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Analysis: Shkreli Isn't to Blame For High Drug Prices in U.S.

by Arthur Caplan /

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Should we care about Martin Shkreli, the man I call the "Wolf of Pharma Street"? His hoodie-wearing perp walk sparks outrage, but he is diverting attention from far bigger and more important systemic problems regarding the cost of drugs for all Americans.

Shkreli, the former Turing Pharmaceuticals CEO, has been indicted by the feds for allegedly running a Ponzi scheme to keep his various drug company investments afloat.

Before the feds came calling to charge him with securities fraud, Shkreli had secured the manufacturing license for Daraprim which is used to treat nasty, often fatal protozoal infections in, among others, those with AIDS. Shkreli, grinned, flipped the rest of humanity the bird, and raised the 62 year-old drug’s price by 5,500 percent; from $13.50 to $750 per tablet overnight — thus retiring the "Biggest Jerk in Health Care Award" forever.

It is way too easy to demonize Shkreli as the face of avarice and sleaze when it comes to the cost of drugs and the high cost of health care in America. Going after him in congressional hearings or in a courtroom is very satisfying. But it does nothing to address the far bigger challenge of why Americans pay so much for their medicines.

And pay we do.

We pay prices that are three times higher than they are in the U.K., six times more than they cost in Brazil and 16 times more than they cost in India. Why are we subsidizing drug prices for the world?

U.S. prices for top brand-name drugs jumped 127 percent between 2008 and 2014, while staying the same in many European countries, according to a Reuters report on research from Britain's University of Liverpool. Granted, these are not Shkrelian price hikes, but they are worthy of congressional hearings, editorial attention and policy reform debate.

Martin Shkreli is Out as CEO of Another Biotech He Founded

Why are we the kings of cost? There are many reasons:

We don’t bargain over prices throughout all of our health care the way the rest of the world does.

The Veteran's Administration and Department of Defense get way lower prices on drugs. That seems to lull Congress into inaction by corporate lobbyists intent on keeping the government from haggling over prices throughout the rest of the health care world.

Drugs that could — and should have — cheaper generic alternatives do not.

This is due to practices such as ‘evergreening' patents by tweaking name brand drugs to extend their patent protection, pay-to-play schemes that permit undue influence over FDA drug approval hearings, pay-for-delay actions that block the introduction of generic competition by buying off generic manufacturers all keep everyone’s drug costs higher than they otherwise might be.

Drug Firms Stave Off Generics, Costing Consumers Billions, Critics Say

And, mainstream pharmaceutical and biotech companies are setting prices so high that many patients and families cannot afford them or the co-pays they carry and fall into debt. Even worse, some prices are so high that payers won’t cover them, leaving adrift many with cancer, hepatitis and other potentially fatal maladies.

Sure, we all feel better when Shkreli gets his comeuppance. However, Shkreli personifies nothing but his own bombastic greed. He has screwed a small number of people with his devious behavior and should not be allowed to screw all Americans by making us think that his downfall fixes anything needing fixing in American health care.

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