Wednesday, November 25, 2015

The VICE Guide to Right Now: That Pharma CEO Everyone Hates Isn't Lowering the Price of That $750 Pill After All

Shkreli on Bloomberg Tuesday

Remember in September when a potentially lifesaving medicine suddenly went from $13.50 a pill to $750 a pill? And then everyone noticed that the CEO of the company behind the decision, Martin Shkreli, was a former hedge fund manager with a penchant for emo music, who quickly seized the top spot on America's "People We Don't Care For All That Much" list? But then Shkreli called himself a "flippant jackass," and said he would ease off the price hike? And then the whole thing pretty much went away?

Well now Shkreli says the price hike is going to stand after all.

In a press release issued yesterday, Turing announced their final decision on pricing for Daraprim, an antimicrobial drug with applications for cancer and AIDS patients. The release details an array of discounts, but makes no mention of a new price.

"Drug pricing is one of the most complex parts of the healthcare industry," according to a quote in the release by Nancy Retzlaff, Chief Commercial Officer for Turing. A pull quote in large print at the top of the release reads, "We pledge that no patient needing Daraprim will ever be denied access."

It appears that Turing has focused much of its attention on the ruinous implications for out-of-pocket patients. Turing says it will "provide Daraprim free-of-charge to uninsured, qualified patients with demonstrated income at or below 500 percent of the federal poverty level through our Patient Assistance Program." 500 percent of the federal poverty level in 2014 was $58,350 a year.

This assistance program was announced in a previous release on September 24, during the initial firestorm. That release also announced a program called Daraprim Direct, which appears to interface with patients shortly after being diagnosed with a parasite. The site reassures patients that the program "can assist you with DARAPRIM delivery, reimbursement and financial assistance, and support services."

There are other promises in the release, but no lower price. The main takeaways are that patients can pay as little as $10 per prescription thanks to federal discounts, that Turing will be making some charity donations, and that expanded access will be offered.

But without a mention of an actual new retail price, the announcement doesn't match what Shkreli said in September to NBC, who then confidently announced that Turing would "in the next few weeks lower the price to either break even or make a smaller profit." His exact words were, "It makes sense to lower the price in response to the anger that was felt by people."

In other words, qualifying patients who jump through all the hoops involved in getting a discount will not be bankrupted by a toxoplasmosis infection. But insurance companies, and, most likely, uninsured individuals making more than approximately $60,000 will still be on the hook for the full $750-a-pill.

Shkreli appeared in a YouTube livestream to answer questions. VICE asked him to confirm that patients at the $60,000 income level would still have to pay the full $750, but a moderator authorized by Shkreli banned us from the accompanying chatroom.

"It's always been affordable," Shkreli told Bloomberg on Tuesday. "I don't know how many times I have to repeat myself."

Follow Mike Pearl on Twitter.



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