{"id":2285,"date":"2016-02-07T06:29:46","date_gmt":"2016-02-07T11:29:46","guid":{"rendered":"http:\/\/allphasepharma.com\/dir\/?p=2285"},"modified":"2016-03-23T04:39:08","modified_gmt":"2016-03-23T08:39:08","slug":"mister-s-goes-to-washington","status":"publish","type":"post","link":"https:\/\/allphasepharma.com\/dir\/2016\/02\/07\/2285\/mister-s-goes-to-washington\/","title":{"rendered":"Mister S. Goes To Washington"},"content":{"rendered":"
\"Shrely-slider<\/a>
Shkrely \u00a0 — \u00a0 Gordon Gekko \/ Michael Doughlas \u00a0 — \u00a0 \u00a0John Martin, CEO Gilead<\/figcaption><\/figure>\n

Let\u2019s just assume that Mr. Martin Shkrely had provided full testimony at the Congressional\u00a0hearing, this is what it might\u00a0have said: Read my lips: NO MORE REBATES !<\/strong><\/p>\n

It\u2019s time to give Shkrely a break \u2013 he has been maligned too much. The media already made him into the new Gordon Gekko of \u201cWall Street\u201d: the impersonification of corporate greed and a poster boy of narcisistic behavior. I think we can expect a movie version starring Mr. S. shortly, and it will be a blockbuster. He has the charisma, the chutzpah, the money; he portrays an aura of invincibility and behaves like an American cowboy in King Arthur\u2019s court. All the ingredients of great entertainment. Remember, you read it here first.<\/strong><\/p>\n

Okay, okay \u2013 the guy is flamboyant and has the affluenza virus. He is a Wall Street product and knows how to irritate the bourgeoisie, the self-righteous, the Bernie Sanders followers, and all those who believe in playing by the rules. We can all agree on that. However, he may have gone too far by irritating those who love to hike up drug prices in a less conspicuous fashion and who hate to have the limelight cast on drug pricing. The public may ultimately benefit from his appalling lack of solidarity with industry behavior.<\/p>\n

Daraprim (pyrimethoprim) is an old drug with few indications nowadays. In its hey days, it was used for malaria, and in the early AIDS days, it was a back-up drug for PCP, now called PJP. It is also still used for toxoplasmosis. Does this make it an \u201cAIDS\u201d drug? Is it a drug with a special status justifying a revolt in the HIV community when the price rises? By that wide definition, pretty much every antibiotic could be considered an \u201cAIDS\u201d drug.<\/p>\n

PCP\/PJP is fairly rare these days; it is seen infrequently and only\u00a0in late stage HIV when the CD4 count falls\u00a0below 200, eg, in non-responders to HAART. Most ID fellows never encounter a patient with PCP anymore; at the SFGH the number of cases has dropped by a factor of 10 compared to the pre-HAART era.<\/p>\n

Clearly, with\u00a0Turing (Mr.Shkrely\u2019s company) charging USD 750 per pill, they are doing more than jacking up the price, they are breaking customary pricing standards. Only sofosbuvir \/ Sovaldi, a break-through HCV drug,\u00a0comes close (it\u00a0is in the $ 1000 \/ pill category). Antibiotics are usually sold at much lower prices; no antibiotics are among the top 10 most expensive medicines. This group comprises treatments for rare genetic diseases for which these drugs are truly life-saving. For a long time Zyvox (linezolid) was the most expensive antibacterial with a cost per pill around $150. You have\u00a0to warn patients when you hand them a 7-day 7-pill prescription for Zyvox before they go to the pharmacy otherwise they get sticker-shock right there. Again, Zyvox was a true new MoA drug and deserved a\u00a0premium price. Daraprim is not in this category.<\/p>\n

Still, you could argue that Mr. Shkrely’s behavior is not so atypical after all. He is just\u00a0imitating\u00a0established pharma industry practices. Because of his antics, he has become the whipping boy for grandstanding politicians who\u00a0want to set an example and show that the public outrage with drug pricing is\u00a0being heard in Washington. But\u00a0the action is – somewhere else.<\/p>\n

Senators Grassley and Wyden just reviewed Gilead\u2019s marketing documents dealing with Sovaldi and Harvoni\u00a0pricing, drugs with a price tag of $85-94k per treatment course. Then they gave a press conference about their findings, complaining about\u00a0unrestrained corporate greed [2]. There was no call for regulatory action, no congressional hearing is planned. Gilead\u2019s revenue last year of USD 19\u00a0billion from\u00a0Harvoni and Sovaldi alone tells the story [1]. It is highly unlikely that daraprim will create a similar windfall for Turing, far from it. Mr. Shkrely is being used as a lightning rod, diverting attention from where the really BIG money is made.<\/p>\n

Alex Gorski, CEO of J&J, likes to say about the Ethical Pharma Industry that “Doing Well\u201d is the reward for \u201cDoing Good\u201d. Mr. Shkrely\u00a0couldn”t have said it better.<\/p>\n

References:
\n<\/strong>[1]\u00a0http:\/\/www.fiercepharma.com\/story\/gileads-hep-c-juggernaut-continues-q4-even-us-sales-fall\/2016-02-02
\n<\/strong>[2]\u00a0http:\/\/www.finance.senate.gov\/ranking-members-news\/wyden-grassley-sovaldi-investigation-finds-revenue-driven-pricing-strategy-behind-84-000-hepatitis-drug<\/p>\n

Abbreviations<\/strong>
\nPCP \/ PJP \u00a0 Pneumocystis carinii (jiroveci) pneumonia
\nSFGH \u00a0 San Francisco General Hospital<\/p>\n","protected":false},"excerpt":{"rendered":"

Let\u2019s just assume that Mr. Martin Shkrely had provided full testimony at the Congressional\u00a0hearing, this is what it might\u00a0have said: Read my lips: NO MORE REBATES !<\/p>\n","protected":false},"author":1,"featured_media":2305,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[3,18],"tags":[1513,1539,1271,403,1512,1542,126,1526,1530,1583,661,1541,523,1510,72,590,1528,1527,1523,655,1524,1525,1521,1529,1531,1509,25,1522,1511,1540,1532,90],"class_list":["post-2285","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-the_news","category-the_viewpoint","tag-aids-drugs","tag-alex-gorski","tag-allphase-pharma-consulting","tag-antibiotic-blog","tag-daraprim","tag-drug-prices","tag-gilead","tag-gordon-gekko","tag-grassley","tag-harald-reinhart","tag-harvoni","tag-hcv-drugs","tag-jj","tag-john-martin","tag-linezolid","tag-malaria","tag-martin-shkrely","tag-michael-douglas","tag-pcp","tag-pfizer","tag-pjp","tag-pneumocystis","tag-pyrimethoprim","tag-senator-grassley","tag-senator-wyden","tag-shkrely","tag-sofosbuvir","tag-toxoplasmosis","tag-turing-pharmaceuticals","tag-wall-street","tag-wyden","tag-zyvox"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2016\/02\/Shrely-slider-NEW-copy.jpg?fit=640%2C180&ssl=1","jetpack_shortlink":"https:\/\/wp.me\/p4KWFr-AR","jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":5814,"url":"https:\/\/allphasepharma.com\/dir\/2025\/11\/27\/5814\/obeldesivir-fails-in-yet-another-study\/","url_meta":{"origin":2285,"position":0},"title":"Obeldesivir Fails in Yet Another Study","author":"Harald","date":"November 27, 2025","format":false,"excerpt":"There are studies that are bound to succeed, and those that are likely to fail.\u00a0 A failed trial is nothing to be proud of \u2013 and in this case, it was a gamble against overwhelming odds.\u00a0 We feel the Gilead marketing department was pushing their luck big time with this\u2026","rel":"","context":"In "Recent Literature"","block_context":{"text":"Recent Literature","link":"https:\/\/allphasepharma.com\/dir\/category\/recent_literature\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/11\/IDSA-Covid-Guideline.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/11\/IDSA-Covid-Guideline.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/11\/IDSA-Covid-Guideline.jpg?resize=525%2C300&ssl=1 1.5x"},"classes":[]},{"id":771,"url":"https:\/\/allphasepharma.com\/dir\/2014\/08\/28\/771\/following-the-publication-trail-of-two-rsv-drugs\/","url_meta":{"origin":2285,"position":1},"title":"Following The Publication Trail of Two RSV Drugs","author":"Harald","date":"August 28, 2014","format":false,"excerpt":"In a publication from 2007, investigators from Arrow Pharmaceuticals told us that A-60444 (later renamed to\u00a0RSV-604) was already in Phase 2.\u00a0 Since then, it has been very quiet about this compound.\u00a0 Some have suggested that Novartis has stopped development [1], an impression supported by the fact that the drug is\u2026","rel":"","context":"In "The News"","block_context":{"text":"The News","link":"https:\/\/allphasepharma.com\/dir\/category\/the_news\/"},"img":{"alt_text":"RSV from Ref. 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All will be given as cocktails, with or without interferon or ribavirin, and for various durations\u00a0depending on genotype (GT) and other factors. \u00a0How\u2026","rel":"","context":"In "The News"","block_context":{"text":"The News","link":"https:\/\/allphasepharma.com\/dir\/category\/the_news\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":445,"url":"https:\/\/allphasepharma.com\/dir\/2014\/07\/02\/445\/why-the-next-novel-antibiotic-will-cost-40k-or-more\/","url_meta":{"origin":2285,"position":3},"title":"Why The Next Novel Antibiotic Will Be A Blockbuster And Cost $40k","author":"Harald","date":"July 2, 2014","format":false,"excerpt":"Looking at all antibiotics in the pipeline, I can\u2019t help but think that \u2013 by 2018 \u2013 there\u00a0will be\u00a0some blockbuster anti-infectives coming to the market. 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They are just too cheap, right?\u00a0 Well, with the exception of HCV and some newer HIV drugs, few compounds have ever reached the stratospheric prices that oncology drugs or TNF alpha inhibitors command.\u2026","rel":"","context":"In "The News"","block_context":{"text":"The News","link":"https:\/\/allphasepharma.com\/dir\/category\/the_news\/"},"img":{"alt_text":"EpiPen","src":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2016\/08\/EpiPen.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2016\/08\/EpiPen.jpg?resize=350%2C200 1x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2016\/08\/EpiPen.jpg?resize=525%2C300 1.5x"},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/posts\/2285","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/comments?post=2285"}],"version-history":[{"count":19,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/posts\/2285\/revisions"}],"predecessor-version":[{"id":2326,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/posts\/2285\/revisions\/2326"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/media\/2305"}],"wp:attachment":[{"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/media?parent=2285"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/categories?post=2285"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/tags?post=2285"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}