Public Enemy: quotes from the Martin Shkreli jury selection process
harpers.org
harpers.org
Listen to the man speak for 5 minutes, instead of listening to the media's portrayal of him, and you'll learn he's an intelligent guy doing no harm.
Nobody was priced out of being able to get Daraprim. Only 2000 people take it. 70% of it was given away FREE to people who said they couldn't afford it. Insurance companies paid the increased price. Drug prices are a very small percentage of the costs insurance companies pay (most of it going towards doctors' fees IIRC). The extra profit was put into researching improvements on Daraprim, which was a 70 (?) year old drug. The only reason Shkreli's company even acquired the rights to Daraprim is because other companies couldn't make enough money on it to want to keep making it.
By which I mean people that pay insurance premiums and taxes (which fund government provided coverage).
Re your edit, drugs are 10% of US health spending: https://www.cdc.gov/nchs/fastats/health-expenditures.htm
But if we want to significantly reduce spending overall, we are probably going to have to seize every opportunity, even the modest ones.
If we assume all 2,000 people that use daraprim daily at $120 a daily dose, it comes out to $87,600,000 yearly.
If we assume half of Americans don't have insurance (160 million), each American would see a hefty 50 cent increase in their yearly premiums.
This is a gross simplification, but $100,000,000 is a literal drop in the bucket.
These are small fish and focusing on them lets the big players make even more moves.
You can see him do it sarcastically on Twitter and see how effective it works.
It's a common tactic these days to exploit the tendency for the news to breathlessly cover insignificant/minor actions of fringe people and blow them up into these exaggerated caricatures of powerful people that need to be stopped/fired/shut down/etc.
When it reality the entire 'power' of these 'monsters' is due to their subsequent notoriety in the media. This is how they gained their following and how they grow it.
If they were ignored they would go back to being nobodies.
The same thing is happening to many people the media calls 'alt-right' and (actual) white supremacists. They're useful idiots for lazy journalists and motivated political groups looking for exaggerated adversaries from which they can rescue the world from.
The media hands them power, which makes them seem powerful and influential. Then a small group of people willing to ignore the 'bad' stuff being said about them, or they actually research it and see it was all blown out of proportion, then joins their cause - people who would otherwise have never heard of them.
The wonderful side effect of outrage culture is that it fuels the things they are outraged about and in many ways becomes a self-fulfilling prophecy. There's far deeper implications to insisting the media takes a balanced and reasoned approach to their coverage than simply having class.
Right now the fringe groups get what they want through "any publicity = good publicity" and low effort journos get what they want through stirring up fake outrage and getting more views by writing exaggerated clickbait about these fringe groups.
Thus they both keep doing what they're doing, which poisons the public debate (by making fringe groups seem more significant than they are, sometimes to the point of drowning out the more reasonable voices)
In the current form that means that
a) the left realizes their obsession with outrage culture have taken fringe, nobody, groups like the 'alt-right' and made them powerful, when they otherwise wouldn't have been. While also making Trump look like an oppressed underdog speaking the 'truth' against a barage of largely overblown exageration and fear mongering. As well as having empowered a number of unhelpful leftist groups in their own ranks who only further alienate their cause amongst the centrists whom they desperately need.
b) the right realizes they will need to see beyond emotional gratification of having fringe groups like Trump and 'alt-right' gain new found power at the left's expense and look for the actual ROI these groups bring. People who gain power through controversy are only good at controversy, smart rational people are needed if you want good productive output.
And if Hitler had a Youtube channel, some might describe him as "visionary" and "a great orator". The problem is none of his Youtube stardom mitigates Shkreli's actions which have demonstrably made the world worse - at the very least by increasing healthcare costs in a country that's already paying for some of the most expensive healthcare in the world.
That said, he's still a pretty typical 4chan-type when he talks of anything of social significance (politics and the like).
I'd say the media portrayal is totally apt. You don't get excused for being a dick because you have a good MOOC.
Raising prices by orders of magnitude on sufferers of rare diseases is a ticket to Hell in the express lane. Making the world hate you is not smart business. Instead of raising prices, maybe they could cut their massive marketing budget to finance more research.
How are you supposed to make money making rare disease drugs if you sell them cheaply?
(Not sure why anyone owns the "rights" to a drug that old in the first place..)
You think a company that sells a single drug for a rare disease has a massive marketing budget?
The pharma industry (medical industry in general, really) has been completely fucked for awhile, and Valeant did much more harm to people than Shkreli but no one bothers to actually read about anything. Knee jerk reactions and following the current is much easier.
He grey hat hacked the pharma system in a way that exposed the vulnerabilities of a the insurance payments here in the US. He did give it at no cost to anyone that reached out to him about not being able to afford it. From everything I've read about him, I really don't think he did this with the intent to harm, rather to show how effed it really is, by orders of magnitude.
What I didn't think he expected was for every other pharma multinational to follow suite, since he basically got away with it, got pretty wealthy too.
The truth is almost always subtler.
“The guy says ‘…before his business practices came to light.’ What the fuck does that mean? I f-ing make money. That’s what I do. That’s why I can f-ing afford a f-ing $2 million album. What do you think I do, make cookies? No, motherf-er. I sell drugs. [Laughs] I felt insulted.”
Every pharmaceutical company is doing exactly the same thing--overpricing their life-saving drugs--and he did it to such an extreme degree that ordinary people actually noticed it.
The only real reason to hate him is that he disrespected Wu-Tang Clan. (Read to the very end of the article.)
Edit-response to comment below due to rate limit: indeed "if I'm acquitted, I get to fuck Lauren Duca" is quite rude, but mocking journalists isn't harassment and more to the point: it was after Duca claimed Skreli was harassing her. Don't misrepresent.
From what I've seen of him on Twitter he's a complete asshole in addition to being kind of a creep (he's currently banned after repeatedly harassing Lauren Duca). That's enough for me to not like him regardless of his company's price gouging.
> The only reason Shkreli's company even acquired the rights to Daraprim is because other companies couldn't make enough money on it to want to keep making it.
I think you should read the Wikipedia article [1] (and it's may sources). But quotes like this don't lead me to believe that Turing acquired Daraprim to "make it better":
> Presentations from Retrophin, a company formerly headed by Martin Shkreli, CEO of Turing, from which Turing acquired the rights to Daraprim, suggest that a closed distribution system could prevent generic competitors from legally obtaining the drugs for the bioequivalence studies required for FDA approval of a generic drug.
> In India, over a dozen pharmaceutical companies manufacture and sell pyrimethamine tablets, and multiple combinations of generic pyrimethamine are available for a price ranging from US$0.04 to US$0.10 each (3–7 rupees).
Regarding pharma he's far from the only person to increase pricing, merely the most popular (and easiest target) among a long list of companies who have jacked up prices in the past few decades. This is a uniquely American phenomenon and pharma is basically the only industry where a company can increase prices 200-500% and not get destroyed by competition (even well after patents expire).
> The “most important factor” that drives prescription drug prices higher in the United States than anywhere else in the world is the existence of government-protected “monopoly” rights for drug manufacturers, researchers at Harvard Medical School report today.
http://khn.org/news/government-protected-monopolies-drive-dr...
In addition to the extensive backlog at the FDA crippling competition, the various monopoly positions are heavily exploited by "pharmacy benefit managers":
> Americans pay the highest health-care prices in the world, including the highest for drugs, medical devices, and other health-care services and products. Our fragmented system produces many opportunities for excessive charges. But one lesser-known reason for those high prices is the stranglehold that a few giant intermediaries have secured over distribution.
> In the case of PBMs, their desire for larger patient networks created incentives for their own consolidation, promoting their market dominance as a means to attract customers. Today’s “big three” PBMs—Express Scripts, CVS Caremark, and OptumRx, a division of large insurer UnitedHealth Group—control between 75 percent and 80 percent of the market, which translates into 180 million prescription drug customers.
http://prospect.org/article/hidden-monopolies-raise-drug-pri...
Notably the power of PBM's monopoly is driven from the fact they control all the lucrative pharma purchasing for "unions, state and federal employee plans, even Medicare and Medicaid" as well as the insurance companies.
Bullshit. He's an intelligent guy who used his his abilities to blatantly subvert the public good for personal profit. There are a lot of smart, greedy people out there; what made him stand out was that he was his fuck-you attitude and how transparently greedy his actions where. Most assholes are smart enough to put up smokescreens and complicate things to deflect the hate. He wasn't. In some ways that imperfection makes him a good example of the idea that the devil has a silver tongue.
Daraprim is generic and off patent. Shkreli's "innovation" was to find a scenario where he could exploit well-meaning safety regulations to essentially make a generic drug proprietary and price-gouge people (or their insurers). Guess what happens when insurers get price-gouged? They jack up the price of everyone's insurance, meaning fewer people can afford it. That's hardly "doing no harm."
That said, your description of him doing "no harm" is not correct based on what I know about him. He has fairly strong arguments for what he did for Daraprim. Namely, the drug is priced similarly to similar kinds of drugs, they need the money for research and development of future treatments, if people cannot afford Daraprim the cost will be subsidized or the drug will be given to them, and ultimately access to the drug has increased after his acquisition of it. However, these arguments are built upon the healthcare system of the United States, and when Shkreli's activity exceeds the confines of the US these arguments start to break down.
KaloBios Pharmaceuticals (Shkreli's company) also acquired worldwide distribution rights for a drug called benznidazole [2] which treats Chagas [3] which most frequently afflicts people living in South and Central America.
While the healthcare system in the US protects the poor from predatory practices like Shkreli's, poor people in Central and South America may not benefit from similar protections. I called in to Shkreli's livestream and asked him if he would make the same commitment he made for Daraprim, that anyone who couldn't afford the drug would be given it for free or for a dollar, and he at first denied that his company even had worldwide distribution rights. When I linked him to the court document [2] that clarifies he did in fact get worldwide distribution rights, he claimed that he hoped what every CEO hoped, which is that everyone would buy his product. I continued to press him on what would happen if poor people in countries that didn't have legal protections needed the drug, would they be able to get access to it, and he called me dense and stupid without ever answering my question.
Shkreli strikes me as an interesting and intelligent person. He is definitely more complicated than the media makes him out to be. And yet, there is also an element of amoral heartlessness to him. I think his business practice does cause harm. In the US, it causes harm by straining the healthcare system with higher costs, and outside the US it poses the potential to reduce access to critical drugs.
I do think media coverage of Shkreli is typically disingenuous - they focus on Shkreli because he is, to many, an unlikeable jerk doing a bad thing. Instead, they should focus on larger companies who are doing similar bad things on a much greater scale, and causing much greater harm. Ideally, this negative coverage would drive the public to understand the problem and seek legal reform to improve healthcare costs and outcomes.
[1] - https://www.youtube.com/watch?v=vuRyItQAqno
[2] - PDF - https://arstechnica.com/wp-content/uploads/2016/02/kalobios....
[3] - https://en.wikipedia.org/wiki/Chagas_disease
Also, I once made a bet with Shkreli about how Google search terms worked. He said if I could prove it with an excel file documenting 100 test cases of my explanation he would tweet out a message I wanted him to send. I produced the excel sheet, showed it to him, walked him through it, then he refused to tweet it.
>Insurance companies paid the increased price.
Yes but who pays insurance? Us as individuals.
>Drug prices are a very small percentage of the costs insurance companies pay (most of it going towards doctors' fees IIRC).
Do you have a recent source for this? Thanks.
>The extra profit was put into researching improvements on Daraprim, which was a 70 (?) year old drug.
Shkreli admitted his company sold the same form of pyrimethamine, or Daraprim, that had been on the market for 70 years — although he expressed hope that his company could develop a more potent form of the drug that did not hinder the body’s production of folic acid.
“The mechanism of the drug is folate inhibition,” Anandya reminded the CEO, adding that what Shkreli had proposed might not even be scientifically possible.
“The entire mechanism of the drug is to stop the production of folic acid in the first place and the bulk of its side effects are tied up with that,” Anandya said. “It’s kind of counter-intuitive to say that you are going to solve this problem when it’s not a problem as much as the whole raison d’etre of the drug. This I find is the main problem with your plan. That the solution is not worth $749.”
“One cannot suggest such a (monstrous) increase in the price of a drug which by your own admission does nothing better while telling me your plan is to (because this is the only way it would work) create an entirely new drug not related to pyrimethamine at all because it would require a new structure,” the physician continued. “Which in turn would give you a big hassle since you would require testing and FDA approval from scratch anyway. I think your plan is flawed.”
http://www.alternet.org/economy/pharma-bro-martin-shkreli-ge...
And:
Here’s an excerpt from an email sent Dec. 8, 2015 from McLeod to Nancy Retzlaff, Turing’s chief commercial officer and Eliseo Salinas, Turing’s president of research and development: “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.”
http://www.marketwatch.com/story/1bn-here-we-come-martin-shk...
And:
As for Shkreli’s claims that the profits will go to research for a better version of Daraprim, experts aren’t buying it.
"Turing has not got a single clinical trial underway. Shkreli’s not testing new drugs of any kind for toxoplasmosis. He's got nothing registered," Attaran said. "No one needs a new drug for toxoplasmosis anyways. It works so well bloody well."
http://www.politifact.com/punditfact/statements/2015/sep/24/...
>The only reason Shkreli's company even acquired the rights to Daraprim is because other companies couldn't make enough money on it to want to keep making it.
Ah yes, the ever charitable Shkreli.
Here’s Shkreli on May 27, 2015 in an email to the chairman of the board of directors after news that Turing was making big progress toward acquiring Daraprim: “Very good. Nice work as usual. $1 bn here we come.”
He sent a couple of emails to company contacts, saying that the drug purchase would be announced, and providing some estimates of how much money the company could make. From one on Aug. 27, 2015 he wrote: “I think it will be huge. We raised the price from $1,700 per bottle to $75,000…So 5,000 paying bottles at the new price is $375,000,000—almost all of it is profit and I think we will get 3 years of that or more. Should be a very handsome investment for all of us. Let’s all cross our fingers that the estimates are accurate.”
http://www.marketwatch.com/story/1bn-here-we-come-martin-shk...
>The only reason Shkreli's company even acquired the rights to Daraprim is because other companies couldn't make enough money on it to want to keep making it.
I'd love to see a source for this as well. As far as I know Impax had no plans to discontinue the drug, do you have anything indicating otherwise?
Otherwise the constitution guarantees a jury of your peers not a jury of people with the same/similar/local values. Certainly in context "peers" could come under scrutiny in light of the dictionary definition.
The worst case scenario is having someone who has been previously influenced by reading newspapers. Especially in this day and age of outrage culture and highly politicized 'journalism'. I do not want my judicial system being tainted by politics and ideology the way the media has.
It is a damn shame. It is also a damn shame people in this country have to be in court/under oath (potential jury members are during the selection process) to admit to these financial shortcomings, because such admissions of financial difficulty are social stigmas that almost anyone would try to avoid admitting (it's the same with millions who were in foreclosure during the Great Recession who would never admit it).
juror no. 52: When I walked in here today I looked at him, and in my head, that’s a snake — not knowing who he was. I just walked in and looked right at him and that’s a snake.Lawyer - "Do you think people have the right to self-defense?"
Potential juror - "No. If someone shoots at you, it's murder if you shoot back."
Never attribute to malice.
This is an alarmingly common line of thinking, especially in more progressive areas. Some would prefer to take (what they believe to be) the moral high ground from the grave.
Don't kill people unless required. I don't want to kill someone, ever, if avoidable; but the world we live in leaves us no choice sometimes if someone has made a poor decision.
You're free to make that decision and quite possibly die for it. Don't attempt to make it for me via legislation.
The best I can say is that it would be morally unacceptable for anyone to murder you, specifically--a person who has publicly renounced killing. And because you desire to not kill in your own defense, it is therefore more acceptable for me to kill someone else in your defense.
But doing so would offend your own values, so do I have time to judge whether that is a principle you would die for?
It gets complicated.
Fortunately, the law only deals with what is legal, and not with what is right. Sometimes, breaking the law is the only upright thing to do. If the law says it is still murder to kill in self-defense, then you kill that assailant, and then you take whatever punishment the state dishes out for it--not because it is just, but because you shouldn't fight an adversary that you cannot defeat. Obviously, it is better to live under laws that match your personal principles, but we can't always do that.
Pacifism is a perfectly reasonable moral stance to take, but I do not think it could exist without non-pacifists willing to use force to defend those pacifists. And that is why I am not a pacifist myself. Obviously, it would be better all around if everyone could be a pacifist, but that experimental world quickly falls apart whenever anyone goes renegade.
Canadian Bill C26 Self-defence against unprovoked assault 34. (1) Every one who is unlawfully assaulted without having provoked the assault is justified in repelling force by force if the force he uses is not intended to cause death or grievous bodily harm and is no more than is necessary to enable him to defend himself.
I read a story about some man swatting at a Raccoon with a broom that almost got 2 years in prison. That's more time than what a rapist or child molester might spend behind bars. There was another story about a Chinese corner store owner who apprehended a thief who had been stealing from him regularly and almost went to prison for it. It's scary proposition when it comes to defending yourself. If you cause any harm to the assailant you will be prosecuted. The law in Canada typically favors the criminal.
That does not seem to be the case in the real world, though. Who would have thought that fiction would lie to me.
clearly the best reason to be biased
I'm surprised he didn't get assassinated for some of that stuff with Wu-Tang, especially in NY. I know I've been waiting a new full-featured Wu-tang album for a LOOOONG time, and I know a lot of new yorkers were too. Multiply that anger by several million people and media deception, it shocks me that he's still around.
The lesson I've learned about all this is the value in nobody knowing your name. Shkreli was fucked over HARD by the media, he's really just a cool guy playing the game, and they spin him as this terrible evil mastermind.
He used to stream all the time, you couldn't watch him for more than five minutes before falling in love with him. He's a man of the people in the truest sense. More than anyone I've ever met.
I hope he finds a way through all this.
You don't get to determine morality based off someone's speech, only off their actions.
Until they actually fuck, it's that big of a deal. People that complain about mean things online were recently attacking people with dangerous weapons the other day. I have become suspicious of most people who want to gatekeep other people, it's usually a signal that they have no respect for the concept of personal property and human rights.
Your denial of it, and the weird generalizations you're making, make me think you're not actually open to rethinking any of this. Oh well.
[1] https://www.nytimes.com/2017/08/04/business/dealbook/martin-...
Source: I was in jury selection for a simple possession trial that lasted two fulls days, and watched peoples excuses become more and more elaborate as the process wore on.
A while back I was called in for jury selection for a Grand Jury which would have involved something like 4 days a week for multiple months, i.e. completely awful from my perspective. The thing that surprised me in that case was that a fair number of people basically volunteered to be chosen--though many obviously did not. (The DA let them go through voir dire first before picking from people who were less inclined to do it.)
Shkreli is internet-meme famous and not exactly a national celebrity. I'd be surprised if so many people would recognise him by name without having an omniscient device in their pocket, let alone sneak in an obscure reference to his Wu-Tang Clan album. I guess people don't know what the case is when they're invited to selection, but nowadays they find out some minutes or hours before the actual interview?
In this case maybe he got lucky because they'd already heard of him and made their stupidity apparent straight away. But what if they hadn't? What if they only learnt about his drug pricing during the trial and then convicted him based on that?
The first thing that potential jurors are asked is if they know anyone in the courtroom, and this is in the presence of the judge, bailiffs, attorneys for both sides, defendant, and a few other people. If you answer that you do know someone, they ask if your knowledge of the person would prevent you from rendering an impartial verdict in the trial to come. The question of whether a potential juror knows a particular person comes up repeatedly.
In the trial I served on, the attorneys also informed us of the sexual orientation of the defendant and asked if that would be a problem.
The jury is allowed to form an opinion of the credibility of the statements of any of the players and use that to weigh anything said against anything else. But it will be from an opinion formed in the courtroom, not from a preexisting opinion, nor from internet research.
BTW I never had to serve the USA in the military, so I weigh the inconvenience of six or seven days of jury service spread over three or four weeks against the fact that my life was not in danger.
Skreli's defense for this is that the costs are primarily borne by insurance providers. I have no idea about US healthcare which seems a bit of a quagmire, is this true?
The term signalling does not mean the same thing as 'saying' or 'showing off' when it is used by economists or biologists. Signalling means credibly giving information that is difficult to prove just by saying it. For example, banks used to have very grand buildings. Any bank could claim to be safe, but only a bank that had lots of money could afford a grand office."
https://www.adamsmith.org/blog/stop-saying-virtue-signalling
https://en.m.wikipedia.org/wiki/Guano
In other words -- why do I give a shit what Adam Smith's opinion is?