Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

Martin Shkreli speaks an inconvenient truth

Dr. Saurabh Jha
Meds
January 6, 2016
Share
Tweet
Share

I don’t subscribe to conspiracy theories. I never believed a second shot was fired. Nor do I believe that Bill Clinton was stalked on the grassy knoll. So I won’t speculate that Martin Shkreli’s arrest for alleged securities fraud that happened years ago is related to his raising Daraprim’s price by 5,500 percent.

Just because something isn’t suspicious doesn’t mean that it isn’t odd.

Shkreli is a perfect poster child for rapacious pharmacocapitalism — so perfect that it’s odd. He openly admits, “I have a sworn duty to my shareholders to maximize profit.” Shkreli’s admission is odd not for its implausibility, but brazen honesty.

Who, in the business of making money, says they’re in the business for profit?

Elizabeth Holmes wants to change the world, including Africa, by biotechnology, and she has recruited Henry Kissinger, known for his contributions to emerging economies and biotechnology, to help. Even Goldman Sachs believe their work leads to greater good. Their CEO once said banking is “doing God’s work.” I developed a Richter’s hernia reading that.

In a land where capitalism is infused with puritanism, Shkreli is odd because he says it as it is. We’re not attuned to such honesty because we want to believe that people want to do the right thing first, that money is incidental. Shkreli says this is not so — if you want new and better drugs for rare diseases, you must please the shareholders by making them money.

Dear Lord, deliver us from the truth.

I haven’t decided what to make of Shkreli, but there is one thing I know. History’s Chaucerian frauds weren’t in your face capitalist pigs. They were pious peddlers of righteousness. They not only feasted on gullibility, but were revered by the insatiably gullible who were gagging to believe in someone. We, too, are gagging to believe, no longer in priests, but in entrepreneurs — our new pardoners.

The robber barons were in it for the money — the railroads were incidental. Health care’s puritans are in it for the progress — the money is incidental. We got railroads. We have yet to see Theranos’s amazing detectors work their magic.

Oddly, Shkreli wasn’t arrested for fleecing immunocompromised patients, but for a Ponzi scheme allegedly set up by his hedge fund. Unlike Enron, which collapsed because it kept digging ponzily, unlike the American Insurance Group, which would have collapsed but for the grace of socialism, Shkreli’s investors actually made money! What an odd Ponzi scheme.

Shkreli is shredding our gullibility. He is saying: Children, this is how capitalism in the U.S. health care works. Did mommy forget to tell you?

He is not fooling us, but reminding us that we’re fools for being so easily fooled by piety such as this:

“My startup will solve diabetes burden, including in the poor.”

“Fantastic. Here’s a check for $400 million.”

We may not be fools, but we live in a kakistocracy. Recently, politicians demanded transparency from Gilead, the manufacturers of Sovaldi. After strutting into Gilead’s office like Spanish Inquisitors, and reading company documents, and interrogating their staff, they concluded that pharma prices drugs to maximize profit.

ROTFLMAO! What a revelation!

Maximizing profits. You really nailed them, Senators.

That high drug prices are irrational is part fallacious and part disingenuous. Yes, they are irrational, but only if we limit the price for extending our lives. What’s irrational is that we believe we’re priceless, but everything else should be cheap.

Another fallacy is that politicians know how to control drug prices. Neither Senator Sanders nor Senator Clinton show any understanding of, and any willingness to accept, the trade-offs of price control. Mercifully, Mr. Sanders has not blamed high drug prices on global warming. As for the Republican front runners — I can only assume drug pricing is still not taught in kindergarten.

Some say Shkreli is a narcissistic sociopath. Be that as it may, it is rather irrelevant. Because when you stop obsessing about Shkreli’s moral compass and follow him, he will show you the worst warts our regulatory system has created. The more we focus on the gamers of the system, the less likely we’ll fix a system that’s so easily gamed.

Pharma is suddenly interested in benznidazole. This drug treats Chagas disease, an infection uncommon in the U.S., but common in Latin America. How did pharma’s compassion for poor Latinos, who suffer the disproportionate burden of Chagas, suddenly arise?

FDA recently gave Chagas a “rare disease” status. If pharma brings a rare disease drug to the market — it matters not that they didn’t develop that drug — they get a voucher for an expedited review for another drug. This “jump the Disneyworld queue” voucher sells for hundreds of millions of dollars in the market. The price should signal something.

The CDC, which buys benznidazole from a Brazilian company, dispenses it free. Yet Shkreli spotted an opportunity, and a need — doctors must fill reams of paperwork because the CDC can’t dispense benznidazole unless for experimental purposes. Hospitals want a distributor.

After the nearly-bankrupt KaloBios Pharmaceuticals, bought rights to one version of benznidazole, under the auspices of a Shkreli-led firm, their shares soared. Because the market, spared of the fog of piety, knew that Shkreli would make money.

KaloBios may raise benznidazole’s price by factor of 100,000. A course of benznidazole is $60 in Latin America. It may cost $100,000 to treat Chagas here. If KaloBios wins FDA’s approval, it will have exclusive rights to sell benznidazole for five years in the U.S. Welcome to the rule of law.

I know you’re seething with pious rage. Before grabbing the pitchforks answer the following:

  1. Why, like the CDC, can’t/ don’t hospitals buy benznidazole directly from that company in Brazil?
  2. Why haven’t insurers pushed for buying drugs directly from foreign manufacturers for infectious diseases?
  3. What will motivate a startup to sell benznidazole in the U.S. at Latin American prices? Please don’t say compassion for poor Latinos. Christmas is no excuse for being that naïve.
  4. Why did no US pharmaceutical company (capitalist or righteous, large or small) bother looking at benznidazole before the FDA declared Chagas a rare disease?
  5. We have an FDA-approved diagnostic kit for Chagas but no FDA-approved drug for Chagas. Why?

When Shkreli says big pharma doesn’t care about rare diseases unless they’re profitable, he speaks an inconvenient truth. The Roche Group, the developers of Avastin, developed benznidazole. But benznidazole wasn’t making money because poor Latinos aren’t a lucrative market. So Roche did what we do with our most useless possessions – donated it to charity. Roche gave supplies and rights to Lafepe, a company owned by the Brazilian state. Roche could have distributed benznidazole in the U.S. — they would barely have noticed a dip in their profits.

It’s more profitable making pills that lower cholesterol, pills that make kids quieter, pills that remind old men transiently of their youth, than pills that cure multiple sclerosis. This strikes me as a decidedly upside down world. But, then again, piety never really helped the most vulnerable.

Shkreli is boldly articulating to you what classy CEOs of big pharma won’t dare admit to themselves, even in their sleep. Ladies and gentlemen, this is how it works. To draw hyenas, you throw leftover food. To draw pharma, you show dollars.

Enjoy the schadenfreude over his arrest. Remember, though, our regulatory warts won’t magically disappear, even if Martin Shkreli is convicted.

Saurabh Jha is a radiologist and can be reached on Twitter @RogueRad.  This article originally appeared in the Health Care Blog.

Prev

These are the moments why we practice medicine

January 6, 2016 Kevin 2
…
Next

This is why patients cannot be customers

January 7, 2016 Kevin 59
…

Tagged as: Medications

< Previous Post
These are the moments why we practice medicine
Next Post >
This is why patients cannot be customers

ADVERTISEMENT

More by Dr. Saurabh Jha

  • Masks are an effigy of American technocratic incompetence

    Dr. Saurabh Jha
  • False negative: COVID-19 testing’s catch-22

    Dr. Saurabh Jha
  • Why the Lancet’s editorial on Kashmir is unhelpful

    Dr. Saurabh Jha

Related Posts

  • The truth about Caribbean medical schools

    Jessica K. Willett, MD
  • Addressing the “ugly truth” about Caribbean medical schools: Why they’re not all the same

    Stacy Meyer
  • 3 ways health plans can help providers

    Martin Lustick, MD
  • The claims data dilemma: 4 things to consider

    Martin Lustick, MD
  • The life cycle of medication consumption

    Fery Pashang, PharmD
  • The abundant and colorful world of pharmaceuticals

    Fery Pashang, PharmD

More in Meds

  • Huntington’s disease gene therapy: FDA reversal delays AMT-130

    Meghan Johnston, MPH
  • The truth about psychiatric supplements and mental health

    Muhamad Aly Rifai, MD
  • Ketamine therapy for chronic pain and substance misuse

    Olumuyiwa Bamgbade, MD
  • Kratom vs. 7-OH: Understanding the potency gap and risks

    Emma Fenske and Bradley M. Buchheit
  • Why the FDA regulations on peptide therapy matter

    Vikas Patel, MD
  • GLP-1 weight regain: Why stopping medication leads to weight return

    Jessica Duncan, MD
  • Most Popular

  • Past Week

    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • Evidence-based medicine vs. clinical judgment: a medical student’s perspective

      Jay Pendyala | Education
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • When side effects are actually a cry for help with medication costs

      Shuchita Gupta, MD | Physician
    • The hidden math behind physician hiring costs and recruitment

      Timothy Lesaca, MD | Physician
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
  • Recent Posts

    • Why measuring muscle mass matters more than tracking your weight [PODCAST]

      The Podcast by KevinMD | Podcast
    • Health insurance incentives and alternatives to opioids for chronic pain

      Molly Candon, PhD and Daniel Clauw, MD | Conditions
    • Independent medical practice: Why private clinics are essential

      Marcelo Hochman, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • Do no harm: Why physician burnout requires bottom-up reform

      Desiree Francis, MD | Physician
    • Institutional distrust in health care: Why a doctor lost faith

      Joshua Mirrer, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 7 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • Evidence-based medicine vs. clinical judgment: a medical student’s perspective

      Jay Pendyala | Education
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • When side effects are actually a cry for help with medication costs

      Shuchita Gupta, MD | Physician
    • The hidden math behind physician hiring costs and recruitment

      Timothy Lesaca, MD | Physician
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
  • Recent Posts

    • Why measuring muscle mass matters more than tracking your weight [PODCAST]

      The Podcast by KevinMD | Podcast
    • Health insurance incentives and alternatives to opioids for chronic pain

      Molly Candon, PhD and Daniel Clauw, MD | Conditions
    • Independent medical practice: Why private clinics are essential

      Marcelo Hochman, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • Do no harm: Why physician burnout requires bottom-up reform

      Desiree Francis, MD | Physician
    • Institutional distrust in health care: Why a doctor lost faith

      Joshua Mirrer, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Martin Shkreli speaks an inconvenient truth
7 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...