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Martin Shkreli was a businessman in the pharmaceutical industry who became famous several years ago when his company increased some drug prices by a huge factor.

I recently watched this video of him in court; to my surprise, I saw multiple people defending Shkreli in the comments. Many claimed that individuals almost never had to pay the large prices for the medication; it was the insurance companies. If a person without insurance contacted Shkreli, then he would give them the medication for free.

I don't buy this, but I was wondering if there was any truth to it.

Brythan
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Ovi
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    A few comments on YouTube are about as far from a 'notable' claim as you can get. Can you find any other source making this claim? Are pharmaceutical companies even allowed to just directly give patients medication? – Giter Jul 19 '18 at 10:30
  • Shkreli livestreams a lot on this topic: https://www.youtube.com/watch?v=HXVQOZDKlRE – Script Kitty Jul 21 '18 at 20:38

2 Answers2

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Yes, with a number of caveats.

Shkreli's company, Turing Pharmaceuticals, promised to give free access to Daraprim to some patients in need after the initial price-hike controversy arose.

Here is a timeline:

  • February 2015: Martin Shkreli founded Turing Pharmaceuticals.

  • September 2015: Turing Pharmaceutical raised the price of Daraprim from $13.50 to $750 per tablet, causing a controversy.

  • November 24, 2015: Turing Pharmaceuticals announced price cuts for Daraprim for some purchasers, under some conditions. This included these statements:

    Sample starter packages at zero cost to ensure physicians treating patients in the community have free and immediate access to start therapy in emergency situations. We plan to make these available in early 2016.

    [...]

    Provide Daraprim free-of-charge to uninsured, qualified patients with demonstrated income at or below 500% of the federal poverty level through our Patient Assistance Program.

    I don't have evidence whether they carried out these promises.

    (The 500% threshold struck me as surprisingly high, but that might just reflect my ignorance. Here are the federal poverty level base lines.)

  • December 17, 2015: Shkreli resigned as CEO, after being arrested on unrelated charges.

  • February 4, 2016: Shkreli appeared before the Full House Committee on Oversight and Government Reform, as shown in the YouTube video.

  • September 1, 2017: Turing Pharmaceuticals started trading in the US as Vyera Pharmaceuticals.

Oddthinking
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    “I don't have evidence whether they carried out these promises.” — And yet your answer starts by saying “Yes”. I’d suggest that “probably not” is more accurate given the evidence we have (and, given what we know about Shkreli from his public appearances, “hell no” would be even more accurate). – Konrad Rudolph Jul 19 '18 at 13:29
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    @KonradRudolph The question has two aspects: 1. did he offer? (Odd: yes!) and 2. "If a person without insurance contacted Shkreli, then he would give them the medication for free." I read 2 as promise actually delivered. And I do not believe that either. – LangLаngС Jul 19 '18 at 13:41
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    @LangLangC This comes back to whether “to offer” means “make an honest offer” or “dishonestly promise without any intent to honour that promise”. For me it *clearly* means the first one. The second one isn’t an offer, it’s a pretence of an offer. In that sense, Shkreli (probably) never actually offered the medication for free. – Konrad Rudolph Jul 19 '18 at 13:54
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    @KonradRudolph: I want to clarify (because you seem to be basing your priors on your estimation of the man, while I am basing mine on what I think a pharmaceutical company can get away with): I think the YouTube comments referring to Shkreli being contacted are really referring to the company. I'm not saying ringing Shkreli's personal mobile would have got you free medication, but applying to a program ([that still exists](https://www.vyera.com/products/patient-access/)) should have. I am trying to out how - if the program did work - how one might find evidence of that. – Oddthinking Jul 19 '18 at 14:25
  • @KonradRudolph Leaving aside the ambiguity about precisely what the question is asking and going with your reading for the sake of argument, what evidence do you have that the promise was *"probably not"* followed up on? Neither of the answers currently given here offers any evidence either way; if you know of some, I'd say it warrants its own answer. – Mark Amery Jul 19 '18 at 14:42
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    @MarkAmery: I understand that Konrad is asking me to support the burden of proof of my "Yes" answer. I concede the burden is currently on me. I thought I had done enough, but Konrad is demanding higher because (as I understand him), I found the press release from a pharmaceutical company sufficient evidence that the program exists and works as advertised, but Konrad believes Shkreli is likely to make false promises. – Oddthinking Jul 19 '18 at 15:14
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    Although, in my own defence, I did say it was subject to caveats, emphasised the word "promised" and identified where my evidence was limited, so I don't think this answer oversteps the evidence. – Oddthinking Jul 19 '18 at 15:15
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    @KonradRudolph: And given that the (multiple-count) conviction of Shkreli was essentially due to him lying over and over in fairly related matters (promised other stuff he knew he would not deliver)... his credibility in terms of delivering on improbable promises is pretty damn low. https://www.theguardian.com/us-news/2018/mar/09/martin-shkreli-sentence-jail-arrogance-sentencing-fraud – Fizz Jul 19 '18 at 17:48
  • The article in the Guardian on S is embarrassingly bad. Slightly better analysis https://www.sfgate.com/business/article/Shkreli-vs-Holmes-2-frauds-2-divergent-12777534.php "Matsumoto said it didn’t matter that Shkreli later repaid the investors he defrauded, or that some of his investors made millions. Still, the magnitude of the fraud was just over $10 million." Now you know why he needed lotsa cash quick... to pay off those he had defrauded. As in 2nd time (actually was more like 4th) he found a scheme that was apparently only morally repugnant, but perhaps legal. – Fizz Jul 19 '18 at 18:01
  • Whether or not it's the person, the company seems to really still offer [this](https://www.daraprimdirect.com) and they seem to [hire](https://vyera.applicantstack.com/x/detail/a2wu5690gjhs) people for doing/enabling/managing that? Alas I did not find any first hand experience account for that procedure. – LangLаngС Jul 19 '18 at 18:06
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    It would be interesting to know what "qualified" patients are. Their website also restricts free meds to uninsured people who meet "eligibility criteria" and says that the financial assistance program is "subject to terms and conditions and patient eligibility requirements" (but doesn't link to either); it also seems that people on medicare will not get any free meds. Given all this and the fact that this was only offered after the scandal, I wouldn't summarize it with a "yes"; there are just too many caveats and unknowns (the second paragraph of the answer summarizes the issue well though). – tim Jul 19 '18 at 18:27
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    Regarding the 500% poverty level: A minimum [6 week treatment](https://www.medicines.org.uk/emc/product/938/smpc) of Daraprim is between 40-120 tablets, or $30-90k after the price hike. Saying people who earn less than $60k/year don't have to pay is probably because they couldn't. – TemporalWolf Jul 19 '18 at 19:40
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    @TemporalWolf: Understood. As an Australian, I cannot pretend to understand the US healthcare industry. In Australia, 5x the poverty line would put you well up in the top 10% of income earners. My first reaction to the US figures was to naively like to think such people could afford health insurance (even if they couldn't afford the pills). I acknowledge in the answer this is ignorance about the US situation. [Again, in Australia, pyrimethamine is listed on the Pharmaceutical Benefits Scheme; a course of 50 tablets of Daraprim would cost an uninsured Australian patient <$AU25.] – Oddthinking Jul 20 '18 at 04:24
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    $60k/yr would be a single person household, for a family of four that 5x target would be $125k. It's not that unreasonable of a limit, just doesn't come close to offsetting the price hike. According to google, that represents the [82% mark](https://dqydj.com/household-income-percentile-calculator-2016/) – TemporalWolf Jul 20 '18 at 17:11
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    @KonradRudolph: _"given what we know about Shkreli from his public appearances, 'hell no' would be even more accurate"_ I'm sure I don't need to send _you_ to that fallacy-listing website – Lightness Races in Orbit Jul 21 '18 at 02:00
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    You should also acknowledge that having a Patient Assistance Program like this is pretty standard for companies selling expensive drugs in the USA. It's not remarkable that Turing Pharma promised to set one up - it's remarkable that they ***didn't*** plan to have one initially, until the surge of bad publicity following the price hike. – user56reinstatemonica8 Jul 21 '18 at 12:05
  • @LightnessRacesinOrbit Or you could just tell me which logical fallacy you think I’m committing here, and then I’ll explain to you why this isn’t the case. – Konrad Rudolph Jul 21 '18 at 14:12
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    @KonradRudolph: ad hominem, false cause, black-or-white, anecdotal, take your pick. What you think you "know" about Shkreli from his public appearances cannot be used to answer this specific, particular question (whether "they carried out these promises"). At all. – Lightness Races in Orbit Jul 21 '18 at 15:10
  • @LightnessRacesinOrbit Oh dear. Apologies, there isn’t enough space to explain *everything* that’s wrong here (cf. “Gish gallop”). Just to tackle the first one: “ad hominem” refers to name calling and irrelevant besmirching of one’s opponent in a debate, not to factual, relevant observations (whether accurate or not) about a person you’re not debating. I’m not debating Shkreli so even if everything I accused him of were inaccurate it wouldn’t be an *ad hominem* fallacy. As it stands, the fact that he’s known to be a pathological liar is both highly relevant and established in a court of law. – Konrad Rudolph Jul 21 '18 at 16:30
  • @KonradRudolph: Ad hominem has nothing to do with "name calling"; that is, itself, a total myth. Anyway, this conversation is not constructive but I stand by what I said. You cannot prove a claim about a particular event by saying "this guy did something or other else in some other public appearance at some other time", and I'm pretty sure you know that already. Have a good day. – Lightness Races in Orbit Jul 21 '18 at 19:11
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The closest I could find was this (see also here):

He also promised: "If you cannot afford the drug we will give it away for free."

This was after the backlash because of the severe price inflation. I found no evidence that he personally or the company ever actually followed up on that (I doubt it though).

tim
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    Enh. It’s actually pretty common for pharmaceutical companies to have a list price they charge to the insurance companies and large hospital networks, while offering huge discounts to indigent individuals and smaller institutions. So it’s at least plausible that this guy followed what is a fairly standard industry practice. – HopelessN00b Jul 20 '18 at 02:27
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    @HopelessN00b But there is a huge difference between discounted and free. With the former, the company makes money because they reach people they otherwise wouldn't. With the latter, they make nothing. And even say a 90% discount would still result in costs of 3k - 9k for treatment after the price hike (using the figures from TemporalWolf comment in the other answer). Compared to the ~20-50 bucks anywhere else in the world or the ~80 bucks in the US before the price hike, that is still a pretty significant sum, especially for people who aren't wealthy. – tim Jul 20 '18 at 07:23
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    @HopelessN00b this might be common in the us. never heard of it in europe. – Mafii Jul 20 '18 at 11:26
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    @Mafii The US healthcare system runs on a very different model from that in most European countries, for a variety of reasons. – JAB Jul 21 '18 at 01:34