There are two sides to Martin
Shkreli’s chessboard, and I believe looking at both sides of the recent events is important in promoting multidimensional thinking. In this article, I cover both sides of the
price gouging scandal and the congressional meeting; Shkreli’s current charges,
and his history of moves on the career chessboard. Shkreli is always playing one side of the
game while society, the media, and the government take turns challenging
him. At times it’s hard to tell if
Shkreli plays on the dark side or the light.
Price Gouging
Scandal
In August 2015, Turing Pharmaceuticals
purchased Daraprim from Impax Pharmaceuticals for $55 million. Daraprim is used to treat toxoplasmosis, a
fatal illness caused by a parasitic protozoan, which affects patients with
AIDS, cancer, and unborn children in pregnant women. In 2014, there were 8,821 prescriptions
filled for Daraprim.
On September 15, 2015, Turing had raised
the price of Daraprim by 5,556% overnight, going from $13.50 to $750 per
pill. What cost $1,350 a bottle now
costs $75,000 per bottle. According to
the IDSA and HIVMA, hospitals and pharmacies were having difficulty acquiring the
pill from wholesalers. The pharmacies
that could obtain Daraprim had to mark up their prices. One Walgreens location was selling it for
$900.06 per pill. A CVS location sold it
for $882.04 per pill. The lowest price
was at a Rite Aid in Engelwood,
New Jersey, retailing for $841.58
per pill.
An overnight 5,556% price increase for
a cheap AIDS drug incurred moral outrage across the nation. It only costs $1.00 per tablet to
produce. The rest would be profit and
recovering capital cost. There is no substitute
for this medication, so the options are Daraprim or death. Since poorer patients would be unable to pay
for the treatment, Medicaid would be expensed which in turn would affect
taxpayers.
Martin Shkreli was very open to
discussing his pricing decision in various interviews. He initially refused to lower the drug
price. Though the pressure from the
media caused him to tentatively reconsider price reduction, but he made no
specifications. The company did downsize
the bottle to a monthly supply of 30 tablets, selling for $22,000 to
$24,000. The only time Shkreli suggested
any price decrease was during an interview with HIV Activist, Josh Robbins, who
requested that Shkreli lower the price by Christmas. Shkreli said he would give a 10% discount and
lower it to $68,000 per bottle ($680/pill).
(Robbins, 38:42). Even Shkreli’s
mental math was miserly. A 10% discount
would be $500 less than that figure.
Daraprim
substitute
Rising from the media’s outrage,
Imprimis Pharmaceuticals teamed up with Express Scripts to make a Daraprim
substitute and sell each bottle of 100 pills for $99. Imprimis plans to compound pyrimethanmine
with leucovorin, a folic acid that cancels some of Daraprim’s side effects and
protects bone marrow. Shkreli bought the
patent for the Daraprim brand, but he does not own the patent for
pyrimethanmine, as Gigi Davidson said.
The solution to the 5,556% price
gouging is not immediate. The Daraprim
alternative is still being developed.
Moreover, there are several obstacles before the better priced drug hits
the market. Any facility providing
compounding ingredients has to be FDA registered and be certified for chemical
purity and potency. New generic drugs
require FDA approval, but according to Express Scripts CEO, Mark L. Baum,
leucovorin would not require FDA approval.
However due to the 2013 Drug Quality and Security Act, FDA regulations
are stricter.
Martin’s Reasons
and Explanations
It’s only fair to show both sides of
this scandal. Instead of saying “no
comment” and ignoring the media, Martin Shkreli let himself be interviewed
through newsgroups and internet personalities.
In the interviews, he explained the reasoning behind his price increase.
Reasons
1.
Profits
go to R&D for developing a better Daraprim.
2.
The
price is appropriate.
3.
Companies
were losing money at the former price.
4.
Daraprim
was in danger of being discontinued.
5.
Maintaining
corporate existence.
6.
Investors’
expectations.
7.
Patients
would still get the drug no matter what.
Interview after interview, Shkreli
emphasized that the profits go into research and development to make a Daraprim
alternative. He said, “I spend all of my
income on research, and they [other pharma CEOs] don’t. They spend their money on salaries. My salary is zero dollars. These guys, they make 10, 20, 30 million
dollars a year. So who’s greedy now?” (Lacy, 1:06).
Shkreli believes Daraprim needs a better
formulation, despite HIV experts saying there is no need for one. According to Shkreli, there are recent
publications indicating that patients have died while taking Daraprim. Two died of autoimmune encephalitis from
toxoplasmosis, and two died from a rare neuromuscular disease, myasthenia
gravis, while taking Daraprim. When asked
on Twitter for a resource, Shkreli did not reply.
Daraprim has been around since 1953 and
the pharmaceutical industry has been content with its performance, however
Shkreli believes 63 years is too long to go without an improvement in the
drug. On MedCity News, Shkreli said that
40% of patients could not finish their Daraprim regimen. (MCN, 23:34).
When the nation hears about “the
AIDS pill” being raised to $750 per tablet, people panic and think that every
HIV positive person is in danger. Not
everyone who is HIV positive is toxoplasmosis-positive, and about 1% has an
active infection of toxoplasmosis. As
Shkreli explained in his interview with Josh Robbins, there is a portion of
AIDS patients with dormant toxo-bugs.
Bradyzoites keep them within the cellular structure, and tachyzoites
cause trouble by releasing them. His
goal was to create a drug that would kill the toxo-bugs in the latent
state. The current Daraprim targets the
folate receptors for the parasite.
Shkreli said the price was
appropriate, and that they were just above breaking even. He said any company would be losing money at
the former price. Daraprim has been sold
a couple of times due to lack of profitability, and it was in danger of being
discontinued. (22:02). If this is true,
Shkreli was preventing that. If
companies can not profit from a drug, they discontinue its production. Then anyone who needs it is deprived. (MCN,
21:40)
Compared to other lifesaving drugs
for rare ailments, $75,000 per bottle is surprisingly tame. The most expensive medicine on a global level
is Glybera, costing $1 million/year for treatment, if not $1.21 million/year depending on your resource. Other expensive drugs include Soliris
($440,000-$500,000), Vimizim ($380,000), Elaprase ($375,000), and Naglazyme ($365,000). The latter treats a pediatric illness, Maroteaux
Lamy Syndome. Martin has stated twice
that he is like one raindrop in a storm. (Robbins, 30:55; MCN, 33:57).
In that storm, companies compete to
remain in the market. Shkreli talked
about maintaining Turing’s corporate existence.
If a company doesn’t generate enough income, then it can not continue to
operate. Moreover, there is pressure
from the investors. He said in a Forbes
interview, “Investors expect us to maximize profits to 100% of the profit
curve, as we learned in our MBA classes.”
What’s more shocking than the price
per pill is that no one is paying that price.
For insured patients, the copay is $10 per prescription, and the highest
is $20. “No patient will pay more than
20 cents per pill.” (MCN, 3:04). Through
Medicaid and other government programs, Daraprim is only $1/bottle. Lastly, for the uninsured, financially needy
patients, they get the medicine for free.
Who is paying $750 per pill
then? The answer is health insurance
companies, employers, and the government.
(Robbins, 24:00, 24:35) More than
half of Turing’s sales since August have been from federal and state
governments. No wonder the government is
mad at Shkreli.
When urged to lower the price,
Shkreli said he felt embarrassed for needing to turn back on his plan (Robbins,
11:30). He expressed what this would
result in by saying, “We might have to curtail research for several lethal
diseases that we are seeking treatments for.
We might have to fire people.” He
relaxed more when talking with Robbins, who coaxed him into a promise in
lowering the price by Christmas.
That was a promise he never had a
chance to keep or betray.
FBI Arrest and
Charges
December 17, 2015: In the hours past midnight, Shkreli was in
the middle of a live streaming session when the FBI called his cellphone.
(1:22:10). He answered it, and the whole
internet could hear, “Hello, this is Special Agent Web-” and Shkreli casually
hung up.
Before dawn, Shkreli was arrested by
the FBI for securities fraud. By 6am,
the FBI escorted him out of the Murray
Hill Tower
apartment complex in midtown Manhattan.
Shkreli's felony charges include, but are not limited to, securities fraud, securities fraud conspiracy, and wire fraud conspiracy – all
relating to his activities in MSMB Capital Management and Retrophin, Inc. The charges were filed by the US Attorney’s
Office for the Eastern District of New York (EDNY) and the Securities Exchange
Commission (SEC). The prosecutors accused
Shkreli of operating a Ponzi-like scheme, even though the term, Ponzi, is no
where in the investigation papers. The
Brooklyn US Attorney, Robert Capers, said Shkreli would start a new company to
pay off the debts of his previous company.
In other words, it’s like taking out a loan to pay off another
loan. If he was using investors’ money
in a new firm to pay off the last company’s investors, then it would be
creating a chain of debt. This has yet
to be determined. It depends which funds
he was using and for what purposes.
According to an EDNY representative,
Shkreli “strongly denies the charges regarding the MSMB entities, which involve
complex accounting matters that the EDNY and SEC fail to understand.” Anything involving “complex accounting” makes authorities suspicious, because
Generally Accepted Accounting Principles (GAAPs) can be violated.
Evan Greebel, Retrophin’s lawyer who
was employed by Katten Muchin Rosenman at the time, was also charged. Greebel was accused of being an accomplice
and not protecting his client, Retrophin.
Both Shkreli and Greebel pleaded Not Guilty to all the allegations. For Shkreli alone, the maximum sentence is 20
years in prison.
The magistrate approved releasing
Shkreli on a $5 million bond. On January
6, Shkreli opened an E-Trade brokerage account, investing $45 million to secure
the bond. Under E-Trade’s terms, he can
not sell or trade his $45 million asset.
This case revealed Martin Shkreli’s
whole career. Under each company, all
activities still under legal scrutiny are listed as alleged activities, because his guilt is not yet officially determined
in court.
History of
Martin Shkreli’s Career
Early
Career
While Martin attended Baruch College,
he started working as a clerk at Cramer, Berkowitz & Company in 2000. He was only 17 years old. His precociousness in predicting stock trends
made him fall under the SEC’s scrutiny for his first time at the age of
19. After the investigation, the SEC
found no fault in Shkreli.
In 2006, Shkreli founded his first
hedge fund company, Elea Capital Management.
It closed in 2007 due to a $2.3 million lawsuit with Lehman
Brothers. Elea
bet a stock would fall when it rose instead, and then did not pay up the money
from the bad gamble. Lehman Brothers
closed before they could collect the settlement.
MSMB
Capital Management
Martin Shkreli and his college friend,
Marek Biestek, used their initials to name their hedge fund business. The purpose of the company was to launch
biotech firms. MSMB solicited $5 million
from investors to found its subsidiary, MSMB Healthcare Management LP. The life of the company lasted between the
years, 2008-2012. Those years were
disquieted by silent scandals scarcely heard in the media.
Silent
Scandals: There were two incidents
where Shkreli urged the FDA not to approve devices specifically manufactured by
companies he was betting against. In
short selling, if a company’s stock rises, then the short-seller loses money.
In 2010, MannKind Corporation was
trying to gain approval for their new inhaled insulin. Shkreli had publicly bet against MannKind,
and if the new product were approved, MSMB would lose money. Shkreli reacted by writing to the FDA not to
approve the inhaled insulin. Reason: The FDA previously had multiple issues with
the drug.
In 2011, Navidea Biopharmaceuticals
was seeking approval for their product, Lymphoseek. Lymphoseek was a new cancer diagnostic tool
that would be less painful to patients.
Shkreli filed a citizens’ petition to the FDA. Reason: Shkreli
said that the clinical trials for evaluating the radioactive agent had flaws in
their design. Both the citizens’
petition and Shkreli’s bet against Navidea were public, resulting in Navidea’s
stock to plummet by almost half.
Inversely, Shkreli profited. It
took until 2013 for Shkreli’s petition to be rejected and Lymphoseek to be
approved. Had Shkreli succeeded,
patients would not have access to this valuable tool that doctors now
appreciate.
In 2012, Shkreli’s last move gained
the attention of the Citizens for Responsibility and Ethics in Washington
(CREW). CREW believed he was spreading
harmful rumors and that he “inserted himself” in the FDA’s approval
process. They requested the SEC and the
Department of Justice to investigate Shkreli for price manipulation of
stocks. Both agencies found nothing
against Shkreli. Shkreli’s response via
email was that the FDA encourages citizens to communicate and that he plans to
continue taking advantage of this interaction when he has legitimate concerns.
Alleged
Activities
Shkreli concealed losses in 2011 by
falsifying documents that his profits were up by 40% since the company’s
establishment. These updates were
forwarded to investors who in turn invested $3 million.
Retrophin,
Inc.
In 2011, Shkreli founded a
biopharmaceutical company, Retrophin, while still managing MSMB. It started as a private firm and went public
in January 2014. The company’s mission
was to acquire and develop drugs for deadly, rare illnesses. He told Bloomberg that, “I want to cure many
diseases and save children’s lives.”
The activities during Shkreli’s
tenure included short selling, price hiking, and being plainly immature. Short selling of stocks was encouraged. The reason was probably because it worked
well before. The notable price increase
was when Retrophin acquired the rights to Thiola, and hiked the price up 20
fold. Thiola treats cystinuria, an
incurable kidney disease.
Shkreli’s employees made gangsta rap
jokes and used their Twitter aliases to promote a “gangsta” image for the
company. In June 2014, the board of
directors told Shkreli to delete the shady tweets on his account.
Throughout 2013, Shkreli harassed an
employee’s family. A manager, Timothy
Pierotti, had bought company shares for his own account and profited $3
million. Shkreli felt that the money
should have gone into Retrophin’s fund.
He terminated Pierotti and sued him for the amount. Both parties dropped the lawsuit a few months
later. Shkreli continued stalking the
Pierotti family until after Christmas.
Retrophin’s board of directors
terminated Shkreli in September 2014, and filed a $65 million lawsuit against
him in August 2015. They accused him of
abusing his power as CEO and using company funds for personal use and to “pay
back angry investors.” The lawsuit
included Shkreli having Retrophin enter consulting agreements that they never
agreed to enter. Shkreli’s legal
representatives requested more time to respond to the suit. Shkreli himself openly responded that the
charges were “preposterous,” and “a sad attempt to avoid paying a very large
severance amount.”
Alleged
Activities
-In 2011, Shkreli falsified profit
reports to mislead investors, resulting in raising $3 million in the course of
a few months.
-In 2013, seven MSMB investors
threatened to sue Shkreli. He and Evan
Greebel misappropriated a total of $11 million to pay back MSMB investors, and
Retrophin was not a responsible party to that debt. Shkreli involved Retrophin in fake consulting
deals and settlement agreements. A
possible motive was that Shkreli and Greebel could pay back the investors
without displeasing the auditor.
Turing
Pharmaceuticals
Shkreli raised $90 million to
establish Turing in 2015, and joining him in this business endeavor was a
number of Retrophin employees. They
currently sell two drugs, Daraprim and Vecamyl.
The latter treats hypertension.
They have 13 other products in their pipeline of development.
Turing’s first action was to acquire
Daraprim, as stated in the company’s prospectus according to a Retrophin
investor. In March 2015, Shkreli
communicated with Impax Pharmaceuticals, and they turned down his first offer
of $30 million. Impax accepted his
second offer of $55 million. Shkreli
said most of that money was his. (Robbins, 13:55).
The conditions of the deal included
Impax withdrawing Daraprim from large wholesalers and pharmacies, preventing
competitors from obtaining samples to make generic versions. In June, Impax tightened its distribution of
the product.
In August, Turing acquired the patent to
Daraprim. A month later, Shkreli gouged
the price up 5,556% overnight. On the
morning of September 15, 2015, everyone woke up to the scandal.
KaloBios
Pharmaceuticals, Inc.
Even after the Daraprim scandal,
Shkreli bought the majority of shares to KaloBios and became their CEO in
November. This San Francisco biotech firm was on the verge
of collapse, and Shkreli was attempting to save the company. Shkreli’s first motion was to acquire the
rights to a brand of benznidazole, which treats Chagas. Chagas is a rare, parasitic, cardiovascular
disease spread by an insect’s fecal matter.
This malady affects people in Latin America. Shkreli also planned to raise the price of
this drug.
After being arrested on December 17,
2015, KaloBios terminated Shkreli, and he resigned as CEO from Turing. Evan Greebel was also Shkreli’s outside
consultant for KaloBios. On December 29,
KaloBios filed Chapter 11. The CFO,
Christopher Thorn, and the company’s accountant resigned.
On the price gouging, I showed both
sides, the public’s reaction to events and Shkreli’s reasons. However, since this case is still underway,
there will be no section for Martin’s side of the story, since he holds the
right not to self incriminate like everyone else. Congress seemed to undermine that right.
Meeting with
Congress – February 4, 2016
The US Congress arranged a televised
meeting to discuss drug pricing with high profile people in the industry. Martin Shkreli had signed an affidavit
affirming his intention to take the Fifth Amendment. The government subpoenaed him to verbalize
the Fifth Amendment in person.
There were about six people sitting at
the long table, but the camera only showed three at most; Mr. Schiller of
Valeant, Nancy Retzlaff of Turing, and Martin Shkreli. The focus was on Shkreli, and no one else’s
testimony was aired. He pleaded the
Fifth Amendment five times.
Despite knowing Shkreli’s plea in
advance, Chairman Chaffetz proceeded to ask him questions. He asked what would he say to a pregnant,
single mother with AIDS and no income who needed Daraprim, and if Shkreli felt
like he did anything wrong. (CNBC, 0:12, 1:14).
Congressman Gowdy (R-SC) repeatedly coaxed Shkreli to waive his Fifth
Amendment Right. Gowdy even asked about
the Wu-Tang Clan album. (3:40). Shkreli
remained adamant in withholding answers to any questions, whether good, bad, or
ridiculous. Shkreli’s legal
representative, Ben Brafman, wanted to make a statement, but Chaffetz
disallowed it because Brafman was not sworn in. (5:00). You can faintly hear Brafman say that they
made illegal arguments. Chaffetz
motioned Brafman to be seated. Then
Elijah Cummings (D-MD) gave a proverbially poetic speech to Shkreli, ending
with, “I truly believe you could become a force of tremendous good.”
(8:38). Shkreli was eventually excused.
(9:13).
Martin’s
Side
A few days before the congressional
meeting, Martin Shkreli was interviewed on Fox News. He expressed how unethical it was for Congress to coerce his attendance. He
was aware that the government was using him to enhance politicians’ reputations
during an election cycle.
After the meeting, Shkreli revealed
in a Live Stream what the media left out.
Congress decided against holding a private meeting in a smaller
room. They insisted on having a large,
publicized meeting. During the
un-televised parts, Congress bombarded Nancy Retzlaff with questions and
repeatedly interrupted her when she tried to answer. There were times that they wouldn’t let
Retzlaff finish her statements.
What Retzlaff couldn’t tell Congress
was posted online the same day. Turing
Pharmaceuticals published a press release explaining Daraprim’s pricing system
and essential facts regarding Daraprim.
This press release confirms everything Shkreli had said in various
interviews. Also, looking at Daraprim’s
side effects, I can see why Shkreli wanted to create an improved version of the
pill. Here is Turing's press release.
My
Take
Shkreli did not want to talk, or even attend, whether the questions
were baiting incrimination or not.
His subpoena implied his presence was
required just to plead the Fifth, not get interrogated or goaded into changing
his mind.
To answer Chaffetz’s first question,
the pregnant, single mother with AIDS and no income would have gotten Daraprim
for free. The congressmen could have
researched and answered their own questions.
Despite their busy schedules, they could have delegated research to
their underlings. Cummings’s floral
poetics and motivational-poster worthy statements were unnecessary; taxpayers’
money also pays for even costlier drugs than Daraprim. If Shkreli made any inaccurate statements,
then the statesmen could have negated them.
Why was Congress asking Martin
Shkreli these questions and not Turing’s current CEO, Ron Tilles? Although Shkreli may own the Daraprim patent,
Tilles is not completely powerless in changing the price. I don’t even know if Tilles was present.
Congress didn’t want Ron
Tilles. They wanted to drag in the “Most
Hated Man in America”
to make themselves look less hate-worthy.
Then the uninformed public thought Shkreli was cold-blooded; the
reaction Congress wanted – shock and hatred.
Question is: What was the government distracting us from?
My Insight: Looking Down at the Chessboard
Shkreli’s price gouging is an
isolated case, hence the ample attention.
If everyone were exposed, the reputation of corporate greed would be
shared. There are hundreds more Martin
Shkrelis out there. As he said, he is
only one raindrop in a rainstorm. One
raindrop can not take the blame for the climate of the pharmaceutical industry.
Let’s widen the myopic lens to the
rest of the industry. Sovaldi, which
treats Hepatitis C, is $1000 per pill, but Dr. John C. Martin, the CEO of
Gilead Sciences, is not a household name.
Maybe there was not an overnight price hike for Sovaldi, but steep
increases are not unheard of. Rodella
Therapeutics acquired Cyclocerine, which treats tuberculosis, and raised the
price from $500 per bottle (30 pills) to $10,800! The headline “Raised the Price for
Tuberculosis Medicine Overnight” does not have the same effect as “Raised the
Price for AIDS Medicine Overnight.”
Unfortunately, TB patients don’t get as much sympathy as AIDS
patients. In a fair world, everyone
would be cared about.
It’s not just small drug companies. On January 1, 2016, Pfizer raised the prices
of 105 products. Pfizer’s company size
gives them the advantage to make smaller incremental price raises that will
yield abundant profits. They made 20%
increases to Dilantin (anticonvulsant), Menest (hormone therapy), Nitrostat
(angina), Tykosyn, (irregular heartbeat), and Tygacil (antibiotic). The more marketed brands that were increased
included Lyrica and Viagra, 9.4% and 12.9% respectively. While a 5% increase for the breast cancer
drug, Ibrance, might not seem extreme, note that a month’s treatment of Ibrance
was $9,850 last year.
In 2014, prices for pharmaceutical
products in general have increased by 10.9%, and brand name drugs had a 15%
price increase, according to the research firm, Truveris.
This industry is the reason why drug ads
pervade television. Companies utilize
the consumer-pull advertising to reach consumers who know nothing about medical
science. “Ask your doctor,” is the key
phrase to increasing demand in a drug so hospitals and healthcare providers
will supply the wanted drug, given that doctors survey the effectiveness. The side effects on some pills are everything
short of an Egyptian curse, and they are still approved by the FDA.
To the pharmaceutical industry,
raising prices unfairly looks like speeding – and speed kills. There are regulations to the traffick, but business people think it’s
a race anyway. In Shkreli’s case, he
wanted his business to advance, so he got in the fast lane and tried to pass
his competitors. Like countless others,
he didn’t think he was going that fast.
It’s like being pulled over by a cop
when everyone is speeding. Perhaps you
were going the fastest, and the cop chose you for that. While the officer is busy writing your
citation, a dozen people fly by going even faster than you were. The cop can only pull over one person at a
time. He/She can not catch them all.
Speculations on
Securities Fraud Case
Guilty: The investigation started long before
September, and it parallels to Retrophin’s lawsuit in August 2015, regarding
using funds to repay investors. Perhaps
the company escalated their case to the FBI.
Furthermore, Shkreli has a history of suspicious activity. Complicated accounting is a red flag.
Not
(Quite) Guilty: The scandal and arrest dates were too close to
be a coincidence. Shkreli received too
much publicity for price hiking, an industry norm. While Shkreli is far from angelhood, he is
not the only shark in the ocean. He has
made some enemies in the past. Perhaps
someone wanted Shkreli to be hated and for his arrest to be known to
everyone. I speculate it was a Retrophin
employee who had access to the prospectus for Turing. If someone had the right connections, he/she
could defame Shkreli on a national level.
Defamation of character is a crime.
So far, that person remains unknown, along with whether or not this has
happened. Machiavelli would smile.
©2016
Caroline Friehs
Originally
posted: March 13, 2016
Last updated upon blog renovation completion.
Last updated upon blog renovation completion.
Photo
Credit
Header
Photo: Originally by Paul
Taggart/Bloomberg
Edited by Caroline Friehs
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(Note:
As of March 2, 2016, Martin Shkreli deleted this video, but I was able to
retrieve the information before deletion.)
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