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Is it Corporate Greed That Led to Turing Pharmaceuticals’ “Price Gouging” on Daraprim?

in Ask Dr. Ruwart, Liberator Online by Mary Ruwart Comments are off

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Question: Is it corporate greed that led to Turing Pharmaceuticals’ “price gouging” on Daraprim?

Turing PharmaceuticalsOver the last couple of days, the media has been aghast as Turing Pharmaceuticals CEO, Martin Shkreli announced his plan to increase the price of Daraprim from $13.50 to $750 a pill. Daraprim was patented in the 1950s, and is used for treating parasitic infections in fewer than 13,000 people a year in the U.S.  Turing bought exclusive rights to distribute the drug in the U.S. from Impax for $55 million; drug sales are less than $10 million/year.  Impax itself bought daraprim several years earlier. It upped the price from $1 to $13.50/pill, causing the number of prescriptions to drop about 30%.

Shkreli’s assertion that the profits would be used to develop a better drug for treating toxoplasmosis was met with skepticism.  Shkreli is a former hedge fund manager, not a pharma veteran, and might not be aware that the new drug will have to be tested against daraprim itself. Testing against placebo would be unethical, given that daraprim is part of the treatment standard.  Showing superiority, in terms of effectiveness or side effects, is much more difficult against another drug than placebo. Indeed, given the small number of patients who need the drug, it might be impossible to show the “statistical significance” required by the FDA, since large numbers of patients can’t be tested.

Why, you might ask, can Shkreli price his drug so high and not fear that a generic competitor will undercut him? After all, the daraprim no longer has patent protection.

The answer: Turing Pharmaceuticals has a de facto monopoly, courtesy of the ever-increasing costs of gaining FDA approval, both for new drugs (over $1 billion and 11 years) and generics. Any generic company could make daraprim; its patent expired decades ago.

However, the FDA would require that the company demonstrate that its pill released the drug into the blood stream at the same rate as the original daraprim.  Coupled with the cost of setting up FDA-approved manufacturing facilities for the new drug, a turn-around time of a couple years or so due to regulatory red-tape, and the expensive clinical trials, a generic company would need to commit to spending many millions, perhaps tens of millions, even with the special exemptions that the FDA gives drugs that have small or “orphan” patient populations.  After jumping through all of these costly hoops, the competitor might be unable to take a substantial part of the market from Turing should it choose to lower its prices for the sole reason of preventing the competitor from getting a foothold.

The $750 pill might be considered an example of “corporate greed.”  However, Turing probably wouldn’t have even attempted such a price hike without high cost of FDA-mandated drug development, both new and generic, which virtually eliminated his competition.


Who’s to Blame for Dangerous Prescription Drugs: The FDA or Big Pharma?

in Healthcare, Liberator Online, Libertarian Answers on Issues, Libertarian Stances on Issues by Mary Ruwart Comments are off

(From the Ask Dr. Ruwart section in Volume 19, No. 10 of the Liberator Online. Subscribe here!)

QUESTION: The pharmaceutical company is sometimes caught pressuring the FDA to approve drugs with dangerous prescription drugsside effects and the FDA does so. Who is the prime mover of aggression here, the FDA or the pharmaceutical cartel?

MY SHORT ANSWER: It’s the karmic circle. The American public allowed the FDA to regulate the pharmaceutical companies under the largely erroneous assumption that they were nefarious. In the beginning, the primary loss to the American public was fewer life-saving drugs, since more money had to be spent on development instead of discovering new drugs.

The regulations reshaped the industry in a way that encouraged graft, as the regulations got more onerous. The industry “fought back” with the Prescription Drug User Fee Act which lets companies pay about $1 million for a faster review. This co-opted the regulators, since about half of their budget now comes from such fees.

In addition to losing many life-saving drugs, the drugs that we get now are less safe. The biggest safety problem with drugs on the market today is that they are meant for long-term use, which amplifies side effects. That’s because only drugs for long-term use can recover the high cost of development that regulations have produced. Even with the high prices of drugs, only 3/10 recover their costs.

This is a lose-lose situation for the American public, the industry itself (which has become close to unsustainable), and even the regulators, who will one day die or watch their loved ones die from diseases that might have been cured without regulations.

LEARN MORE: Suggested additional reading on this topic from Liberator Online editor James W. Harris:

* “Abolishing the FDA: FDA Policies Keep People Sick and Create a False Sense of Security“ by Larry Van Heerden The Freeman, March 1, 2007.

Excerpt: “The Food and Drug Administration (FDA) started out as a bulwark against snake-oil peddling. It has since swung back and forth between hostility and subservience to the drug industry. The FDA seems indifferent to the many deaths its own intransigence has caused and imperious when forced to defend its actions in court, resulting in a system that withholds life-saving drugs from the market, approves dangerous drugs, and denies everyone freedom of choice. The time has come to seriously consider abolishing the FDA.”