Nick Henderson was a participant on the 2014 Student Stop AIDS Speaker tour. He is currently a member of the European AIDS Treatment Group and the Youth Stop AIDS Steering Committee.

Martin Shkreli; He’s the former hedge fund manager that the world loves to hate. His company, Turing Pharmaceuticals, bought the rights to a drug called Daraprim, and raised the price from $13.50 per pill to $750 overnight.

It’s an eye watering increase, over 5,000%, and the world was rightly outraged. Although Shkreli has now said he will reduce the cost due to the overwhelming backlash, everything he did was perfectly legal.

While Daraprim (Pyrimethamine) has been available since 1953 and its patent long since expired, the drug has remained the standard treatment option for toxoplasmosis, an Opportunistic Infection mainly affecting immuno-compromised people, particularly those who have developed AIDS.

Daraprim used to cost $1 per pill, but in 2010 GlaxoSmithKline sold the marketing rights to CorePharma, which is how someone like Shkreli came to be in control of the drug this year. The price increase affects the US.  In the UK, Daraprim is available from GSK at a cost of £13 for 30 tablets, while in much of the developing world, Pyrimethamine is available from Indian generic companies at a cost of $0.05-$0.10 each

There are many scandals in this story, and while it’s easy to direct all our anger at one obnoxious individual, we shouldn’t forget what this says about our broken world.


Scandal 1 – Any person living with HIV needs Daraprim

Many of the stories in the media have mentioned that Martin Shkreli hiked up the price of a vital “HIV” drug. Daraprim is not a drug used to treat HIV, it’s a drug used to treat an Opportunistic Infection acquired as a result of a person’s immune system being broken down so far that they have developed AIDS.

The United States is one of the worst countries in the West in tackling the HIV epidemic. People are still asking if they can afford to start treatment, while society continues to criminalise people living with HIV. It’s no surprise that with more than 1.2m people living with HIV in the US, barely 30% are achieving viral suppression, one of the lowest rates in the world.

We already have the medical ability to prevent HIV infection with PrEP, treat HIV infection with single-pill ARV regimens, and stop any further transmission once someone has a fully suppressed viral load. It’s a scandal that today any person should develop AIDS and require Daraprim in the first place.

Scandal 2 – the rights to Daraprim can be bought and sold on a whim

Martin Shkreli bought the drug because he could. Business-wise, it was a great decision. Buy the rights to a cheap but exclusive product that most people haven’t heard of, then charge what you like.Big pharma problem, Bayer Ceo “Because Daraprim is the only game in town, it provides an opportunity for startups like Turing to swoop in, snag exclusive marketing rights, and spike the prices.”

Huffington Post

“Dr. Aberg of Mount Sinai said some hospitals will now find Daraprim too expensive to keep in stock, possibly resulting in treatment delays.”
New York Times

The problem with unrestricted medical capitalism is that, medicines aren’t commercial products, they are lifesaving treatments. In the case of Daraprim, it’s a medicine specifically for people who are already very ill. If it wasn’t for this global backlash, it’s highly likely that Turing Pharmaceuticals would have continued to charge such an insane price. After all, it’s standard industry practice.

Scandal 3 – no one has the power to stop price gouging

There’s an epidemic of price gouging, and it affects the neediest drugs. Cycloserine, which is used to treat multi-drug resistant TB, went from $500 per 30 pill course to $10,800 after its acquisition by Rodelis Therapeutics. Doxycycline, an antibiotic went from $20 a bottle in October 2013 to $1,849 by April 2014.

But one of the greatest price gouging scandals in recent times is Gilead’s price for sofosbuvir. It’s a complete cure for Hepatitis C, and practically side effect free. Gilead charges $1,000 per pill. A course of treatment can be up to 28 weeks, costing nearly $200,000! It is the most expensive drug ever sold. Gilead says they need to recoup their research and development costs, but that is stretching the truth.

A company called Pharmasset had already developed this new Hep C cure, and was testing it in various clinical trials. In 2011,Gilead came along and bought the company for $11bn. In just one year, Gilead made $14bn on sales of sofosbuvir in the US alone. So yes, Gilead did recoup their costs, but like many pharmaceutical companies, their costs are not for labs and scientists, but stocks and shareholders.

Unfortunately, the impending TTIP deal will make this practice even easier, and import problems prevalent in the US to Europe and the UK (upcoming #noTTIP actions here).

Plenary session week 24 2015 - Debate : Negotiations on the Transatlantic Trade Investment Partnership (TTIP)

Negotiations on the Transatlantic Trade Investment Partnership (TTIP), 2015

Scandal 4 – the world relies on for-profit companies for life saving drugs

Our current system to develop new medicines is fundamentally flawed. Medical research is prioritised according to the profit that can be made rather than our health needs. Governments, global institutions and corporations need to ensure access to appropriate and affordable medicine for all who need it, and to prioritise people’s lives over profit. We should be angry at Martin Shkreli, but he is a symptom of an untreated disease.

Youth Stop AIDS has an effective cure. If the UK committed just 0.01% of Gross National Income to a global fund for research on diseases to create patent free drugs, while fighting for access to medicines and human rights for all, we could start to fix our broken system and start to treat the world.

Don’t just be angry, take action with Youth Stop AIDS. Let’s end AIDS, end the broken drug development system, and end the ability of people like Martin Shkreli to hold the most vulnerable to ransom.