Sunday, December 13, 2015

There's A Conservative Way At Looking At Martin Shkreli And There's A Progressive Way


Until Friday, the newest controversy around young greed and selfishness icon Martin Shkreli was how he bought the single existent copy of the 31-track Wu-Tang Clan double album, Once Upon A Time In Shaolin, for a million or two million dollars (no one who knows for sure is telling) at an auction, after having a trusted staffer listen to a 13 minute snippet. Then Friday the former hedge fund manager-turned-pharmaceutical CEO was in the news again with a plan to sharply increase the price of a decades-old drug for a serious infectious disease, Chagas disease, a parasitic infection that can cause potentially lethal heart problems.
The plan also is upsetting some organizations that supply drugs for neglected diseases because Mr. Shkreli has said he wants to take advantage of a federal program intended to encourage companies to develop such drugs. The program awards vouchers that can be sold to other companies for hundreds of millions of dollars.

Mr. Shkreli has said he hopes to obtain such a voucher by getting the Chagas disease drug approved by the Food and Drug Administration for sale in the United States. Critics say that it would be another case of the system being abused by awarding a voucher not for developing a new drug but merely for obtaining F.D.A. approval of a drug already used in tropical countries.

...Last month, Mr. Shkreli led an investor group that took control of a failing California biotechnology company, buying a majority of its shares on the open market at an average price of about $1.50 a share. The stock of the company, KaloBios Pharmaceuticals, now sells for about $28,  based in part on expectations that the company will prosper under Mr. Shkreli.

  As one of his first moves at KaloBios, Mr. Shkreli agreed to license the worldwide rights to one version of benznidazole, a standard treatment in South and Central America, where Chagas disease is most common.

Benznidazole has never been approved for sale in the United States but is provided free to patients by the Centers for Disease Control and Prevention on an experimental basis.

Mr. Shkreli said on a conference call with KaloBios investors last week that if the company won F.D.A. approval for benznidazole, it would have exclusive rights to sell it in the United States for at least five years. He said the price would be similar to that of hepatitis C drugs, which cost $60,000 to nearly $100,000 for a course of treatment.

In Latin America, benznidazole costs $50 to $100 for the typical two-month course of treatment.

KaloBios’s price would be “pretty devastating,” said Dr. Meymandi of U.C.L.A. “The people with Chagas for the most part are poor” and many lack insurance, she said.

It is estimated that 300,000 people in the United States have Chagas disease, virtually all of them immigrants from Latin America who were infected before they came.
When asked at a recent Forbes health-care summit, how he could have redone his first bout of national publicity around his decision to buy Daraprim, a standard treatment in the care if a life-threatening parasitic infection, just to raise the price from $13.50/pill to $750/pill, he boasted he would have raised the drug’s prices higher. "My shareholders," he said, "expect me to make the most profit. That’s the ugly, dirty truth... I’m going to maximize profits. That’s what people are afraid to say."

Even Republicans are afraid to say that too loud-- and in mixed company-- but that's an underlying principle of their Law of the Jungle philosophy, which, in effect, enshrines price gouging. And that, of course, is why societies protect themselves with one of the bêtes noires of the conservative movement and their Republican Party: regulation that protects the interests of society.

As many people know, especially-- though not exclusively-- as they age, high drug prices are killing people, not rich people, not the millionaires and billionaires, of course, but everyone else. As Social Security Works warned their members this week, "The U.S. pharmaceutical industry is forcing Americans to pay the highest drug prices in the world while stashing their profits in tax havens overseas, even while most of the drugs that they profit from are produced with taxpayer funded research."

This is especially concerned for them because fully 37% of Social Security checks go toward out-of-pocket health care costs. "Big Pharma is gouging the American people with sky-high drug prices, dodging taxes, and eroding our Social Security benefits," something none of the establishment presidential candidates is seriously addressing, although it is certainly at the heart of Bernie Sanders' renegade campaign. Bernie has been working for decades to stop pharmaceutical companies from raking in record profits while avoiding taxes and ripping off American consumers.

In 2013, the U.S. spent nearly 40% more per person on prescriptions than Canada, the next most expensive industrialized nation. This is because drug lobbyists have been able to:
block Medicare from negotiating prescription drug prices,
block legislation that would require transparency on how pharmaceutical companies set their prices,
and block legislation that would prevent greedy CEOs and investors from forcing drug prices through the roof-- bankrupting patients.

And while the pharmaceutical industry is raking in record profits, Pfizer-- one of the world’s wealthiest drug companies-- is attempting to move its corporate headquarters out of the United States to a tax haven overseas in order to avoid paying what it owes in taxes here at home. Pfizer already has $140 billion in untaxed profits stashed offshore.

...Congress should recognize that this is not a partisan issue. According to a recent Kaiser Health poll, 86% of Americans-- Democrats, Republicans and Independents-- want Congress to address skyrocketing drug prices by requiring drug companies to release information on how they set their prices.

Taking on the greedy, out-of-control pharmaceutical industry has been a core priority for Bernie for his entire career. And Shkreli is just an extreme manifestation-- a kind of Overton Window version-- of this kind of Republican Party business-as-usual. Shkreli, whose contribution to Bernie's campaign was publicly rejected and donated to charity, went to Fox Business News where he declared that "I don’t think [Bernie] understands pharmaceuticals at all." Unfortunately for price gougers like Shkreli, Bernie, more than anyone else who has ever run for president understands exactly how the pharmaceutical industry actually does work. And he's vowed to change that to make sure the industry serves the public interest not just a narrow and sociopathic profit motive. For Bernie health care is a human right that includes access to safe and affordable prescription drugs.
Americans pay, by far, the highest prices for prescription drugs in the entire world. When we talk about health care, we are talking about the need of the American people to be able to afford the medicine their health care providers prescribe. A life-saving drug does no good if the people who need it cannot afford that drug.

Yet, last year, nearly one in five Americans between the ages of 19 and 64-- 35 million people-- did not get their prescriptions filled because they did not have enough money. In the wealthiest country in the history of the world, Americans should not have to live in fear that they will go bankrupt or die because they cannot afford to take the medication they need.

In any given month, more than half of all American adults take at least one prescription drug. There is no question that medicines help millions of people live healthier and longer lives, and can also prevent more expensive illnesses and treatments. However, it is unacceptable that the United States now spends more than $370 billion on prescription drugs and spending is rising faster than at any point in the last decade.

Instead of listening to the demands of the pharmaceutical industry and their 1,400 lobbyists, it is time that Congress started listening to the American people, who overwhelmingly believe that the cost of medication is too expensive. More than 70 percent of Americans believe drug costs are unreasonable and that drug companies are putting profits before people.

Americans filled 4.3 billion prescriptions last year. The Sanders plan includes six policies to get better deals for the American people. Sanders’ plan will:

Require Medicare to use its bargaining power to negotiate with the prescription drug companies for better prices-- a practice that is currently banned by law.

Last year there were more than 37 million Medicare beneficiaries enrolled in private Part D plans. 90 percent of seniors take at least one prescription. Many seniors-- almost two-thirds-- take three or more prescription drugs.

Not only would negotiation substantially reduce prices seniors and people with disabilities pay for drugs, it could save Medicare between $230 billion to $541 billion dollars over the next decade.

83 percent of Americans support allowing the federal government to negotiate with drug companies for better prices.


Allow individuals, pharmacists, and wholesalers to import prescription drugs from licensed Canadian pharmacies.

The United States spends more than $1,000 per person per year on prescription drugs-- that’s nearly 40 percent more than Canada, the next highest spender.

In 1999, Sanders became the first Member of Congress to take a busload of Americans across the border into Canada to purchase prescription drugs. Americans should not have to pay higher prices for the exact same drugs than our Canadian neighbors simply because Congress is bought and paid for by the powerful pharmaceutical industry.

72 percent of Americans support this policy of allowing Americans to easily import safe and affordable prescription drugs from Canada.

Prohibit the United States from agreeing to provisions in international trade deals that would raise drug prices in the United States or extend the monopoly period when a brand name drug company has no generic competition.

Suspend the government’s authority to destroy packages of imported drugs at the border until new legislation is passed ensuring that Americans can import safe and affordable drugs from Canada.


Close the Medicare Part D donut hole for brand and generic drugs by 2017, three years earlier than under current law.

The private Medicare Part D benefit contains a “donut hole.” It’s a coverage gap, wherein seniors and people with disabilities must pay for their medications even while they are paying monthly premiums. Under current law, this gap in coverage will close by 2020. Sanders’ plan closes the gap by 2017.

Require generic drug companies to pay an additional rebate to Medicaid if their drug prices rise faster than inflation.

Brand name drug makers have to pay a rebate to Medicaid if their drug prices rise faster than inflation. This provision ensures generic drug companies are subject to the same rules. Nearly 10 percent of generic drugs more than doubled in price last year.

According to the nonpartisan Congressional Budget Office, this policy will save the federal government $1 billion over 10 years.

Restore Medicare prescription drug discounts for low-income seniors and people with disabilities.

Pharmaceutical companies got a huge victory ten years ago, when prescription drug coverage for low-income seniors and people with disabilities was moved from Medicaid to Medicare. Because Medicaid gets a much better price for prescription drugs than private Medicare Part D plans, this policy change meant that drug companies would gain even larger profits on the backs of low-income seniors at the taxpayers’ expense.

The Sanders plan will restore these rebates for low-income seniors, saving $103 billion over 10 years, according to the nonpartisan Congressional Budget Office.


Prohibit anti-competitive deals-- “pay-for-delay” deals-- between brand and generic drug makers.

Brand name drug companies sometimes try to delay their competition by paying generic drug makers to stay off the market. When these deals occur, drug prices stay high, costing patients and taxpayers more money.

The Sanders plan prohibits these pay-for-delay deals. According to the Federal Trade Commission, these anticompetitive deals cost consumers and taxpayers at least $3.5 billion in higher drug costs every year.


Terminate exclusivity-- a government-awarded monopoly period-- from a drug company convicted of fraud.

The Sanders plan holds the pharmaceutical industry accountable when they defraud the American people. Today, nearly every major pharmaceutical company has been convicted of either civil or criminal fraud for violations including off-label promotion, kickbacks, anti-monopoly practices, and Medicare fraud.

Even though the Justice Department has won suits requiring companies to pay hundreds of millions of dollars in fines, the prescription drug companies simply treat those fines as the cost of doing business.


Require drug companies to publicly report information that affects drug pricing.

Companies routinely distort the true cost of drug research and development to justify skyrocketing prescription drug prices. Under the Sanders plan, drug makers would be required to report certain price information to the federal government and the public on their products, including the total expenditures on research and development and clinical trials, as well as the portion of their drug development expenses offset by tax credits or paid for by federal grants.

Companies would also be required to report not only the price information charged to federal payers, such as Medicare, but would also have to submit price, profit, and sales information for other countries in which the drug is sold.

86 percent of Americans, including 82 percent of Republicans, think drug companies should be required to release information to the public on how they set their prices.
This is not a partisan issue. Most Americans-- Republicans, Democrats, and independents-- want Congress to do something about drug prices. Tens of thousands of Americans now spend more than $100,000 a year on prescription medications. Drug costs are out of control because that’s the way pharmaceutical companies want it. Other countries have national health insurance plans that negotiate better prices for all of their residents. In this country, however, drug lobbyists have been able to block all of these common-sense solutions that we must work to pass into law. That is unacceptable and that has got to change.
If you'd like to help Bernie win his race for the White House, you can contribute here, on this ActBlue page. And if you need more convincing, take a look at this poll of national Republicans that NBC and the Wall Street Journal just released this morning. Cruz is on the move, my friends. And if you think Trumpf was bad... what 'til you find out more about this maniac!

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