There is no denying that the research and production of drugs cost billions of pounds, as well as up to twenty years of efforts from the research lab to safe use in a patient. It is therefore no surprise that drugs are often painfully expensive, especially for rare conditions. But in the wake of a vital medication skyrocketing from a mere $13.50 to an eye-watering $750 a pill, are more regulations needed to protect those vulnerable and in need?
Big pharma is big business, with the industry worth a whopping £200 billion a year and only set to rise. Many are keen to profit from such a necessity to modern medicine, and ten of the largest drug companies dominate over a third of the market. Recently joining the ranks of those benefiting from the booming drug business is entrepreneur Martin Shrekli, who has severe backlash for his actions from not just the science community, but global media outlets, presidential candidate Hilary Clinton, and even the notorious Donald Trump.
American hedge fund manager specialising in healthcare business, Shrekli was the founder of Turing Pharmaceuticals AG. As executive chairman of the company, after obtaining the rights to a drug known as Daraprim, he controversially raised the price by 5000%, costing an American patient $75,000 for a monthy course instead of the more affordable $1,300. It is now only available from a single source in the U.S and is only available from a single speciality pharmacy, Walgreens. Even hospitals and other institutions can’t order from general wholesalers – instead they have to make an account with Daraprim Direct.
Daraprim is a medication regarded as one of the most important drugs in a basic health system, and features on the World Health Organization’s “List of Essential Medicines”. It is used as an antimalarial drug, and is vital in treating parasitic disease, especially in those with a weakened immune system, such as sufferers of HIV.
How is it that such a vital medicine can legally be price-hiked to such an astronomical value? The drug has been available since 1953, developed by Nobel Prize Winner Gertrude Elion, and is not subject to any patent obligations. However, according to Suzanne McGee writing for The Guardian: “Part of the problem is that there are individuals like Shkreli scouring the market for drugs like Daraprim that don’t have effective generic rivals.” It appears that because the market is quite small, no generic manufacturer ever emerged. When the marketing rights were obtained, “the profit-minded individual or company snaps up the patents, suddenly hikes the drug’s price and puts consumers – from insurance companies to individuals – in a position of either paying what is demanded or going without,” McGee added.
The fact that in the UK, the very same drug is available from pharma giant GlaxoSmithKleine at only $0.66 dollars a tablet only adds fuel to the fire. The Infectious Disease Society of America and the HIV Medicine Association have heavily criticized the move, stating “this cost is unjustifiable for the medically vulnerable patient population in need of this medication.” Some organizations are taking their outrage further: the National Alliance of State and Territorial Aids Directors (NASTAD) are calling for a federal investigation in response to the daraprim price hike and lack of availability to such an important drug.
Politicians haven’t shied from criticizing the stunning move of Turing Pharmaceuticals either. Hilary Clinton, Democratic candidate in the race for Barack Obama’s seat in the White House, said on Twitter, “Price gouging like this in a specialty drug market is outrageous.” In a rare agreement of both political parties in the U.S, Republican front-runner Donald Trump simply put it: “He looks like a spoilt brat to me. That guy is nothing. He’s zero. He’s nothing. He ought to be ashamed of himself.”
It’s absolutely no surprise that Shrekli has got under the skin of so many people around the world, when his online presence is somewhat provoking. When the news broke of the price-hike and criticisms flooded in, the businessman replied on his Twitter, “It seems like the media immediately points a finger at me so I point one back at em, but not the index or pinkie.” This insulting comment has been quoted numerous times, alongside a laughable image of Shrekli posing in shades in front of a TV screen. This 32 year old has acquired the rights to a vital drug and yet acts with such audacity in the face of criticism after price-gouging. Should this even be possible?
Shrekli unfortunately isn’t the only individual profiteering from the small demand of rarer drugs. Rodelis Therapeutics, with the rights to a tuberculosis drug called cycloserine, bumped the cost of 30 tablets from an affordable $500 to an unbelievable $10,800. After a public outcry, rights were returned to the original owners and the price dropped. Another case in point is that of a new hepatitis C drug sold by Gilead Science and AbbVie, which can cure 90% of those infected. This condition affects over three million Americans, yet a drug with such potential is being priced at $94,500.
Pressure from the media seems to have paid off however in the case of Daraprim. Shrekli announced that he will lower the cost of the medication, but by how much, he is yet to announce. When asked whether this was in response to the harsh criticism of his move, Shrekli said, “Yes it is absolutely a reaction – there were mistakes made with respect to helping people understand why we took this action, I think that it makes sense to lower the price in response to the anger that was felt by people.”
Hilary Clinton outlined her plans to prevent Shrekli and hungry drug companies from making such a move again. At a campaign stop in Iowa two weeks ago, Clinton said she wants to put a monthly cap on patient drug costs that would prevent insurance companies and pharmaceutical companies from “excessive profiteering”. She added, “It is time to deal with skyrocketing out-of-pocket costs”.
After her announcement, shares in pharmaceutical companies nose-dived, even in Europe where shares in GSK and AstraZeneca fell by more than 3%. However, if such measures can protect “essential medicines” and the patients who need them, then let’s hope Clinton’s measures will come into force, and she hasn’t just jumped on the issue to boost her election campaign. Drugs aren’t cheap, but by no means should a 55 fold price increase overnight ever be acceptable.