In 2015, Turing Pharmaceuticals purchased the American marketing rights to Daraprim, the branded version of the drug known generically as pyrimethamine. The drug is on the World Health Organization’s List of Essential Medicines because it is used to treat the parasite infection toxoplasmosis, malaria, and is often used for people with compromised immune systems, including AIDS patients, as well as some cancer patients and elderly patients. After Turing purchased the rights to Daraprim, the company increased the price from $13.50 per tablet to $750 per tablet, raising the annual cost of treatment for some patients to hundreds of thousands of dollars.
The price increase sparked widespread criticism. The Infectious Diseases Society of America and the HIV Medicine Association sent a joint letter to Turing, claiming the increase to be “unjustifiable for the medically vulnerable patient population” and “unsustainable for the health care system.” Dr. Judith Aberg, of the Icahn School of Medicine at Mount Sinai, said that Daraprim will be too expensive for hospitals to keep in stock and that use of the drug would require special review, possibly forcing hospitals to seek “alternative therapies that may not have the same efficacy.” She stated, “This seems to be all profit-driven for somebody,” adding, “I just think it’s a very dangerous process.”
Turing founder and CEO Martin Shkreli, a former hedge-fund manager, defended the price increase. He claimed that many patients use Daraprim for less than a year, bringing the price more in line with other drugs for rare diseases. Shkreli stated, “Daraprim is 0.01 percent of healthcare costs in the U.S.,” and promised that Turing would negotiate volume discounts for hospitals. He also claimed that a tablet would only cost $1 for patients without insurance. He noted, “I’m like Robin Hood… I’m taking Walmart’s money and doing research for diseases no one cares about.” He claimed that the money from profits would be used to develop new and better drugs.
Dr. Wendy Armstrong, professor of infectious diseases at Emory University, said in response, “An old drug is not necessarily a bad drug… This happens to be an incredibly effective drug and has been cheap and well tolerated by patients for years.” Armstrong and Aberg both noted that some patients who take Daraprim must use the drug indefinitely. Writing for Bloomberg and The Washington Post, Max Nisen described how the price increase was indicative of larger issues in the pharmaceutical industry. He stated, “Old medicines are still sold at inflated prices because there’s no mechanism to compel drugmakers to lower them.” Nisen added that pharmaceutical companies “justify drug prices by reminding the public that developing drugs is costly and failure-prone. That’s a fair point. But drug companies also announced more than $50 billion worth of share buybacks and dividend hikes after the new [2017] tax-cut law passed.”
In 2018, Shkreli was sentenced to seven years in prison for defrauding investors of $10 million. But as Nisen points out, “Shkreli’s fraud conviction stemmed from his hedge-fund days — everything he did with drug prices remains legal.” In May 2018, the price of Daraprim remains $750 per pill.