way to make money in the stock market.
posted by GuyZero at 2:07 PM on September 23, 2015
posted by GuyZero at 2:07 PM on September 23, 2015
He would need to predict that a presidential candidate would respond, that it would be Hillary Clinton, and that the response would have such an effect on the market. That's a lot to ride a bet on.
posted by a lungful of dragon at 2:10 PM on September 23, 2015
posted by a lungful of dragon at 2:10 PM on September 23, 2015
He's the one setting the drug prices? Whether he benefits from an inside trade or not, it's illegal. He can't simply trade in and out of his own company like a non-insider.
posted by GuyZero at 2:16 PM on September 23, 2015
posted by GuyZero at 2:16 PM on September 23, 2015
Wow, that generated some interest and some good questions.
How do you know they didn't just sell you blue-colored flour?
As Justinian notes, it's fairly unambiguous that the dick pill powder works. Also, it's actually a fine white powder. The most terrifying thing is what it looks like when you open the package, because it's a baggie of fine white powder. It could easily be mistaken for something much different.
How does you check that the stuff is reliable and sufficiently chemically pure?
Well, reliable is easy. Pure is much harder, but here is my reasoning. First, life is risk. Second, there are many factories all over the world which have been making generic sildenafil for years. While there have been imported dick pills that don't work there hasn't been a wave of poisonings, and it seemed most likely to me that this US company was just buying the same stuff by the kilo that the Indian pill makers do and packing it in baggies instead of making pills. There isn't really any reason for them to cut corners and this really represents the minimal number of steps between the lab and me. Finally, having verified that the powder works the same as Pfizer's pills at the stated milligram doses, there's not a lot of room left for toxins and while there are some hella powerful microgram toxins, having one of them come up as a surprise side product in the manufacture of something that's been made commercially for 20 years seems unlikely.
Plus it eliminates all the problems of going overseas, like the pharmacy that 's well known enough to have a good rep also being well known enough that customs puts them under a microscope.
The downside is ordering that is illegal, not that you might be out $50.
Yes. This is a very gray area but my reasoning here is that I don't have to outrun the bear, I just have to outrun the other campers. Sildenafil is a drug that is not Schedule 1 nor is it ever going to be and for which I actually have a prescription, so I have a couple of fig leaves to hold up. I did not buy from a company that offers "legal highs," e.g. rearranging THC to try to keep it psychoactive while making new, presumably legal (until the narcs notice) molecules. With that crap you don't know the potency, the manufacture side products, or how long until your stash becomes an automatic felony. Then, most of the customers of the company I did buy from are bodybuilders and students buying things like steroids and nootropics.
I think it would be a lot more dangerous if I was selling the dick pills I make, but I'm making them strictly for personal use and I think most prosecutors would not try to put that in front of a jury when there are much more unsavory bad guys to pursue.
And as far as any moral obligation to follow the law, in this case fuck that sideways. With a dick pill.
As far as the OP, if someone I cared about died because this asshole made the drug unaffordable I would make his total destruction my mission in life by whatever means, legal or otherwise, are available. I thought it might be useful to present my adventure in dick pill anarchy because it illustrates the problem of heartless calculation without quite the level of gut outrage that is there when, instead of "our business model does not provide for you to have a sex life," you strike the word "sex" from that sentence.
posted by Bringer Tom at 3:35 PM on September 23, 2015 [10 favorites]
How do you know they didn't just sell you blue-colored flour?
As Justinian notes, it's fairly unambiguous that the dick pill powder works. Also, it's actually a fine white powder. The most terrifying thing is what it looks like when you open the package, because it's a baggie of fine white powder. It could easily be mistaken for something much different.
How does you check that the stuff is reliable and sufficiently chemically pure?
Well, reliable is easy. Pure is much harder, but here is my reasoning. First, life is risk. Second, there are many factories all over the world which have been making generic sildenafil for years. While there have been imported dick pills that don't work there hasn't been a wave of poisonings, and it seemed most likely to me that this US company was just buying the same stuff by the kilo that the Indian pill makers do and packing it in baggies instead of making pills. There isn't really any reason for them to cut corners and this really represents the minimal number of steps between the lab and me. Finally, having verified that the powder works the same as Pfizer's pills at the stated milligram doses, there's not a lot of room left for toxins and while there are some hella powerful microgram toxins, having one of them come up as a surprise side product in the manufacture of something that's been made commercially for 20 years seems unlikely.
Plus it eliminates all the problems of going overseas, like the pharmacy that 's well known enough to have a good rep also being well known enough that customs puts them under a microscope.
The downside is ordering that is illegal, not that you might be out $50.
Yes. This is a very gray area but my reasoning here is that I don't have to outrun the bear, I just have to outrun the other campers. Sildenafil is a drug that is not Schedule 1 nor is it ever going to be and for which I actually have a prescription, so I have a couple of fig leaves to hold up. I did not buy from a company that offers "legal highs," e.g. rearranging THC to try to keep it psychoactive while making new, presumably legal (until the narcs notice) molecules. With that crap you don't know the potency, the manufacture side products, or how long until your stash becomes an automatic felony. Then, most of the customers of the company I did buy from are bodybuilders and students buying things like steroids and nootropics.
I think it would be a lot more dangerous if I was selling the dick pills I make, but I'm making them strictly for personal use and I think most prosecutors would not try to put that in front of a jury when there are much more unsavory bad guys to pursue.
And as far as any moral obligation to follow the law, in this case fuck that sideways. With a dick pill.
As far as the OP, if someone I cared about died because this asshole made the drug unaffordable I would make his total destruction my mission in life by whatever means, legal or otherwise, are available. I thought it might be useful to present my adventure in dick pill anarchy because it illustrates the problem of heartless calculation without quite the level of gut outrage that is there when, instead of "our business model does not provide for you to have a sex life," you strike the word "sex" from that sentence.
posted by Bringer Tom at 3:35 PM on September 23, 2015 [10 favorites]
There's several English folk (I'm English myself) on my twitter feed doing the usual, smug, tedious, we-have-the-NHS, judgemental-superiority thing over something happening in America. This article from the Guardian today is for them and similar.
posted by Wordshore at 3:38 PM on September 23, 2015
posted by Wordshore at 3:38 PM on September 23, 2015
Oh, and per dephlogiscated...
If you go read the news reports from 2012 there was a mood of shock in the legal community that Pfizer was granted their post-dated "use patent" for Viagra-as-a-dick-pill. This is a patent extending dodge that is apparently tried with some regularity in the industry but which also almost never works, and there are some very lengthy analyses online of how Pfizer managed to pull it off, none of which mentions judges being paid off but all of which reek of the incredulous.
Anyway Pfizer cutting the deal with Teva for 2017 makes sense since it's obvious the whole industry will suffer a price collapse when any of the big 3 become generic. I saw one estimate that Canada alone cost Pfizer $6 billion per year when Viagra went generic there. Unfortunately for the bad boys it's well known Cialis was pursued directly because of the fact that Viagra existed, so there's no similar do-over in its development history. By 2020 no PDE5 molecule will be safe, and those assholes at Pfizer will have to look for real jobs.
posted by Bringer Tom at 4:58 PM on September 23, 2015
Pfizer filed a patent for this use in 1994 (the original patent was for its cardiovascular uses), but for reasons I've never heard explained, the patent did not officially get approved until 2002.Pfizer's original patent was for the drug itself, as most drug patents are; drugs tend to be recommended for certain uses but all doctors can prescribe drugs for off-label use. Normal drug patents do not specify usage, since you want the patent to cover whatever the drug might be used for.
If you go read the news reports from 2012 there was a mood of shock in the legal community that Pfizer was granted their post-dated "use patent" for Viagra-as-a-dick-pill. This is a patent extending dodge that is apparently tried with some regularity in the industry but which also almost never works, and there are some very lengthy analyses online of how Pfizer managed to pull it off, none of which mentions judges being paid off but all of which reek of the incredulous.
Anyway Pfizer cutting the deal with Teva for 2017 makes sense since it's obvious the whole industry will suffer a price collapse when any of the big 3 become generic. I saw one estimate that Canada alone cost Pfizer $6 billion per year when Viagra went generic there. Unfortunately for the bad boys it's well known Cialis was pursued directly because of the fact that Viagra existed, so there's no similar do-over in its development history. By 2020 no PDE5 molecule will be safe, and those assholes at Pfizer will have to look for real jobs.
posted by Bringer Tom at 4:58 PM on September 23, 2015
I hope the Senate investigates this and Bernie Sanders gets to question this guy on the stand. The most bothersome thing to me is how many other drug companies are doing something like this. We clearly need new regulations to prevent severe price gouging on life-saving pharmaceuticals.
posted by Golden Eternity at 5:49 PM on September 23, 2015 [1 favorite]
posted by Golden Eternity at 5:49 PM on September 23, 2015 [1 favorite]
Cornering the Market on Essential Drugs - Generics companies were supposed to make drugs cheaper, but some have become the new villains of health care.
posted by Golden Eternity at 6:47 PM on September 23, 2015
posted by Golden Eternity at 6:47 PM on September 23, 2015
GuyZero: "I'm pretty sure a) that would be insider trading and b) the guy clearly knows easier way to make money in the stock market."
I'm also pretty sure that this price hike scheme wasn't an elaborate Rube Goldberg device to engage in insider trading... mainly because I think he did the price hike scheme because he's already under investigation for various financial frauds at his previous company, including insider trading:
posted by mhum at 7:25 PM on September 23, 2015
I'm also pretty sure that this price hike scheme wasn't an elaborate Rube Goldberg device to engage in insider trading... mainly because I think he did the price hike scheme because he's already under investigation for various financial frauds at his previous company, including insider trading:
According to the court records and people with knowledge of the case, the allegations against Shkreli that are under investigation involve insider trading, disguising the purpose of corporate payments for his benefit, defrauding shareholders by snatching business opportunities for himself, destruction of evidence, failure to disclose material facts to shareholders and other potential crimes.Also, I can't tell if having Donald Trump call you out on your business practices ("He looks like a spoiled brat to me. He’s a hedge fund guy. I thought it was disgusting what he did.”) should be a badge of honor or of shame.
posted by mhum at 7:25 PM on September 23, 2015
Someone found Shkreli's OKC dating profile and describes himself as "easygoing." Lolololol.
Pharma companies have plenty of opportunities to recoup a large amount of R&D through tax credits.
posted by discopolo at 8:49 PM on September 23, 2015
Pharma companies have plenty of opportunities to recoup a large amount of R&D through tax credits.
posted by discopolo at 8:49 PM on September 23, 2015
First, life is risk. Second, there are many factories all over the world which have been making generic sildenafil for years.
Yeah, be sure to regularly check the list FDA has up for the international factories That are on their banned list from having failed inspections. They added yet another Indian factory to the list a few days ago. That factory won't be able to afford to keep up with standards so I'd be real careful with your baggie of powder.
(Being in the field, I have heard enough stories about the guys who lurk around the pharmacy annoying young and pretty pharm techs and pharmacists while yelling loudly about the price of Viagra (but willing to pay the price) to fill a book. Way too many are not embarrassed at all. Especially not the many, many old men who have time on their hands to just perv and leer at the female staff and demand dates, make dirty jokes out loud, etc.)
posted by discopolo at 9:36 PM on September 23, 2015
Yeah, be sure to regularly check the list FDA has up for the international factories That are on their banned list from having failed inspections. They added yet another Indian factory to the list a few days ago. That factory won't be able to afford to keep up with standards so I'd be real careful with your baggie of powder.
(Being in the field, I have heard enough stories about the guys who lurk around the pharmacy annoying young and pretty pharm techs and pharmacists while yelling loudly about the price of Viagra (but willing to pay the price) to fill a book. Way too many are not embarrassed at all. Especially not the many, many old men who have time on their hands to just perv and leer at the female staff and demand dates, make dirty jokes out loud, etc.)
posted by discopolo at 9:36 PM on September 23, 2015
I saw one estimate that Canada alone cost Pfizer $6 billion per year when Viagra went generic there.
No. Wrong. 'Cost' is something that hits your bottom line. We said "nope sorry, you don't get to make obscene profits on something that helps people." It's not a cost if all it does is take a nibble out of your global profits.
When the prices are limited to something that actually impacts R&D before it impacts bonuses and shareholder dividends, we can talk about 'cost.'
posted by feckless fecal fear mongering at 10:25 PM on September 23, 2015 [8 favorites]
No. Wrong. 'Cost' is something that hits your bottom line. We said "nope sorry, you don't get to make obscene profits on something that helps people." It's not a cost if all it does is take a nibble out of your global profits.
When the prices are limited to something that actually impacts R&D before it impacts bonuses and shareholder dividends, we can talk about 'cost.'
posted by feckless fecal fear mongering at 10:25 PM on September 23, 2015 [8 favorites]
Turing boss Martin Shkreli says Daraprim price drop 'might curtail research for lethal diseases'. Somehow I suspect the research he's talking about is the sort that will involve a new patented version of Daraprim and running the generic off the market.
I ranted about this on FB a little and one of the Usual Suspects had to stick his libertarian nose in and explain that IHNSHO the profit motive is what drives research and he trusted the dude who wanted the yacht to do research more than some government paid committee. He is a healthy middle-aged white dude with no dependents, of course, which I guess means he has the luxury of thinking that. I told him I thought anybody in the medical research industry primarily for the benjamins was probably an asshole who needed to be in a different job, and of course I didn't trust the guy who wanted a yacht because that guy brings you Vioxx because the money is more important than the safety of patients taking the drug. (He also wanted to talk about the VA, but I seriously doubt he wants to talk about strangling the government by cutting off money as a cause, so we didn't go there.) But the real argument is about human nature, and how some people trust greed as a motive. I just don't where medicine is concerned.
posted by immlass at 8:03 AM on September 24, 2015 [3 favorites]
I ranted about this on FB a little and one of the Usual Suspects had to stick his libertarian nose in and explain that IHNSHO the profit motive is what drives research and he trusted the dude who wanted the yacht to do research more than some government paid committee. He is a healthy middle-aged white dude with no dependents, of course, which I guess means he has the luxury of thinking that. I told him I thought anybody in the medical research industry primarily for the benjamins was probably an asshole who needed to be in a different job, and of course I didn't trust the guy who wanted a yacht because that guy brings you Vioxx because the money is more important than the safety of patients taking the drug. (He also wanted to talk about the VA, but I seriously doubt he wants to talk about strangling the government by cutting off money as a cause, so we didn't go there.) But the real argument is about human nature, and how some people trust greed as a motive. I just don't where medicine is concerned.
posted by immlass at 8:03 AM on September 24, 2015 [3 favorites]
From the same Guardian article immlass linked:
“I’m not affected by the anger,” he told the Guardian. “I don’t think much about the wider world. I work with my patients.”
posted by theora55 at 10:06 AM on September 24, 2015 [1 favorite]
“I’m not affected by the anger,” he told the Guardian. “I don’t think much about the wider world. I work with my patients.”
posted by theora55 at 10:06 AM on September 24, 2015 [1 favorite]
In theory, capitalism says that if the price is high enough, other manufacturers will make the drug and the price will go down. We have globalism, so there should be lively import/export to allow cheaper drugs form other countries to be purchased. Pretty sure that American pharma companies have used lots of regulations to keep that from happening. We should probably have some Congressional study to look at drug regulation, but that's not going to happen. Regulation is bad when it protects consumers, good when it boosts profit.
posted by theora55 at 10:10 AM on September 24, 2015
posted by theora55 at 10:10 AM on September 24, 2015
Pfizer's original patent was for the drug itself, as most drug patents are; drugs tend to be recommended for certain uses but all doctors can prescribe drugs for off-label use. Normal drug patents do not specify usage, since you want the patent to cover whatever the drug might be used for.
It's true that doctors can prescribe a drug off-label for any use. It's not true that patents for the specific use of a drug are unusual. They're fairly standard in the industry. The reason such patents exist is that, for any new labeled indication, a pharmaceutical company must perform clinical trials demonstrating safety and efficacy for that specific use. Clinical trials make up about two-thirds of the cost of drug R&D; the market exclusivity afforded by use patents is meant to compensate that investment. There is arguably an ethical grey area in some cases (e.g., the patenting of colchicine for its most common off-label use), but there is nothing prima facie unethical about patenting the use of a drug.
posted by dephlogisticated at 11:04 AM on September 24, 2015 [1 favorite]
It's true that doctors can prescribe a drug off-label for any use. It's not true that patents for the specific use of a drug are unusual. They're fairly standard in the industry. The reason such patents exist is that, for any new labeled indication, a pharmaceutical company must perform clinical trials demonstrating safety and efficacy for that specific use. Clinical trials make up about two-thirds of the cost of drug R&D; the market exclusivity afforded by use patents is meant to compensate that investment. There is arguably an ethical grey area in some cases (e.g., the patenting of colchicine for its most common off-label use), but there is nothing prima facie unethical about patenting the use of a drug.
posted by dephlogisticated at 11:04 AM on September 24, 2015 [1 favorite]
A lot of them have gone off the web but here is a 2011 story about the Viagra use patent. (You can just answer "no" to the stupid survey.) The mood of surprise is common to other articles from the day; nobody seriously expected Teva's challenge to fail, and there were other articles which described the heroic lengths Pfizer went to to get this decision, including unprecedented moves like having the actual research doctors who did the trials testify in court. People who write about the industry were universally surprised and in some cases outright shocked by the decision. It was not at all considered business as usual.
posted by Bringer Tom at 4:08 PM on September 24, 2015
posted by Bringer Tom at 4:08 PM on September 24, 2015
OK FT's paywall is more aggressive if you don't go through the Google search link so Here's another one.
posted by Bringer Tom at 4:21 PM on September 24, 2015
posted by Bringer Tom at 4:21 PM on September 24, 2015
For some obnoxious reason, links from Law360 work fine if you access them via Google but magically disappear behind a paywall if you try to direct-link them. Here's a fairly in depth analysis of the case from elsewhere. I'm not really familiar with the legal details myself, but it seems like Teva was arguing (among other things) that Pfizer's patent was not specific and informative enough to be valid.
posted by dephlogisticated at 5:47 PM on September 24, 2015
posted by dephlogisticated at 5:47 PM on September 24, 2015
Daily Beast: Martin Shkreli is Big Pharma's Biggest Asshole
"And it seems like the media immediately points a finger at me So I point one back at em, but not the index or pinkie."
FFS.
posted by homunculus at 6:38 PM on September 24, 2015 [1 favorite]
"And it seems like the media immediately points a finger at me So I point one back at em, but not the index or pinkie."
FFS.
posted by homunculus at 6:38 PM on September 24, 2015 [1 favorite]
Martin Shkreli is an American hero. Here's why.
posted by Golden Eternity at 11:43 PM on September 26, 2015
posted by Golden Eternity at 11:43 PM on September 26, 2015
Daraprim 'profiteering' controversy lifts lid on soaring cost of prescription drugs.
posted by immlass at 9:01 AM on September 27, 2015 [1 favorite]
posted by immlass at 9:01 AM on September 27, 2015 [1 favorite]
I'm glad I've been reserving judgement until it shakes out a little.
posted by rhizome at 1:03 PM on September 27, 2015
posted by rhizome at 1:03 PM on September 27, 2015
Well of course, we shouldn't hate on the guy for how evil he looks and acts and sounds, we should make sure we only hate on him for how evil he really is.
Pretty fuckin' evil seems to be the emerging consensus, though.
posted by Bringer Tom at 2:03 PM on September 27, 2015 [1 favorite]
Pretty fuckin' evil seems to be the emerging consensus, though.
posted by Bringer Tom at 2:03 PM on September 27, 2015 [1 favorite]
Some Notes Toward a Comprehensive Plan For Screwing Martin Shkreli
posted by Golden Eternity at 6:40 PM on September 27, 2015
posted by Golden Eternity at 6:40 PM on September 27, 2015
Price Gouging Pharma-Bro Martin Shkreli Returns to Twitter, Still an Asshole
posted by homunculus at 7:22 PM on October 9, 2015
posted by homunculus at 7:22 PM on October 9, 2015
So apparently Shkreli's ability to hold everybody up is due to a combination of the trade secret of exactly how they make their formula combined with an FDA approval process that is very expensive for a different formula even if it has the same active ingredient.
It occurs to me that the technicians who are responsible for actually making the drug probably didn't see their pay go up 5,000% when Shkreli pulled his fabulous stunt. Maybe a little industrial espionage is in order. Whoever pulls it off could pay for the payoffs by charging $30 a pill for a few years.
posted by Bringer Tom at 6:32 AM on October 10, 2015
It occurs to me that the technicians who are responsible for actually making the drug probably didn't see their pay go up 5,000% when Shkreli pulled his fabulous stunt. Maybe a little industrial espionage is in order. Whoever pulls it off could pay for the payoffs by charging $30 a pill for a few years.
posted by Bringer Tom at 6:32 AM on October 10, 2015
Shkreli came to Atlanta last week allegedly to meet with the CDC about toxoplasmosis. He claims they support him in his pursuit of an opthmalogic version of Daraprim. Our local public radio station interviewed him. I leave it to you to draw your own conclusions from the interview.
posted by hydropsyche at 7:33 AM on October 10, 2015
posted by hydropsyche at 7:33 AM on October 10, 2015
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posted by GuyZero at 2:26 PM on September 22, 2015 [25 favorites]