On Thursday, the House Committee on Oversight and Government Reform will hold a hearing on prescription drug prices. The committee has obtained more than 300,000 pages of documents from Turing Pharmaceuticals and Valeant Pharmaceuticals. Both have been accused of jacking up the price of necessary drugs (of which they were the sole supplier). Representative Elijah Cummings, the committee’s ranking member, released two memos on Tuesday highlighting the most illuminating emails, public relations strategy outlines, and corporate projections.
“These new documents provide a rare, inside look at the motivations and tactics of drug company executives,” Cummings said in a statement. “They confirm what Americans across the country have experienced firsthand for years—that many drug companies are lining their pockets at the expense of some of the most vulnerable families in our nation. The documents show that these tactics are not limited to a few ‘bad apples,’ but are prominent throughout the industry.”
According to one of the memos, the Turing documents show that Shkreli expected increasing the price of Daraprim to push revenue generated from sales of the drug from less than $10 million to several hundred million dollars, annually.
On May 27, 2015, Mr. Shkreli sent an email to the Chairman of the Board of Directors in response to news that Turing had made significant progress towards acquiring Daraprim. He wrote: “Very good. Nice work as usual. $1bn here we come.”
The, in the fall, somebody needed Daraprim for their dog—tough shit.
On October 1, 2015, the Director of Specialty Pharmacy Development at Walgreens forwarded a request for financial assistance for a dog that had been prescribed Daraprim to treat its toxoplasmosis. The request stated: “I have an unusual request. There is a dog that is a patient and he needs Daraprim. He is obviously not covered by insurance ... the cost of what was prescribed is $5,000 for this little guy.” Jon Haas, the Director of Patient Access at Turing, responded: “You can buy Pyramethamine/Sulfa [sic] combo pills from a vet meds website for about $80.”
Indeed, even HIV patients who needed the drug were not human beings facing death but a PR problem to be managed.
On September 21, 2015, an outside consultant forwarded a press article about Mr. Shkreli to senior leadership at Turing, writing: “With the inflammatory coverage of the last two days, it will be difficult to get HIV/AIDS KOLs [key opinion leaders] to spoke out [sic] on behalf of Turing. However, we still come out ahead if we can frame this issue within the HIV/AIDS community as a fight between a drug company and insurance companies. As long as everyone who needs Daraprim can get it as soon as they need it, regardless of ability to pay, the community should have no issue. There is no love lost between HIV/AIDS activists and insurance companies, and they certainly don’t want to be manipulated by them to fight on their behalf.” He also wrote: “With the price increase comes new research, support systems, patient education and greater awareness, so pragmatically and strategically, the community shouldn’t advocate against its own interests. If we can get HIV/AIDS activists to ‘sit this out,’ we come out way ahead.”
And ultimately, Turing Pharmaceuticals thought, the best way to get activists to “sit this out” was to invite them to get to know the company.
An October 12, 2015, internal presentation warned: “HRC [Human Rights Campaign] has been vocal and in the media about the pricing issue and is potentially the most vocal organization able to garner media coverage. While their motivation is primarily political given their actions we feel it would be important to get a meeting with CEO Chad Griffin in an attempt to slow their aggressive stance and work with them to better understand the company.”
Turing worked very hard to get doctors to advocate for them. Most rebuffed their advances, but at least one—University of Chicago’s Dr. Rima McLeod—was willing to try to make things work. Not that Shkreli didn’t make it difficult.
On December 8, 2015, Dr. McLeod sent an email to Ms. Retzlaff and Eliseo Salinas, Turing’s President of Research and Development. She wrote: “I understand I know nothing of what makes Turing solvent and able to do research and of course I value that a lot too. ... However, Martin [Shkreli] did say that he had to maximize profit for investors and that was why price is high. He did not say it was for research primarily that it was a high price. He called that the ‘dirty secret’ of pharma.”
Anyway. Thursday should be interesting!