[thucydides]

Where's your evidence for these high co-pays that Turing did not subsidize? I searched both transcripts for "co-pay" and "mortgage," and didn't find anything like what you're claiming. In fact, I see the opposite. I see the CEO of Turing being cross-examined by a hostile Massachusetts congressman accusing her of causing $6000 co-pays. She says, no, we paid anyone directly who fell through the cracks in this way. He replies, "after 4 days."

Searching for the word "mortgage" yielded no results for me.

I used to think drug companies were a scourge. After researching the Shkreli controversy last year I'm not so sure. But Shkreli, with his (often funny) dickhead antics, certainly would be a convenient whipping boy -- if anyone, like Congress or special interests -- needed a whipping boy to distract the public from what's actually ailing American health care.

For some perspective, drugs are only 1/10 of American health care costs.

  Prescription drugs: 10%
  Dental care: 4%
  Hospital care: 32%
  Physician/clinical services: 20%
  
  Source: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/PieChartSourcesExpenditures2014.pdf

And as far as Shkreli goes, the reality, as far as I've seen so far, is that no one is paying these sky-high prices for Daraprim out of pocket. Check out Turing's 10-K's; they reinvest their profits in R+D. Shkreli himself seems to be legitimately interested in developing new and better treatments for rare diseases. (CMD+F: "PKAN" on this page: http://www.bloomberg.com/news/articles/2014-04-17/retrophins...)

Serious question. For these super-rare diseases like toxoplasmosis, the current profit model is this. First, charge a high price ($30k-$100k) for a course of treatment. Then, the few people suffering from the rare disease get the drug via insurance. Does anyone have a better way of incentivizing drug companies to create new treatments, or better treatments, for rare diseases?

[gizmo]

The evidence is in the hearings, just watch them. The transcript search doesn't work for me (paywalled).

Also see page 4 of this document (which I already linked to):

http://democrats.oversight.house.gov/sites/democrats.oversig...

And in the congressional hearing there was one family facing a $350,000 price tag for their Daraprim cure which insurance refused to cover altogether because of the price hike, and Turing refused to help. The family did eventually get the medicine they needed, but Turing left them out to dry.

I'm fully aware Turing states "nobody falls through the cracks", but it's a blatant and audacious lie and there are dozens of experts testifying as much. You'll also find expert testimony in the linked videos. Many hospitals stock one or two bottles of Daraprim so they can immediately help walk-in patients. So now when somebody can't get Daraprim through insurance the doctors beg nearby hospitals to fedex the pills they have in stock from before the price hike. This supply is quickly running out.

The sales volume of Daraprim dropped by 80% or so as a result of the price increase, and the Turing executives state that thanks to their actions availability of the drug has broadened. A clear contradiction. Less volume means sick folks simple have to go without, which can have very serious health consequences.

Heck, even the Massachusetts General Hospital stated, and I quote!

    This is a critical matter, visible at the highest levels of our
    Infectious Disease Department [...] Daraprim’s new price on their
    inpatient pharmacy budget, which they have determined to be
    prohibitively expensive. Against their clinical convictions
    they are currently switching patients to Bactrim.

Observe that patients who are now forced to use the inferior Bactrim do not deal with Turing at all, which means there is no application for Turing to reject. Translated into Turing's bizarro PR language: "nobody falls through the cracks". In the real world we understand that people not getting the medicine they need is a problem.

Watch the hearing videos (especially the Subcommitte on Aging one). Read the actual filings and other primary sources, not the PR spin.

[thucydides]

Again, you make two claims here. 1: co-pays for Daraprim are very high. 2. Turing does not reimburse for those high co-pays.

You're right about number 1.

You cite no evidence for number 2. For its part, Turing says they reimburse for the high co-pays. Why wouldn't they? It would be a PR disaster not to reimburse, so it's manifestly in their interest. And they're making such a fat profit they can afford to reimburse people for high co-pays.

Page 4 of the document you cited is just a list of examples of high co-pays. Yes.

Again, where's the evidence that Turing does NOT reimburse for those co-pays? Do you have an example?

[gizmo]

The evidence is right there in the PDF as well as in the C-SPAN videos I linked. I'm not going through 8 hours of video I watched several months ago to find the exact timestamp, but since you claimed you researched all this you must have watched the videos with all the damning testimony they contain already. It's pretty clear at this point you refuse to acknowledge any evidence that makes saint Shkreli look bad so there's no point in going back and forth any further.

From the memo I linked earlier:

> The email stated that the first patient “has a $6000.00 co-pay. She is not a Medicare part D but has a federal funded insurance plan so wouldn’t quali[f]y for co-pay assistance or be covered under whatever Medicare Part D plan you are working on right now with Turing.” The email stated that the second patient “has insurance, however her plan does not cover Daraprim. Attempted to transfer to UCB for free drug program but was advised that because she has insurance, she does not qualify. Free drug program is only for patients with no insurance.”

Basically, Turing says "sorry, you don't qualify". Turing denies people's claims repeatedly, because they just don't give a fuck. Not to mention the obvious problem of patients not being able to afford the co-pay, thereby having to go without the pills. I've clearly demonstrated that there are cases where patients cannot get the medicine they need as a direct consequence of the price hike. But hey, feel free to believe Turing is acting honorably because they want to protect their reputation. Believe whatever you want. I'm done here.

https://i.imgur.com/XBsKiFx.png

[thucydides]

I don't have a horse in the race. I just think you're not reading these documents carefully or considering the evidence carefully.

For example, that case you cite above, the $6k copay. OK. Read the memo closely. A Walgreens exec is emailing a Turing exec citing a patient's problem with Turing's bureaucracy.

How was the problem resolved? Did Turing pay? You say that CLEARLY Turing didn't end up paying in this particular case, because you hate Turing, but the document doesn't say. And you have no idea. Neither do I, but I'm not pretending.

Generally: Turing says, for goodwill, they give away 60% of the drug for a dollar.

Do you know of even one case where someone - verifiably - fell through the cracks and Turing refused to EVER pay?

Are you opposed to the idea of pharmaceutical companies selling orphan drugs at high prices ($100k, $300k, or more)? Or are you only opposed to Turing's purchase of Daraprim and raising the price? Would you still oppose them if, in 10 years, it turned out Turing's profits had, e.g., produced a PKAN drug? Do you know a better way than high drug prices to incentivize the creation of drugs for serious rare diseases?