At times, the company feared a backlash, but it figured there would be too few patients to effectively lobby on the issue. As patients’ co-pays climbed and doctors scrambled to find alternate medications, the company’s board weighed removing Shkreli as CEO and hired consultants to help them repair the damage to Turing’s reputation.
By October, Shkreli’s friends were abandoning him. Rima McLeod, a toxoplasmosis expert at the University of Chicago, had initially spoken out in favor of Turing in news articles. But when news surfaced that patients were struggling to obtain the drug, she peppered Turing execs with anxious emails.
“… Patients wait for medicines, and that is unacceptable,” McLeod wrote. “People will really be hurt lifelong. You have a monopoly on safe reliable medicine right now and it truly matters for people’s lives.”
In December, she begged two Turing execs to reconsider their profit goals.
“I understand I know nothing of what makes Turing solvent,” McLeod wrote. “However, Martin [Shkreli] did say that he had to maximize profit for investors and that was why price is high … ”
“He called that the ‘dirty secret’ of pharma.”
Of course, Turing is far from the only company in on this secret. Also present at the hearing was Howard Schiller, the interim CEO of Valeant Pharmaceuticals, which raised the price of two cancer drugs by about 1,700 percent over the past six years.
But Schiller seemed contrite, telling the committee, “where we have made mistakes, we are listening and changing.” So after Shkreli refused to answer for the emails—or really, for anything—Cummings pleaded with him to “use any remaining influence you have over your former company to press them to lower the price of these drugs.”
Shkreli seemed to look away.
“I know you're smiling, but I'm very serious,” Cummings said. “You could go down in history as the poster boy for greedy drug company executives, or you could change the system.”
It's unlikely Shkreli can do the latter, since he resigned as CEO in December, though he remains a Turing shareholder.
The committee excused Shkreli, and they turned their ire on Nancy Retzlaff, Turing's chief commercial officer. Several members pressed her on just how much patients pay for Daraprim.
According to Retzlaff, after noticing that price “seemed to be an issue,” Turing put in place steep discounts. Now, she said, practically no one pays the list price. A quarter of Daraprim's patients have private insurance, and if their copays are more than $10, Turing will pay the difference. For Medicaid patients, the drug now costs one penny per pill. Only hospitals still pay an eye-popping price: $350 per tablet, which is already a 50 percent discount from the list price, she said.
(The problem, of course, is that commercial insurers must still cover the list price, which contributes to rising premiums.)