Dear Turing Pharmaceuticals,
Thank you. Thank you for exposing what I have known for years, that health care in the United States is commoditized instead of treated like a human right. By showing the severity of your greed in raising the price of Daraprim from $13.50 to $750 per pill, you captured the ire of the public. However, you've done one good thing for the American public through this incredibly greedy move: You put price gouging of specialty drugs on a national stage.
I've known about this for years because I've been exposed to price gouging in the medical world since I was 16. While most kids were worrying about school and social lives, I was worrying about going to my next Remicade infusion or hospital visit. Remicade costs hundreds to thousands of dollars per vial and is administered intravenously. This resulted in bills that, combined with outpatient treatment fees including bloodwork and saline, were $23,000 per treatment, but I had the privilege of insurance, so most of those costs were paid.
It makes me sick to say that my medical coverage is a "privilege" in any way. Everybody should have the right to manage their health, and it is imperative that this right includes the medications that work for their individual conditions. Price gouging by pharmaceutical companies destroys this right by prioritizing the greed of the companies who commoditize our health over the needs of patients.
Let's take another example: One of my main issues with Remicade was that I developed a staph infection that was incurable for five years due to the lasting effects of immunosuppression from the drug. In the beginning of those five years, I kept these infections in check with a generic antibiotic, doxycycline. Around the time I was taking "doxy," the price per bottle was around $20. However, between 2013 and 2014, it increased to an average of $1,849 per bottle. Doxycycline is a common generic drug used to treat a wide range of conditions, including urinary tract infections, sexually transmitted diseases, acne, skin infections, and even malaria.
By raising the price of this drug, those who do not have adequate prescription drug coverage will have to pay higher out-of-pocket costs, or else develop alternatives to taking doxycycline. While this might include switching to a more affordable drug, it could also include making their current supply last longer by taking fewer pills, which would reduce the effectiveness of the drug, or even stopping the drug completely. For those taking Daraprim for HIV infections, and especially for toxoplasmosis, an infection that can only be treated by Daraprim, they will be paying between $300,000 and $600,000 per year for treatment, or else will have to quit taking the drug if they do not have adequate coverage.
For those with HIV infections, cancer, or malaria being treated by Daraprim, why not simply switch to another drug? Unfortunately, it's not that simple. We can't make our bodies match our budgets. While I can't speak to those on Daraprim, my own experience with medication is that you have to find what works. As with most medical conditions, what works for one person may not work for another. In the inflammatory bowel disease community, Remicade may not work for some patients, while it may be the only thing that works for others. You and your doctor have to find what achieves remission or a reduction of symptoms, and there may be only one medication that does the job.
Something needs to be done about price gouging, including tougher regulations on pharmaceutical companies. For those who cry that price gouging will be taken care of by the "hand of the free market," it isn't. According to the New York Times, "Daraprim's distribution is now tightly controlled, making it harder for generic companies to get the samples they need for the required testing." There are real barriers to creating competition that could drive the price of this drug down, and those barriers may be so severe as to hinder any competitors from taking on the challenge. The absence of regulation of pharmaceutical companies has in this case actually hindered the free market and has directly contradicted the capitalist ideal of competition controlling price.
For millions like myself treating autoimmune diseases with costly biologics, developing generic drugs to serve as competition isn't even an option. Biologic drugs are developed from human and animal proteins instead of through a chemical process, and there is no way to make a generic with similar active ingredients when the "active ingredients" in biologic medications are living cells. A class of drugs called "biosimilars", which uses very similar proteins to create drugs, has no drugs on the market in the United States due to a different approval process, and even if they were approved, the drugs would not result in much of a price reduction due to the complexity of their production.
Although CEO of Turing Pharmaceuticals Martin Shkreli says that the 5,000-fold increase in price for this drug will fund research and development for more efficient drugs, this explanation is not as altruistic as it sounds, as American pharmaceutical companies make a massive profit off of these R&D costs. For example, the American drug company Pfizer made a 42 percent profit margin in 2013, one of five major pharmaceutical companies in 2013 to make a profit margin of over 20 percent. While they are in fact putting money towards developing drug advancements, they are also padding their pockets extremely significantly. In comparison, the media industry had an average profit margin a bit over 10 percent, and oil and gas below that.
The free market can't properly control the prices of these drugs when competition doesn't exist. Turing Pharmaceuticals' price gouging of Daraprim may be a more extreme example of this practice, but it has caught public attention and generated outrage. Now, maybe this attention will finally give patients the solutions they deserve. Let's prioritize patients over profits.