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A Pill Doesn't Have to Cost $750 To Be Outrageous and Exploitative

Turing is just a symptom of much deeper pharmaceutical woes.

by Michael Byrne
Sep 27 2015, 8:29pm

Image: David Goehring/Flickr

The internet's villain of the month is easily Martin Shkreli, CEO of Turing Pharmaceuticals. In August, Turing, a pharma startup that had just received its first round of financing, bought the rights to manufacture an anti-parasitic drug called Daraprim. Turing's first act was to jack the price of Daraprim from $13.50 to $750 per tablet, inciting much justifiable outrage.

Here's the thing though: The drug was already priced outrageously and prohibitively. Daraprim is a very old and off-patent drug—just a few years ago, when the drug was still being manufactured by GlaxoSmithKline, it cost $1 per pill. When GSK sold it to CorePharma in 2010 (CorePharma was eventually bought by Impax Labs, who sold the drug to Turing), the price went up to $13.50. Which is indeed much cheaper than $750 per pill, but relative cheapness doesn't translate to accessibility. For many patients, a $13.50 daily medication might as well cost $750.

I more or less owe my life to, first, a drug samples and drug co. patient assistance programs, but then the Affordable Care Act. For years and years, I took a medication—another quite old medication—that goes for around $15 a pill. It's the sort of thing that punishes missed doses severely and immediately; it's notorious for that, actually. I realize now just how much of a highwire act it was to pay out of pocket for it in the first place.

It's a unique fear: being out of money and out of medication. You think it's just a few days away—a paycheck and a refill—but you also know the pounding misery those days will bring. $15 starts to sound like a bargain actually, if only you had it.

When your whole life begins to revolve around the medication you need to keep living, the world becomes a much more primitive place.

And so, on the second day without meds, you limp into the emergency room, a hyperventilating knot of exhaustion and pain. Years later, you may still be getting bills from that visit, but at the time, the small paper cup of pills felt absolutely priceless.

What happens is that you get progressively more behind. Buying pills three days at a time eats at your finances but eventually also your energy and soul. When your whole life begins to revolve around the medication you need to keep living, the world becomes a much more primitive place.

Six months later, I had insurance through the ACA, which covered most of my prescription costs. Every month and year since I've made progress out of my hole, in terms of money, health, and also life, generally. And every month and year since I see more clearly how deep the hole was.

My situation was hardly unique. A 2013 CDC study found that around 13 percent of young adults failed to take medication as prescribed (which jumps to 20 percent for those without insurance), while 20 percent asked their doctor to prescribe alternative, cheaper medications, even if they're less effective. Heath care costs remain the leading cause of bankruptsy in the United States.

We can reasonably assume that the ACA (aka ObamaCare) has improved this situation quite a bit. For one thing, the percentage of Americans (18 to 64) with out insurance dropped from 18 percent in 2013 to 11.4 percent in the second quarter of this year. In California, meanwhile, the state's ObamaCare insurance exchanges have established caps on monthly out of pocket payments for specialty medications (like Daraprim) at $250 for most consumers. That's something.

But it's not everything. Drugs are still the domain of Big Pharma, which means they're still just a means to profit for private businesses. This pretty much ensures a bleak pharmaceutical landscape, whether the cost of it is being shouldered by consumers directly or the feds. Private businesses make money, that's why they exist. Turing, however rotten, should be viewed as a symptom rather than the disease.