Post by SamB. Featured Image by NEPA Scene
Most people who know who Martin Shkreli is also hate him. He gained national criticism when he raised the price of life saving drug Daraprim from $13.50 per pill to $750. People say that is much too high for a life saving drug that treats toxoplasmosis, an infection in some people with HIV. His decision has been the subject of much discussion this election season with candidates all around picking on Shkreli. Hillary Clinton, according to Business Insider, said that Shkreli should “do the right thing” and that she will “hold him accountable”. Donald Trump , in this Business Insider article, said Shkreli was a spoiled brat, and that his tax plan will hit people like Shkreli the hardest. However, despite all the naysayers, Shkreli is a good person, and what he did is good as well.
FREE DARAPRIM
First off, the claim that some people won’t be able to pay for the drug because of the price increase is just wrong. According to Shkreli in this Vice interview, the insurance companies will be the ones suffering for the hike, not the consumer. Now, you may think that the insurance companies will pass the cost off to the consumer, but the drug industry is so massive (according to statista, a conservative estimate of the value of the industry is 425 billion) that a price increase on even the biggest of drugs (which Daraprim is not.) won’t affect premiums. Even so, if someone was to be put in the position of not being able to afford the lifesaving drug, Turing sells it to the government for one dollar per pill, and Shkreli will give it to anyone who contacts him about it for free. Finally, there are some hospitals who claimed that they cannot stock the drug for emergency situations, so Turing Pharmaceutical has made a smaller, cheaper bottle for them. It doesn’t need to be the full size since again, Daraprim has a miniscule audience and an emergency situation is unlikely. Also, Daraprim isn’t a drug you take for a lifetime. You take it, it kills the infection, and you’re done. In that sense, it’s still pretty cheap.
GREED
Now, lets talk about greed. Most people who hate Shkreli think that his move was nothing but a cash grab to get himself and his shareholders rich. And in a sense that’s true. Shreli himself, in an interview by Vanity Fair says: “My investors expect me to maximize profits[.]” It was his job as chief executive to maximize profits. However, Shkreli himself, according to this The Odyssey Online article, takes no salary from the profits of Daraprim. Before the price hike, Daraprim simply was not profitable as a product, and it was Shkreli’s job to change that. And there’s nothing inherently wrong with greed anyway. The greedy desire for money has caused inventors and businessmen everywhere to create products and services that improve the lives of those who choose to use them, and Shkreli is no different.
GOOD MOTIVATIONS
Martin Shkreli has a different motivation than money for Daraprim’s price increase. Turing Pharmaceuticals goal is to use the profits from Daraprim to research a new treatment to replace Daraprim, among other things. Daraprim is an old drug. According to the same The Odyssey Online article, Daraprim hasn’t been upgraded since the 1940’s, and its age shows. Setting aside the risk of an immunity developing when only one drug is used to combat every case of toxoplasmosis for 60 years, the drug has some scary side effects. According to WebMD’s description of Daraprim, its common side effects are nausea, vomiting, and loss of appetite, but the more serious effects can be blood problems, extreme dizziness, chest pain, and infection. Daraprim needs an alternative, and the profits raised by its price hike can help achieve that. However, its not just Daraprim. According to the same Vanity Fair article, he was motivated by the story of a young boy was afflicted by muscle dystrophy to develop treatments for rare and deadly diseases.
BAD ECONOMICS
Some people claim that Turing would have made more money without the hike, since the low price would attract more customers. However, that is false as well. In other cases perhaps, but not Daraprim’s. Daraprim is special for a few reasons. First, the ailment it treats is not widespread. It has a very limited market. It treats a toxoplasmosis infection that’s very rare, so it has a low amount of demand to begin with. Since it’s a lifesaving drug, everyone who would buy it already does (or receives it through government aid or for free from Turing Pharmaceutical). Thus, keeping the price at the level it was at would not increase profits.
COOL GUY
Now, some people may still hate Shkreli despite what I have said, simply because he seems like a total jerk. He enjoys playing the villain from time to time, at least in jest. According to this article by TIme, he bought the only copy of the Wu-Tang Clan’s latest album. He has never listened to it, and won’t let anyone else listen either. He also plans that “Within 10 years, more than half of all rap/hip-hop music will be made exclusively for [him]”. He says he will share some of it. He frequently gets himself in flame wars of various intensity on twitter, and he livestreams himself arguing with his opposition. Online, he seems to have some disdain for people he deems less intelligent than he. However, according to the Vanity Fair interview, “he’s such a perfect villain when viewed from afar that it’s almost impossible not to like him more up close. He swerves seamlessly among obnoxious bravado, old-world politeness, purposeful displays of powerful intelligence, and even flashes of sweetness. He is slight and pale, almost vampirish, with dark hair, which he has a habit of twirling. He’s oddly twitchy (you can see this in the many lengthy livestreams he does of himself analyzing stocks) and fast-talking, especially when it comes to the scientific details of how drugs work. (“Most pharmaceutical C.E.O.’s don’t even know where the spleen is located,” he says.)” Of his online and public persona, he says that “anyone who knows me knows I am not that guy[,]” and that it’s really “an extremely weird form of sarcasm.” His favored sense of humor and online persona suggest heavily layered irony. He livestreams free finance and chemistry lessons on his Youtube channel. He has his own charity, where they make “charitable contributions to pioneering causes, especially within the medical community.” With his help, Retrophin (his old company) has advanced a drug for a rare kidney disease, according to this The Street article. Knowing a lot of the extravagant things he does are jokes, I feel it’s appropriate to excuse them, and look to the bright side.
FINAL THOUGHTS
Martin Shkreli did nothing wrong and if you still disagree you may have communism.
Sydney
I completely disagree. Raising the price of life saving medication means that many people will not get the treatment they need. It is almost impossible for people with pre-existing conditions, including HIV, to get health insurance, for the very reason you stated earlier in this blog; because raising the price of drugs hurts insurance companies. In the likely case that the Affordable Care Act is repealed, many Americans with HIV (and those with other pre-existing conditions. Daraprim is not alone in drugs that are outrageously expensive.) will be unable to have access to medication they need to live. Insurance companies are not the ones who suffer because of Shkreli, people with HIV are.
Samuel
“I completely disagree. Raising the price of life saving medication means that many people will not get the treatment they need. ”
No. As stated in my post, there are too many ways to get cheap/free daraprim (and insurance is definitely a viable option, as I’ll soon explain) for that to be true. These include: pills that Turing sold to the government for cheap, free daraprim directly from contacting Turing/Shkreli, and cheaper daraprim provided to hospitals. There have been no reported deaths due to lack of daraprim. There’s also probably no way a death would go unreported. The media make up some of the loudest voices criticizing Shkreli. If someone had died as a result of his actions, it would be all over the news.
” It is almost impossible for people with pre-existing conditions, including HIV, to get health insurance, for the very reason you stated earlier in this blog; because raising the price of drugs hurts insurance companies.”
It shouldn’t be impossible for people with preexisting conditions to get insurance, considering the ACA made it illegal to discriminate on that basis.
Also, the drug isn’t specifically for people with HIV. It’s for people with toxoplasmosis (ok it also can treat malaria but that’s not much of a problem here), which usually causes no symptoms in adults. This is part of why the audience for the drug (here) is relatively small, because not everyone with the infection even needs it.
And I argued that the price hike doesn’t hurt drug companies, or at least not in a way that could also hurt the consumer. Basically, the drug industry is so massive, that even a raise on the highest cost drugs couldn’t affect premiums in any noticeable way, and anyway, daraprim isn’t a very big drug, or even an exceptionally costly one.
” In the likely case that the Affordable Care Act is repealed, many Americans with HIV (and those with other pre-existing conditions. Daraprim is not alone in drugs that are outrageously expensive.) will be unable to have access to medication they need to live. ”
I believe the plan at the moment is to repeal and replace the ACA. I find it likely that the whole “no discrimination for preexisting conditions” part of the Affordable Care Act is likely to be found in whatever it’s replacement is. Regardless, the hike happened back in late 2015, when Obamacare was firmly in place. I don’t think Shkreli can be blamed for not seeing a possible ACA repeal coming.
“Insurance companies are not the ones who suffer because of Shkreli, people with HIV are.”
People with HIV aren’t suffering for Shkreli’s actions. People with rare cases of toxoplasmosis aren’t either. There is no cause for alarm.
Sydney
I’m not sure you understand just how difficult it is to have free or reduced cost in medication just by contacting companies directly. The way you present that option, you make it seem as though it is very simple and always guaranteed, which is far from the truth. There was another thing you said… that the fact that Daraprim is used to treat Malaria is “not much of a problem here”. I’m not sure I understand the point that you were trying to make. Why would life saving treatment for Malaria be any more or less important than life saving treatment for toxoplasmosis caused by HIV/AIDS? The point is that people in are unable to access life saving medication because of high prices. And insurance companies do discriminate against people with pre-existing conditions. It may be illegal under the Affordable Care Act, but insurance companies always find ways to make it look legal. Anyone with, or who has close family/friends with major, chronic pre-existing conditions knows this, because ability to get health insurance as they become too old to be on their parent’s insurance plan is always a concern.
Samuel
“I’m not sure you understand just how difficult it is to have free or reduced cost in medication just by contacting companies directly. The way you present that option, you make it seem as though it is very simple and always guaranteed, which is far from the truth.”
I wasn’t saying that was the be all end all way to get daraprim. But, I have reason to believe that it’s easier than you think, or at least it was. Back when Shkreli was still on twitter all the time, he would use it as a way for people who can’t afford daraprim to contact him directly, in order to get it. He’s still very active on social media, so I doubt that’s changed, even though he was banned from twitter.
Here’s an article that lists more of the ways that you can get daraprim for free:
http://www.fiercepharma.com/pharma/turing-reduces-cost-of-daraprim%C2%AE-pyrimethamine
” There was another thing you said… that the fact that Daraprim is used to treat Malaria is “not much of a problem here”. I’m not sure I understand the point that you were trying to make. Why would life saving treatment for Malaria be any more or less important than life saving treatment for toxoplasmosis caused by HIV/AIDS?”
Sorry, I should have been clearer. I wasn’t really trying to make a point, I just wanted to be as accurate as I could.
Basically, the reason malaria doesn’t matter in this case for two reasons: Malaria has been eliminated in the US, and Turing only controls the patent for daraprim in the US. So, Turing’s actions don’t affect malaria. Also, according to the article I pasted above, it is not the preferred treatment for malaria anyway.
Also, toxoplasmosis isn’t caused by HIV/AIDS. It’s just a regular infection that can be bad for people who are immunocompromised.
“The point is that people in are unable to access life saving medication because of high prices. ”
My point is that is not the case.
“And insurance companies do discriminate against people with pre-existing conditions. It may be illegal under the Affordable Care Act, but insurance companies always find ways to make it look legal. Anyone with, or who has close family/friends with major, chronic pre-existing conditions knows this, because ability to get health insurance as they become too old to be on their parent’s insurance plan is always a concern.”
Well, I looked it up, and you’re probably correct here. The only statistic I could find was that 30% of people with HIV are uninsured. But again, it’s not a HIV/AIDS drug. It’s a toxoplasmosis drug.
Here’s where I found that 30% stat: http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2013/10/28/how-the-aca-will-affect-people-with-hiv-and-aids
But as stated before, and in the article I linked above, there are plenty of ways for an people who don’t have insurance to get daraprim regardless.
Samuel
*Basically, malaria doesn’t matter in this case for two reasons:
Drat!
Sydney
I still don’t think you fully understand that accessing and paying for medication is not as simple as you make it sound without insurance. The same goes for these discounts to those who are insured. I will likely be writing a blog about this, as well as the difficulties people with pre-existing conditions go through trying to get insured, soon.
Ben
While I understand the point about the validity of Mr. Shkreli’s actions, I think it paints him in too positive of a light. Mr. Shkreli was arrested for securities fraud, in which he took money from the pharmaceutical company he headed and gave it to investors he had cheated. So Mr. Shkreli is actually an alleged criminal. In addition, he was banned from twitter due to the targeted harassment of a journalist; I certainly do not think this constitutes a “good guy.” You certainly can argue that what Mr. Shkreli did was legal/ethical but, at the same time, the public has a right to question it. I appreciate the well written article.
http://www.theverge.com/2017/1/8/14205552/martin-shkreli-suspension-twitter-harassment-lauren-duca
http://www.cnbc.com/2017/01/26/martin-shkreli-in-court-as-securities-fraud-case-moves-closer-to-trial.html
Samuel
I don’t consider an alleged criminal to be a bad person. Being accused is different from being guilty, at least in my eyes. He is accused of securities fraud, but that doesn’t mean he did it.
And on the topic of the twitter incident, I guess I just don’t see his actions as being harassment. They seemed like jokes to me. Of course, it’s subjective, but that’s how I see it.
Samuel
I love this. Totally agree. Martin is a friend to all.
Samuel
I just realized I probably should have broken up the huge walls of text into something more presentable. Oh well.