Tuesday, September 22, 2015

15 Things You Should Care (And You Should Know) About Daraprim's 5,000% increase in price. (Tuesday's Newsday).

This is an actual picture of one of the highest-profile
pharmaceutical CEOs in America today.
About 8x a day I get really worked up about some news story I read, and go on a Twitter rant about it. In hopes of being EVERY BIT AS EFFECTIVE as tweeting to a nominal number of people, I'll try to feature a (relatively?)(brief?) post about one of those every Tuesday.

1. Daraprim is the trade name for pyrimethamine, a 'generic drug' used to treat infections.  It's been determined to be one of the most important medicines in a basic health care system.  It was invented in 1953.

2. Aside from the basic uses of Daraprim, it is being investigated to help delay or cure Tay-Sachs Diseased as well as ALS -- Lou Gehrig's disease which, ice-buckets notwithstanding, still exists.

3. In India, you can buy a tablet of Daraprim for about 5 to 10 cents. The price per dose in America is $833 per tablet. That price was raised from $13 per tablet by cartoon version of a hedge fund manager "Martin Shkreli,"  who is under investigation by two federal agencies as well as the subject of a $65,000,000 lawsuit by the company he founded; the latter alleges that Shkreli misused company funds to benefit himself personally. Shrkeli has also been accused of manipulating regulatory processes and may have engaged in a weird form of racist Twitter insider trading/trolling.

4. Shrkeli also once tried to buy his way into a championship of an "e-sports team" and failed miserably.  Unlike  many people, I do not turn away from my glee when bad things happen to bad people.  I want more bad things to befall Martin Shrkeli; minor embarrassment over being so terrible at videogames that he cannot buy a victory in one is not enough justice.

5. The rights to manufacture Daraprim were previously held by a company known as "Impax," which got the rights to Daraprim in March 2015.  Impax then sold those rights to Turing Pharmaceuticals for $55,000,000.

These are the protozoa that cause toxoplasmosis,
which Daraprim can treat, for $650,000 a year.
As many as 1/2 of all the people in the world may have the
disease, which causes symptoms ranging from flu-like conditions
to seizures.
6. Impax's purchase of the companies that allowed it to own Daraprim cost $700,000,000, so the sale of rights to one drug netted back 8% of Impax's outlay.

7. In 2011, Impax was warned by the FDA about "significant" violations of federal law including adulterated drug products. The letter notes "This is a repeat observation from the April 2010 inspection." That April 2010 inspection required changes to avoid metal contamination. Additional concerns over the companies practices continued into at least 2013.

8. While everyone is up in arms over Daraprim, right now, for now, it seems important to also note that two members of the House Oversight Committee wrote the president of Valeant Pharmaceutical International, Inc., around the same time, about Valeant's decision to increase the costs of 'staple heart drugs' they had just bought by 300-600%.

9. Another company, Gilead Sciences, increased the price of a hepatitis-C drug, Solvadi, from $500 per pill to $1,000 per pill. Gilead made $10,300,000,000 off that pill in one year. 

10. That is $326 dollars every second of every day.

11. While companies frequently cite the costs of development as a reason drug prices are so high, the facts are not always in line with that.  The company that developed Solvadi occasionally got government grants, but was losing money until it developed Solvadi.  From 2003 to 2011, that company lost $314,000,000.  But when it came up with Solvadi, the company was purchased for $11,000,000,000.  The founder, who hadn't worked for the company since 2006, received $400,000,000 from that sale.

12. Gilead, therefore, made back nearly 100% of its purchase price in the first year of its right to sell the drugs.  Estimates are that 2,000,000 patients still are awaiting treatment for Hepatitis C.  Medicare-based agencies are already saying they cannot afford the cost of those drugs.

13. Like college tuitions, medical spending is heavily subsidized by the federal government.  As a country, we spent a total of $2,900,000,000,000 on health care in 2013.  33% of that was paid by private health insurers.  35% of that was paid through Medicaid and Medicare.

14. Many drug companies, once the patent runs out on a drug, enter into a situation they call "pay for delay," where they pay potential competitors not to produce a cheaper, generic form of the drug.  The FTC used to deter use of these through enforcement. An appellate court ruled them per se illegal.  They have made a return though, following 'novel' interpretations of anti-trust law.  The FTC asked the government to take action after finding that the delays cost Americans billions of dollars. That was in 2010. Guess what hasn't happened yet? GOOD THING WE FIXED HEALTH CARE.

14. Every time  you pay a premium to your health insurance company, or taxes to state and federal governments, you are helping Martin Shkreli buy his way into an 'e-sports league,' or otherwise subsidizing a billionaires' private pursuits.  This is what the 'free market' has amounted to in this area.

15. One in five Americans routinely skips a prescription because they cannot afford to pay for it.

That is all very depressing. Here is a kitten:

Maybe a world with kittens in it isn't ALL bad?

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