0
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1
00:00:13,472 --> 00:00:16,308
We're just a regular, you know, middle class couple.

2
00:00:16,308 --> 00:00:19,770
We both had good jobs,
we both were making decent money.

3
00:00:19,770 --> 00:00:23,148
Um, we had two cars,
we had a nice house.

4
00:00:23,148 --> 00:00:27,277
And then all of a sudden,
I find out that I had this disease...

5
00:00:27,277 --> 00:00:31,240
and it's like that life is over,
it's like all of a sudden a book got slammed shut.

6
00:00:33,450 --> 00:00:36,787
I had neoadjuvant chemo.

7
00:00:36,787 --> 00:00:42,542
I had a single right side mastectomy
and then 37 rounds of radiation,

8
00:00:42,542 --> 00:00:46,421
after which I was placed on a drug
called Tamoxifen,

9
00:00:46,421 --> 00:00:51,093
which is a maintenance drug,
and, uh, certain other drugs.

10
00:00:51,093 --> 00:00:54,179
Cystic fibrosis is a genetic illness,

11
00:00:54,179 --> 00:00:58,558
and, um, it is a terminal disease.

12
00:00:58,558 --> 00:01:02,562
I worry about him feeling terrible,

13
00:01:02,562 --> 00:01:06,358
as if it's his fault that his family
might have to go through,

14
00:01:06,358 --> 00:01:09,569
you know, some financial trauma or financial strain.

15
00:01:09,569 --> 00:01:11,738
At three years old, my son looked at me and said,

16
00:01:11,738 --> 00:01:13,073
"Mommy, am I expensive?"

17
00:01:14,741 --> 00:01:16,535
"Mommy, am I expensive?"

18
00:01:16,535 --> 00:01:20,664
He was looking for a reason
to blame himself at three.

19
00:01:25,127 --> 00:01:28,714
I'm a HER2-positive breast cancer patient.

20
00:01:28,714 --> 00:01:31,925
I was very lucky they have a great drug.

21
00:01:31,925 --> 00:01:33,552
It's a targeted therapy.

22
00:01:33,552 --> 00:01:36,388
And then of course the first bills appear,

23
00:01:36,388 --> 00:01:42,561
and then we started to calculate
how long our saving would last.

24
00:01:44,354 --> 00:01:49,443
I tell my children all the time
that they better start saving money

25
00:01:49,443 --> 00:01:52,487
because sooner or later,
you're gonna come to a point in your life

26
00:01:52,487 --> 00:01:56,825
where your health needs a prescription drug,

27
00:01:56,825 --> 00:02:04,541
and God forbid, because you will lose
the things that you hold most dear.

28
00:02:11,506 --> 00:02:13,216
C.S. Lewis says,

29
00:02:13,216 --> 00:02:20,474
"Education without values
seems rather to make man a more clever devil."

30
00:02:20,474 --> 00:02:23,310
Can the same be said for modern medicine?

31
00:02:25,562 --> 00:02:28,982
By the time you finish watching this film,

32
00:02:28,982 --> 00:02:33,487
at least seven Americans will have died,

33
00:02:33,487 --> 00:02:38,575
not because of bad luck
or genetics or tragedy,

34
00:02:38,575 --> 00:02:43,538
but because they couldn't pay
what the market will bear.

35
00:02:43,538 --> 00:02:49,836
If we're asking how much it costs
to keep someone alive,

36
00:02:49,836 --> 00:02:53,924
maybe we are asking the wrong question.

37
00:02:55,217 --> 00:02:57,969
An investigation into the cost of prescription drugs

38
00:02:57,969 --> 00:03:00,889
reveals huge price hikes over the past five years.

39
00:03:00,889 --> 00:03:02,766
Several brand name medications
more than doubled...

40
00:03:02,766 --> 00:03:06,186
Now, let's turn to the rising price
of prescription drugs

41
00:03:06,186 --> 00:03:08,105
and outcries to do something about it.

42
00:03:08,105 --> 00:03:12,109
U.S. medical community is outraged
after a life-saving drug

43
00:03:12,109 --> 00:03:15,153
saw a more than 5000% price hike.

44
00:03:15,153 --> 00:03:19,074
Who raised prices by how much,
and who are the biggest offenders?

45
00:03:19,074 --> 00:03:21,201
-Everyone.
-Why is this happening?

46
00:03:21,201 --> 00:03:25,080
Well, the simple truth is
they can do anything they want

47
00:03:25,080 --> 00:03:27,582
at any time they want to do it.

48
00:03:27,582 --> 00:03:32,838
Let's not forget the drug industry
is the most profitable industry in America.

49
00:03:32,838 --> 00:03:34,548
No other industry is even close.

50
00:03:34,548 --> 00:03:36,049
Shouldn't be surprised.

51
00:03:36,049 --> 00:03:39,177
'Cause it's impossible to escape
pharmaceutical ads.

52
00:03:39,177 --> 00:03:42,973
Everything we were to do
was about making Wall Street happy.

53
00:03:42,973 --> 00:03:45,350
All the way over.

54
00:03:45,350 --> 00:03:49,229
Seventy percent of Americans
take at least one prescription drug.

55
00:03:49,229 --> 00:03:50,689
Thousand dollars a pill.

56
00:03:50,689 --> 00:03:53,108
Twenty thousand dollars
every three weeks.

57
00:03:53,108 --> 00:03:56,236
Seven hundred and fifty thousand dollars a year.

58
00:03:56,236 --> 00:03:58,155
They really are a gatekeeper.

59
00:03:58,155 --> 00:04:01,032
They determine, in many cases,
who lives and who dies.

60
00:04:04,744 --> 00:04:07,414
Call your doctor right away
if you experience fever,

61
00:04:07,414 --> 00:04:11,209
tiredness, body aches, chills,
nausea, vomiting,

62
00:04:11,209 --> 00:04:13,670
seizures, loss of vision, or weakness.

63
00:04:20,594 --> 00:04:24,306
The livelihoods of Americans
are being held captive

64
00:04:24,306 --> 00:04:26,892
by rising drug prices,

65
00:04:26,892 --> 00:04:29,478
and there's no discernible ceiling.

66
00:04:29,478 --> 00:04:33,064
A lot of Americans are being hit
by soaring prescription drug prices.

67
00:04:33,064 --> 00:04:37,152
Americans spent
an estimated $450 billion with a B

68
00:04:37,152 --> 00:04:39,488
on prescription drugs in 2016.

69
00:04:39,488 --> 00:04:42,491
Imagine knowing your child
has a rare disease

70
00:04:42,491 --> 00:04:45,702
that will slowly destroy
all the muscles in their body.

71
00:04:45,702 --> 00:04:47,787
Now imagine there's a new treatment for it,

72
00:04:47,787 --> 00:04:52,209
but it is so expensive
you would never be able to afford it.

73
00:04:52,209 --> 00:04:57,839
There's a fundamental problem
when the price tag of contracting a disease

74
00:04:57,839 --> 00:05:01,468
is more dreadful than the disease itself.

75
00:05:01,468 --> 00:05:04,513
In February, Valeant Pharmaceuticals
raised prices

76
00:05:04,513 --> 00:05:08,767
for two newly purchased hard drugs,
Isuprel and Nitropress,

77
00:05:08,767 --> 00:05:12,103
212% and 525%.

78
00:05:12,103 --> 00:05:14,648
Spinraza got FDA approval last December

79
00:05:14,648 --> 00:05:19,611
and a price tag: $125,000 per dose.

80
00:05:19,611 --> 00:05:24,199
Many cases, the costs add up
to a million dollars a year for a lifetime.

81
00:05:24,199 --> 00:05:28,286
These drugs are priced at incredibly high levels, right,

82
00:05:28,286 --> 00:05:30,831
which are unaffordable
to not only people in this country,

83
00:05:30,831 --> 00:05:32,749
but people around the world.

84
00:05:32,749 --> 00:05:35,335
They know that the prices they charge
for a lot of drugs

85
00:05:35,335 --> 00:05:37,504
exclude people from having access
to those drugs.

86
00:05:37,504 --> 00:05:39,548
It's not like they don't understand that, they do.

87
00:05:39,548 --> 00:05:42,342
Insulin is a life or death medication.

88
00:05:42,342 --> 00:05:46,221
Those high prices combined
with rising insurance deductibles

89
00:05:46,221 --> 00:05:49,891
mean many people who rely on insulin
are feeling sticker shock.

90
00:05:50,767 --> 00:05:56,648
Assuming we are able to take the humanity
and emotion out of the equation,

91
00:05:56,648 --> 00:06:01,069
we're still left with the question
of economic sustainability.

92
00:06:01,069 --> 00:06:05,240
Well, all you have to do is project the trends
which are already off the charts.

93
00:06:05,240 --> 00:06:08,368
You'd have to tape another piece of paper
to the top of the chart

94
00:06:08,368 --> 00:06:10,370
and watch them go up some more.

95
00:06:10,370 --> 00:06:14,457
It is ludicrous to think that
the U.S. and healthcare in general

96
00:06:14,457 --> 00:06:19,546
can go on spending about 18%
of our gross domestic product

97
00:06:19,546 --> 00:06:21,381
on health in general.

98
00:06:23,049 --> 00:06:28,555
The percentages of our gross domestic product
are swelling at an alarming rate.

99
00:06:29,764 --> 00:06:34,477
If this trend continues,
a crash is inevitable.

100
00:06:36,062 --> 00:06:39,232
If the price of milk or bread
or any other staple

101
00:06:39,232 --> 00:06:43,570
went up at the same rate
that drug prices are going up,

102
00:06:43,570 --> 00:06:45,864
people would be rioting in the streets.

103
00:06:45,864 --> 00:06:51,745
Uh, Mr. President, I rise to discuss
one of the major crises

104
00:06:51,745 --> 00:06:55,040
facing our healthcare system today,

105
00:06:55,040 --> 00:07:00,253
and that is that the pharmaceutical industry itself

106
00:07:00,253 --> 00:07:05,216
has become a major health hazard
to the American people.

107
00:07:06,384 --> 00:07:08,178
Prices are going up outrageously.

108
00:07:08,178 --> 00:07:09,596
No justification.

109
00:07:09,596 --> 00:07:11,890
So you can walk into a drugstore tomorrow

110
00:07:11,890 --> 00:07:13,433
and find that the price that you're paying

111
00:07:13,433 --> 00:07:16,686
for the same medicine you've had for 20 years
has been doubled.

112
00:07:16,686 --> 00:07:18,480
And you ask the pharmacist why.

113
00:07:18,480 --> 00:07:21,149
There's no reason, they can double it
based on market needs.

114
00:07:21,149 --> 00:07:26,738
So what you have is an incredibly powerful industry
charging any price they want

115
00:07:26,738 --> 00:07:29,532
and the result of that is that one out of five Americans

116
00:07:29,532 --> 00:07:32,410
can't afford the medicine that they need.

117
00:07:32,410 --> 00:07:33,745
Can you imagine that?

118
00:07:33,745 --> 00:07:36,581
So they go to the doctor,
doctor writes a prescription,

119
00:07:36,581 --> 00:07:38,458
but they can't afford to fill it.

120
00:07:38,458 --> 00:07:41,378
But five major companies made
$50 billion in profits last year.

121
00:07:41,378 --> 00:07:43,672
Listen, you have an insane situation

122
00:07:43,672 --> 00:07:48,301
in which people are dying
because they can't afford the medicine they need,

123
00:07:48,301 --> 00:07:49,844
or getting much sicker than they should

124
00:07:49,844 --> 00:07:52,055
just so these companies
can make outrageous profits.

125
00:08:06,528 --> 00:08:08,196
Yeah, you better give yourself a shot.

126
00:08:41,271 --> 00:08:45,483
In 2007, Mylan Pharmaceuticals
acquired EpiPen,

127
00:08:45,483 --> 00:08:49,362
a device used for injecting measured doses
of epinephrine.

128
00:08:49,362 --> 00:08:53,992
The call's growing louder for drug makers
to lower the price of the EpiPen.

129
00:08:53,992 --> 00:08:57,704
Since the acquisition,
prices have risen continuously.

130
00:08:57,704 --> 00:09:00,457
Pharmaceutical giant Mylan
was at the center of criticism last year

131
00:09:00,457 --> 00:09:01,875
over rising drug prices.

132
00:09:01,875 --> 00:09:04,461
Pressure mounting on EpiPen maker
Mylan Pharmaceutical.

133
00:09:04,461 --> 00:09:07,464
A trio of senators now calling for an explanation.

134
00:09:07,464 --> 00:09:12,969
The auto-injector's price has risen
by more than 480% since 2009.

135
00:09:15,096 --> 00:09:18,266
My daughter Kennedy was diagnosed
with food allergies

136
00:09:18,266 --> 00:09:20,226
when she was about 13 months old.

137
00:09:20,226 --> 00:09:22,729
Kennedy also has asthma,

138
00:09:22,729 --> 00:09:24,898
she has reflux,

139
00:09:24,898 --> 00:09:27,484
and she has eosinophilic esophagitis.

140
00:09:27,484 --> 00:09:30,862
So for Kennedy,
she does have a medication regimen

141
00:09:30,862 --> 00:09:32,530
that she has to take every day.

142
00:09:32,530 --> 00:09:35,492
She has to take maintenance meds
for her asthma.

143
00:09:35,492 --> 00:09:41,372
She also has to take a maintenance
swallow medication for her EoE.

144
00:09:41,372 --> 00:09:44,125
And then she carries around her EpiPen.

145
00:09:44,125 --> 00:09:49,923
And Shane has a life-threatening allergy
to blueberries.

146
00:09:49,923 --> 00:09:52,926
He also has mild asthma.

147
00:09:52,926 --> 00:09:57,096
But Shane also has what they call
idiopathic anaphylaxis,

148
00:09:57,096 --> 00:09:59,474
whereas just out of the blue,

149
00:09:59,474 --> 00:10:02,060
there are times that things that we don't know yet

150
00:10:02,060 --> 00:10:04,938
could actually cause him to go into
an anaphylactic reaction.

151
00:10:04,938 --> 00:10:06,606
We are here with the CEO that is no doubt

152
00:10:06,606 --> 00:10:09,567
the center of a national firestorm--
I think that's fair to say.

153
00:10:09,567 --> 00:10:12,028
Heather Bresch, CEO of Mylan Labs.

154
00:10:12,028 --> 00:10:15,573
The price hike has been labeled "outrageous"
by Hillary Clinton,

155
00:10:15,573 --> 00:10:17,450
"egregious" by Bernie Sanders,

156
00:10:17,450 --> 00:10:20,161
"greedy" by the White House,

157
00:10:20,161 --> 00:10:22,080
and parents all over the country are outraged

158
00:10:22,080 --> 00:10:23,748
that they've got to pay more for their EpiPen.

159
00:10:23,748 --> 00:10:24,833
How do you respond to all that?

160
00:10:24,833 --> 00:10:29,462
As a mother, I can assure you
the last thing that we would ever want

161
00:10:29,462 --> 00:10:31,464
is no one to have their EpiPen
due to price.

162
00:10:31,464 --> 00:10:35,969
The cost is more prohibitive than people realize.

163
00:10:35,969 --> 00:10:40,890
Two kids, $600 for one set,
and I need multiple sets.

164
00:10:40,890 --> 00:10:44,853
The school that they go to,
they have to have a set for themselves,

165
00:10:44,853 --> 00:10:46,771
a set for the nurse,

166
00:10:46,771 --> 00:10:50,149
and a set for the trainer
if they go out for any sports,

167
00:10:50,149 --> 00:10:52,610
and we also have to have a set for our house.

168
00:10:52,610 --> 00:10:54,863
So the cost is insane.

169
00:10:54,863 --> 00:10:57,323
The American Medical Association has said

170
00:10:57,323 --> 00:11:00,827
this is basically the same product it was in 2009,

171
00:11:00,827 --> 00:11:03,955
and yet have raised the price 17 times.

172
00:11:03,955 --> 00:11:05,748
If you follow the money,

173
00:11:05,748 --> 00:11:09,294
the reason for these price hikes
comes into sharp focus.

174
00:11:09,294 --> 00:11:11,296
What was your salary last year?

175
00:11:11,296 --> 00:11:13,965
-About $18 million.
-About $18 million...

176
00:11:13,965 --> 00:11:16,885
Sounds like you're doing pretty well on this.

177
00:11:16,885 --> 00:11:20,179
When Mylan acquired EpiPen in 2007,

178
00:11:20,179 --> 00:11:24,100
Heather Bresch's salary
was $2.4 million.

179
00:11:24,100 --> 00:11:27,353
As the price of EpiPen swelled,
so did her salary,

180
00:11:27,353 --> 00:11:30,398
all the way to $18.9 million.

181
00:11:30,398 --> 00:11:32,650
Heather, you understand the headlines, right,

182
00:11:32,650 --> 00:11:36,946
which is EpiPens,
which are needed by millions of children,

183
00:11:36,946 --> 00:11:41,618
the price goes from 50 bucks ten years ago
to 500 or 600 today,

184
00:11:41,618 --> 00:11:43,703
and you're making $18 million a year.

185
00:11:43,703 --> 00:11:46,247
You understand how that looks?

186
00:11:46,247 --> 00:11:49,417
Brian, look, I understand better than anyone

187
00:11:49,417 --> 00:11:52,378
that facts are inconvenient to headlines.

188
00:11:52,378 --> 00:11:55,423
We have given out 700,000 free EpiPens.

189
00:11:55,423 --> 00:12:00,136
We stock 65,000 public schools
in this country with free EpiPens

190
00:12:00,136 --> 00:12:02,430
to ensure that they're there when needed.

191
00:12:02,430 --> 00:12:06,559
Heather Bresch has been vocal
about Mylan's free and discounted EpiPens,

192
00:12:06,559 --> 00:12:11,105
but those who are listening closely
can hear the canary in the coalmine.

193
00:12:11,105 --> 00:12:13,232
So I'm holding here a certification form

194
00:12:13,232 --> 00:12:15,944
where EpiPen, where Mylan has actually said

195
00:12:15,944 --> 00:12:20,406
that the school will hereby certify
that it will not, in the next 12 months,

196
00:12:20,406 --> 00:12:24,202
purchase any products that are competitive
to EpiPen Auto-Injectors.

197
00:12:24,202 --> 00:12:28,998
So you actually put into practice
forcing schools--

198
00:12:28,998 --> 00:12:30,917
and you're so concerned about these kids,

199
00:12:30,917 --> 00:12:32,585
you've raised the price to $600,

200
00:12:32,585 --> 00:12:35,171
if you want it for the hundred buck price
that it used to be at,

201
00:12:35,171 --> 00:12:39,092
you need to sign this and say that
you can't buy this from anybody else.

202
00:12:39,092 --> 00:12:40,927
Don't answer, I'm not asking you a question.

203
00:12:40,927 --> 00:12:42,261
That's what you've done here.

204
00:12:43,972 --> 00:12:45,974
Sometimes I do feel like a burden.

205
00:12:45,974 --> 00:12:49,102
I sometimes think that maybe if I didn't have this allergy

206
00:12:49,102 --> 00:12:52,313
or maybe if I wasn't, per se, here

207
00:12:52,313 --> 00:12:54,607
then maybe my mother would have
a little less stress.

208
00:12:54,607 --> 00:12:56,818
Uh, she wouldn't have to carry the burden

209
00:12:56,818 --> 00:13:00,780
of having to come up with that extra money

210
00:13:00,780 --> 00:13:04,283
to pay for the EpiPens.

211
00:13:04,283 --> 00:13:07,286
I feel bad because, like, I know it's not my fault,

212
00:13:07,286 --> 00:13:12,125
but they're so expensive,
and it's, like, a lot,

213
00:13:12,125 --> 00:13:16,087
even though, like, my mom says
that I'm worth it and everything.

214
00:13:18,339 --> 00:13:24,137
Knowing that my kids feel like they're a burden to me,

215
00:13:24,137 --> 00:13:25,888
it actually hurts and it makes me angry.

216
00:13:25,888 --> 00:13:28,016
I guess the anger comes from being hurt.

217
00:13:28,016 --> 00:13:29,892
Because kids should never feel like that.

218
00:13:29,892 --> 00:13:33,062
And I think it's just so unfair
because it's unnecessary.

219
00:13:33,062 --> 00:13:37,775
The medication inside the device
is so cheap.

220
00:13:37,775 --> 00:13:40,570
It does not warrant the cost.

221
00:13:43,948 --> 00:13:47,452
When journalists and lawmakers
ask pharmaceutical companies

222
00:13:47,452 --> 00:13:49,454
to justify their pricing,

223
00:13:49,454 --> 00:13:52,999
the same two words come up again and again:

224
00:13:52,999 --> 00:13:55,793
research and development.

225
00:13:55,793 --> 00:13:58,629
There are a couple of myths
that are out there

226
00:13:58,629 --> 00:14:00,631
about why drugs cost what they do.

227
00:14:00,631 --> 00:14:04,052
One myth is that the company spends
so much money on research

228
00:14:04,052 --> 00:14:07,138
that they need to recoup
their research expenditures.

229
00:14:07,138 --> 00:14:10,266
And if it wasn't for the drug company,
we wouldn't have any new drugs

230
00:14:10,266 --> 00:14:12,226
because they're making all the discoveries.

231
00:14:12,226 --> 00:14:15,480
We need to invest in innovation
for cures and treatments

232
00:14:15,480 --> 00:14:16,689
for unmet medical need,

233
00:14:16,689 --> 00:14:19,025
and we need to charge a price
for our medicines

234
00:14:19,025 --> 00:14:21,194
that allow us to invest in R&D.

235
00:14:21,194 --> 00:14:26,407
The reality is that much of the research
is not done by them at all.

236
00:14:26,407 --> 00:14:29,118
We increase prices as part of that process

237
00:14:29,118 --> 00:14:30,953
of, you know, getting back our R&D costs.

238
00:14:30,953 --> 00:14:33,790
Given the number of product candidates
we have in development,

239
00:14:33,790 --> 00:14:34,999
our expenses will go up.

240
00:14:34,999 --> 00:14:38,044
Almost all of the innovative products,

241
00:14:38,044 --> 00:14:39,962
the blockbuster drugs,

242
00:14:39,962 --> 00:14:43,966
are acquired from small start-ups,

243
00:14:43,966 --> 00:14:45,468
biotech companies,

244
00:14:45,468 --> 00:14:47,470
from university research.

245
00:14:47,470 --> 00:14:49,430
We wake up every day trying to invent new medicines

246
00:14:49,430 --> 00:14:51,349
and get them to people who are sick.

247
00:14:51,349 --> 00:14:52,892
And the system is complicated.

248
00:14:52,892 --> 00:14:55,019
So for us it's all about innovation
from R&D,

249
00:14:55,019 --> 00:14:56,312
and value for money.

250
00:14:56,312 --> 00:15:00,108
The best way we can invest
in our innovation and R&D

251
00:15:00,108 --> 00:15:02,360
is by growing the top line.

252
00:15:02,360 --> 00:15:07,323
What makes one company
a better innovator than another?

253
00:15:07,323 --> 00:15:11,536
To actually come up with a drug
takes a very sophisticated team

254
00:15:11,536 --> 00:15:14,288
that understands all aspects of drug development.

255
00:15:14,288 --> 00:15:18,167
If I was a drug company, I might want to take credit
for all of scientific discovery too,

256
00:15:18,167 --> 00:15:20,795
because it's a way of justifying those prices.

257
00:15:20,795 --> 00:15:22,547
It just happens to not be true.

258
00:15:24,924 --> 00:15:30,304
David Poole is the former director
of government affairs at Gilead Sciences,

259
00:15:30,304 --> 00:15:34,684
one of the most profitable pharmaceutical companies
in the world.

260
00:15:34,684 --> 00:15:38,104
In the eight and a half years
that I spent with Gilead Sciences,

261
00:15:38,104 --> 00:15:42,233
their investment in R&D and in the laboratories
that I visited and toured

262
00:15:42,233 --> 00:15:45,736
seems very disproportionate to what the yield is.

263
00:15:45,736 --> 00:15:48,739
It was more like here we have a showcase,

264
00:15:48,739 --> 00:15:52,076
and when visitors come,
whether it was investors or patients

265
00:15:52,076 --> 00:15:54,745
or whomever might be touring
Gilead's headquarters,

266
00:15:54,745 --> 00:15:58,708
they had these beautiful, large laboratories
that they could present to people

267
00:15:58,708 --> 00:16:02,420
and say, "This is where we do
all this grand research and development,"

268
00:16:02,420 --> 00:16:07,216
when in fact we didn't see products
that had been innovated by Gilead,

269
00:16:07,216 --> 00:16:10,595
they just were very strategic
in the companies they purchased,

270
00:16:10,595 --> 00:16:12,430
then they would often take those products

271
00:16:12,430 --> 00:16:17,476
and in some cases combine drugs
to make them an effective better therapy.

272
00:16:17,476 --> 00:16:21,189
But from--as far as innovation
from start to finish,

273
00:16:21,189 --> 00:16:23,399
I quite frankly don't think that occurred,

274
00:16:23,399 --> 00:16:27,486
perhaps maybe even only once
in the 30-year history of Gilead Sciences.

275
00:16:27,486 --> 00:16:31,741
So then the question is not
how do you develop the next miracle drug

276
00:16:31,741 --> 00:16:34,243
but how do you get hold of it?

277
00:16:34,243 --> 00:16:36,537
And that you can do through acquisitions.

278
00:16:36,537 --> 00:16:40,458
So you acquire the company
that is the developing the drug,

279
00:16:40,458 --> 00:16:43,836
and then try to exploit it
as much as possible.

280
00:16:45,421 --> 00:16:50,176
In 2011, Gilead Sciences positioned itself
to acquire a company

281
00:16:50,176 --> 00:16:51,510
that was leading the field

282
00:16:51,510 --> 00:16:56,557
in the fight against the most deadly infectious disease
in the United States:

283
00:16:56,557 --> 00:16:58,976
hepatitis C.

284
00:16:58,976 --> 00:17:02,772
This merger between business
and miracle drug

285
00:17:02,772 --> 00:17:05,900
triggered the most contentious
industry move to date.

286
00:17:05,900 --> 00:17:10,696
One of the biggest controversies
that erupted in the pricing of new drugs

287
00:17:10,696 --> 00:17:12,823
occurred about two to three years ago.

288
00:17:12,823 --> 00:17:15,117
Was around these drugs to treat hepatitis C.

289
00:17:15,117 --> 00:17:18,371
And I wouldn't say Gilead is an outlier,

290
00:17:18,371 --> 00:17:22,291
it's just that they were able
to get hold of a drug

291
00:17:22,291 --> 00:17:23,709
that is a miracle drug.

292
00:17:26,003 --> 00:17:27,964
There is a new cure on the rise.

293
00:17:27,964 --> 00:17:31,592
There is a new drug on the market
that will help cure hepatitis C.

294
00:17:31,592 --> 00:17:33,678
The drug has been called a miracle drug.

295
00:17:33,678 --> 00:17:36,347
It actually cures hepatitis C.

296
00:17:36,347 --> 00:17:37,598
Sofosbuvir.

297
00:17:37,598 --> 00:17:41,102
Sofosbuvir was designed by a chemist
called Mike Sofia

298
00:17:41,102 --> 00:17:42,812
at a company called Pharmasset.

299
00:17:42,812 --> 00:17:45,940
Wait a minute, so this is a definite cure
for hepatitis C?

300
00:17:45,940 --> 00:17:47,233
This is a cure for hepatitis C.

301
00:17:47,233 --> 00:17:48,693
-No kidding!
-Yeah.

302
00:17:48,693 --> 00:17:50,319
-No kidding!
-I mean, that's amazing, right?

303
00:17:50,319 --> 00:17:52,822
We did the original human studies of that drug.

304
00:17:52,822 --> 00:17:56,117
I presented the data at the Berlin Liver meeting.

305
00:17:56,117 --> 00:17:59,996
And I remember the meeting because
the audience was in stunned silence.

306
00:17:59,996 --> 00:18:03,916
This was perhaps the only time
I've ever sat in a medical conference

307
00:18:03,916 --> 00:18:06,752
where everybody went, "Ah..."

308
00:18:06,752 --> 00:18:07,837
They couldn't believe it.

309
00:18:07,837 --> 00:18:11,632
For the first time, tablets had cured hepatitis C.

310
00:18:11,632 --> 00:18:14,468
We're not talking about a drug
with marginal benefits;

311
00:18:14,468 --> 00:18:18,139
we're talking about a drug that's a game changer
for people's lives.

312
00:18:18,139 --> 00:18:21,934
Gilead Sciences, making a big move
into the world of hepatitis C treatment

313
00:18:21,934 --> 00:18:24,020
with its acquisition of Pharmasset,

314
00:18:24,020 --> 00:18:27,815
a deal in fact expected to close
by the end of the day tomorrow.

315
00:18:27,815 --> 00:18:33,738
Gilead Sciences is buying drug developer Pharmasset
for $11 billion.

316
00:18:33,738 --> 00:18:36,032
Gilead's chairman and CEO, John Martin, joins us.

317
00:18:36,032 --> 00:18:38,701
What gives you the confidence
that this is a company

318
00:18:38,701 --> 00:18:41,495
that was worth $11 billion of Gilead's money?

319
00:18:41,495 --> 00:18:44,248
The company that we're talking about, Pharmasset,

320
00:18:44,248 --> 00:18:45,666
made tremendous progress,

321
00:18:45,666 --> 00:18:47,585
especially over the last year,

322
00:18:47,585 --> 00:18:49,628
and it's already in Phase 3 studies,

323
00:18:49,628 --> 00:18:51,839
studies that lead to approval,

324
00:18:51,839 --> 00:18:55,217
so we expect 7977 to be the first to market.

325
00:18:55,217 --> 00:18:57,636
Now this is 2011.

326
00:18:57,636 --> 00:18:59,930
By 2014,

327
00:18:59,930 --> 00:19:02,725
we had combined drugs and done the clinical trials

328
00:19:02,725 --> 00:19:04,268
and presented the data

329
00:19:04,268 --> 00:19:07,188
that resulted in a treatment for hepatitis C

330
00:19:07,188 --> 00:19:12,693
that could cure 95% of patients
with one tablet once a day

331
00:19:12,693 --> 00:19:15,780
that was simple, safe, and effective.

332
00:19:15,780 --> 00:19:18,991
All of a sudden it changes to,
"We have a med that works in three months,

333
00:19:18,991 --> 00:19:22,453
the side effects are minimal to none,
it's there,

334
00:19:22,453 --> 00:19:25,164
and let's get everybody tested,
let's get everybody cured."

335
00:19:25,164 --> 00:19:27,208
There'd be no transmission of hepatitis C

336
00:19:27,208 --> 00:19:30,586
if everybody started on it immediately.

337
00:19:30,586 --> 00:19:32,713
I mean, this is a virus that could be cleared.

338
00:19:32,713 --> 00:19:34,840
We could clear it from the planet.

339
00:19:34,840 --> 00:19:38,511
But we can't because it's too expensive.

340
00:19:38,511 --> 00:19:42,014
The thousand-dollar-a-day pill.

341
00:19:42,014 --> 00:19:44,725
That's a lot of money for a single tablet.

342
00:19:44,725 --> 00:19:48,813
In fact, that makes one tablet of sofosbuvir,
as it's called,

343
00:19:48,813 --> 00:19:52,566
the most expensive substance on Earth.

344
00:19:54,485 --> 00:19:58,489
So Gilead brings a cure to market.

345
00:19:58,489 --> 00:20:00,074
That didn't make the headlines.

346
00:20:00,074 --> 00:20:02,952
What made the headlines was their price.

347
00:20:02,952 --> 00:20:06,372
And so what you saw a few days later

348
00:20:06,372 --> 00:20:09,458
when it first launched,
it was somebody holding up a pill,

349
00:20:09,458 --> 00:20:12,211
and it said, "The new face
of the pharmaceutical industry,

350
00:20:12,211 --> 00:20:13,421
the thousand-dollar pill."

351
00:20:13,421 --> 00:20:15,172
It's important to understand, you know,

352
00:20:15,172 --> 00:20:18,843
something about hepatitis C and the disease.

353
00:20:18,843 --> 00:20:22,012
A thousand dollars a pill sounds outrageous,

354
00:20:22,012 --> 00:20:24,098
but, you know, the cost
and the investment involved,

355
00:20:24,098 --> 00:20:26,350
we're talking billions of dollars were spent

356
00:20:26,350 --> 00:20:30,688
to, you know, to purchase this treatment or this drug.

357
00:20:30,688 --> 00:20:33,441
A lot of that development happened
at Emory University

358
00:20:33,441 --> 00:20:36,777
by a faculty member who received
a lot of NIH grants.

359
00:20:36,777 --> 00:20:41,532
There was also some work that happened
in the Veterans Administration Hospital.

360
00:20:41,532 --> 00:20:45,077
The faculty member set up a company
called Pharmasset,

361
00:20:45,077 --> 00:20:49,331
which was going to monetize that discovery,

362
00:20:49,331 --> 00:20:52,668
and then Gilead Pharmaceuticals
decided to buy the company

363
00:20:52,668 --> 00:20:54,670
that this faculty member had started.

364
00:20:54,670 --> 00:20:58,757
They paid $11.2 billion for this product,

365
00:20:58,757 --> 00:21:03,804
at the time, a price that Wall Street
viewed as excessive.

366
00:21:03,804 --> 00:21:06,098
Down the road, it was proven by Gilead

367
00:21:06,098 --> 00:21:10,269
that they recouped that $11.2 billion
in less than a year

368
00:21:10,269 --> 00:21:12,229
from the rollout of that product.

369
00:21:12,229 --> 00:21:16,400
There's an interesting ethical and political
and societal question

370
00:21:16,400 --> 00:21:21,363
of who should reap the benefits
of initially that sale

371
00:21:21,363 --> 00:21:25,659
if the drug really was in large part
developed with public funds,

372
00:21:25,659 --> 00:21:29,580
and the answer is it certainly doesn't end up
in the pocket of the taxpayer.

373
00:21:29,580 --> 00:21:32,208
They get to pay twice--
once for the discovery

374
00:21:32,208 --> 00:21:34,502
and once to buy the drug if they need it.

375
00:21:36,212 --> 00:21:41,509
They lofty prices forced unprecedented levels
of pharmaceutical rationing.

376
00:21:41,509 --> 00:21:44,094
As demand for the life-saving drug swelled,

377
00:21:44,094 --> 00:21:47,097
access continued to diminish.

378
00:21:47,097 --> 00:21:49,725
Health insurers and government payers said

379
00:21:49,725 --> 00:21:54,104
basically we're only gonna treat you
if you already have liver damage.

380
00:21:54,104 --> 00:21:57,608
So, no, we're not gonna give you this cure

381
00:21:57,608 --> 00:21:59,026
until you're already sick.

382
00:22:08,869 --> 00:22:13,290
I had, um, ammonia on my brain, you know,

383
00:22:13,290 --> 00:22:17,837
from having the virus in my system.

384
00:22:19,797 --> 00:22:23,217
Some of the side effects are, like, brain fog,

385
00:22:23,217 --> 00:22:27,012
is, like, not being able to think clearly,

386
00:22:27,012 --> 00:22:29,598
poor memory.

387
00:22:29,598 --> 00:22:33,852
I knew that there was a new treatment
that was gonna be available,

388
00:22:33,852 --> 00:22:37,815
and I was hoping that I'd be able
to avail myself of that.

389
00:22:37,815 --> 00:22:40,401
But it seemed like it was never gonna happen

390
00:22:40,401 --> 00:22:47,366
because of all of the restrictions
that, um, that I had to go through to qualify.

391
00:22:47,366 --> 00:22:49,743
And then even after I qualified,

392
00:22:49,743 --> 00:22:53,455
I wasn't able to afford or get the medication.

393
00:22:53,455 --> 00:22:56,709
And the medication was obscenely expensive.

394
00:22:56,709 --> 00:22:59,420
Now anybody looking at a single pill will say,

395
00:22:59,420 --> 00:23:02,423
"That couldn't possibly cost a thousand dollars,"
and they'd be right.

396
00:23:02,423 --> 00:23:04,425
No way that pill costs a thousand dollars.

397
00:23:04,425 --> 00:23:07,970
The cost of that drug is less than a dollar a day,

398
00:23:07,970 --> 00:23:10,889
and that includes the plastic bottle it comes in.

399
00:23:10,889 --> 00:23:14,977
And the price to the consumer
is a thousand dollars a day.

400
00:23:14,977 --> 00:23:18,606
So I don't know, is that a reasonable profit margin?

401
00:23:18,606 --> 00:23:22,484
That very question ripped through the industry
and patient groups alike.

402
00:23:23,736 --> 00:23:26,989
And the answer wasn't unanimous.

403
00:23:26,989 --> 00:23:30,326
Now, I think the drug was priced very fairly.

404
00:23:30,326 --> 00:23:33,871
The drug was priced cheaper
than what existed,

405
00:23:33,871 --> 00:23:36,707
uh, safer than what existed,

406
00:23:36,707 --> 00:23:40,252
uh, and more effective than what existed.

407
00:23:40,252 --> 00:23:45,132
I think that's a pretty powerful argument
to say why that price should be where it was.

408
00:23:45,132 --> 00:23:48,802
I was just so scared for my daughter
because, you know,

409
00:23:48,802 --> 00:23:51,472
if something were to happen to me
and I died...

410
00:23:56,143 --> 00:24:00,022
...she wouldn't have me to be there for her.

411
00:24:00,022 --> 00:24:03,567
And I wanted--I wanted her to be happy

412
00:24:03,567 --> 00:24:07,154
and to meet a man to love her

413
00:24:07,154 --> 00:24:10,366
and support her.

414
00:24:10,366 --> 00:24:13,452
Go to her wedding.

415
00:24:13,452 --> 00:24:17,331
See my grandchildren.

416
00:24:17,331 --> 00:24:19,708
Things that I thought about a lot.

417
00:24:19,708 --> 00:24:23,170
Gilead Sciences hit a home run yesterday
with its earnings

418
00:24:23,170 --> 00:24:25,381
when it reported after the market closed.

419
00:24:25,381 --> 00:24:27,549
Gilead delivered revenue of $5 billion.

420
00:24:27,549 --> 00:24:30,678
That was almost double
what it earned last year at this time

421
00:24:30,678 --> 00:24:32,721
because of its drug Sovaldi.

422
00:24:32,721 --> 00:24:36,016
While hundreds of thousands of patients
lingered on waiting lists

423
00:24:36,016 --> 00:24:38,811
hoping for their chance at the miracle drug,

424
00:24:38,811 --> 00:24:40,938
Gilead's stock prices soared.

425
00:24:40,938 --> 00:24:42,314
If anything, it's now very clear.

426
00:24:42,314 --> 00:24:44,942
Gilead dramatically underpaid for Pharmasset.

427
00:24:44,942 --> 00:24:46,902
They were just visionaries.

428
00:24:46,902 --> 00:24:48,946
Boy, it makes me like them even more.

429
00:24:48,946 --> 00:24:53,742
When you talk about these new hepatitis C drugs,

430
00:24:53,742 --> 00:24:55,953
the system's working the way
it's supposed to.

431
00:24:55,953 --> 00:25:02,376
Gilead comes up with a new drug
that literally cures hep C in 12 weeks.

432
00:25:02,376 --> 00:25:04,712
It's expensive when it first comes out,

433
00:25:04,712 --> 00:25:06,130
but you're done, you're cured.

434
00:25:06,130 --> 00:25:10,467
It turned out that a number of the people
who I was in the group with

435
00:25:10,467 --> 00:25:15,681
did die before they were able to qualify
or get the money together.

436
00:25:17,141 --> 00:25:20,602
That made me angry
and also feeling guilty.

437
00:25:20,602 --> 00:25:24,273
You know, why was it that it was me
and not one of those other people

438
00:25:24,273 --> 00:25:26,817
who I had befriended in the group?

439
00:25:26,817 --> 00:25:30,696
Maybe, you know, why did they have to die

440
00:25:30,696 --> 00:25:33,991
and leave their families.

441
00:25:33,991 --> 00:25:35,784
As someone in the industry,

442
00:25:35,784 --> 00:25:40,247
do you believe that people are only driven
by massive profit?

443
00:25:40,247 --> 00:25:43,542
I mean, is that the only reason
why they get up in the morning?

444
00:25:43,542 --> 00:25:46,837
There's a very cynical view of what motivates people,

445
00:25:46,837 --> 00:25:49,840
both in science and in medicine in particular.

446
00:25:49,840 --> 00:25:53,177
And it must be very sad to be a person
who believes that,

447
00:25:53,177 --> 00:25:57,389
that the only reason people get up
out of bed and go to work in the morning

448
00:25:57,389 --> 00:26:02,311
is because they really want to make
as much money as possible no matter what.

449
00:26:02,311 --> 00:26:03,937
I have had the good fortune,

450
00:26:03,937 --> 00:26:07,483
as have most people who work
in hospitals and universities,

451
00:26:07,483 --> 00:26:09,902
to be surrounded by people
who get out of bed in the morning

452
00:26:09,902 --> 00:26:11,695
because they want to help other people.

453
00:26:11,695 --> 00:26:14,323
And the idea that people would not do that anymore

454
00:26:14,323 --> 00:26:16,617
if they didn't become bazillionaires

455
00:26:16,617 --> 00:26:20,704
is a very cynical and probably incorrect view
of human nature.

456
00:26:20,704 --> 00:26:25,083
Using Gilead's own documents,

457
00:26:25,083 --> 00:26:30,923
the evidence shows that the company
pursued a calculated scheme

458
00:26:30,923 --> 00:26:35,511
for pricing and marketing its hepatitis C drug

459
00:26:35,511 --> 00:26:37,763
based on one goal:

460
00:26:37,763 --> 00:26:40,349
maximizing revenue,

461
00:26:40,349 --> 00:26:44,394
regardless of the human consequences.

462
00:26:46,021 --> 00:26:52,402
When you look at the way in which
top executives in the United States are being paid,

463
00:26:52,402 --> 00:26:58,534
the vast majority of their pay
is geared toward stock price performance.

464
00:26:58,534 --> 00:27:02,830
Now, in this particular case,
there's another dimension of executive pay

465
00:27:02,830 --> 00:27:04,081
which we've done research on,

466
00:27:04,081 --> 00:27:08,335
and the research we've done is kind of,
as far as I'm concerned,

467
00:27:08,335 --> 00:27:11,421
is a breakthrough because other people
have not noticed this,

468
00:27:11,421 --> 00:27:14,800
that almost every number you read
in The Wall Street Journal,

469
00:27:14,800 --> 00:27:16,385
The New York Times, and the press,

470
00:27:16,385 --> 00:27:19,096
it's not what the CEOs actually get paid,

471
00:27:19,096 --> 00:27:22,349
it's an estimate of what
they might make in the future

472
00:27:22,349 --> 00:27:24,685
from their stock options
and stock awards.

473
00:27:24,685 --> 00:27:27,187
But it's the buybacks that are the problem,

474
00:27:27,187 --> 00:27:29,648
and they're huge.

475
00:27:29,648 --> 00:27:33,485
Stock buybacks are when a company
buys back its own share

476
00:27:33,485 --> 00:27:35,279
from the stock market.

477
00:27:35,279 --> 00:27:39,992
In 2014, after the huge profits of Sovaldi kicked in,

478
00:27:39,992 --> 00:27:44,413
Gilead spent $11 billion on these buybacks,

479
00:27:44,413 --> 00:27:47,708
and in doing so, they sent the company's
stock price through the roof.

480
00:27:48,959 --> 00:27:51,211
With such an intense spike in share values,

481
00:27:51,211 --> 00:27:54,047
this opened up a window for company executives

482
00:27:54,047 --> 00:27:56,925
to cash in on their stock options.

483
00:27:56,925 --> 00:27:59,219
So in the case of John C. Martin,

484
00:27:59,219 --> 00:28:02,014
it was reported, if you use the estimated fair value,

485
00:28:02,014 --> 00:28:06,727
that he made $19 million in each year.

486
00:28:06,727 --> 00:28:09,354
Now that sounds like a lot of money, and it is.

487
00:28:09,354 --> 00:28:12,566
But that's not what he actually took home.

488
00:28:12,566 --> 00:28:18,405
A close look at Gilead's publicly filed proxy statements
from 2014 and 2015

489
00:28:18,405 --> 00:28:23,076
reveal not only John C. Martin's
estimated value of stock options

490
00:28:23,076 --> 00:28:27,456
but more importantly,
the actual realized gains.

491
00:28:27,456 --> 00:28:32,085
In 2014, he took home almost $193 million,

492
00:28:32,085 --> 00:28:36,506
and in 2015, $232 million.

493
00:28:36,506 --> 00:28:41,637
That was the whole point of being the CEO
of the company for this guy.

494
00:28:41,637 --> 00:28:45,140
And the executive pay didn't stop at John Martin.

495
00:28:45,140 --> 00:28:50,062
The top five executives combined
took home over $400 million

496
00:28:50,062 --> 00:28:53,440
within one year of the drug's release.

497
00:28:53,440 --> 00:28:55,275
To put that in perspective,

498
00:28:55,275 --> 00:28:59,404
if you apply the one-year salaries
of these five individuals

499
00:28:59,404 --> 00:29:03,867
towards selling Sovaldi at the company's cost
of a dollar a day,

500
00:29:03,867 --> 00:29:07,162
you could completely eradicate hepatitis C

501
00:29:07,162 --> 00:29:13,752
from France, Spain, Argentina,
the United Kingdom, Canada,

502
00:29:13,752 --> 00:29:18,674
Australia, and the United States of America.

503
00:29:23,762 --> 00:29:25,597
According to Jonas Salk,

504
00:29:25,597 --> 00:29:31,061
the reward for work well done
is the opportunity to do more.

505
00:29:31,061 --> 00:29:34,731
But our current culture seems to believe
that the reward for work well done

506
00:29:34,731 --> 00:29:38,151
is the opportunity to take more.

507
00:29:38,151 --> 00:29:40,779
Is this business as usual?

508
00:29:40,779 --> 00:29:44,074
The price we pay for living in a free market?

509
00:29:44,074 --> 00:29:46,910
Has it always been like this,

510
00:29:46,910 --> 00:29:48,412
or have we lost our way?

511
00:30:08,306 --> 00:30:11,226
Also known as infantile paralysis

512
00:30:11,226 --> 00:30:14,229
because of its propensity to affect children,

513
00:30:14,229 --> 00:30:16,648
polio was pandemic.

514
00:30:16,648 --> 00:30:21,862
Outbreaks ravaged Europe, North America,
Australia, and New Zealand

515
00:30:21,862 --> 00:30:24,364
during the first half of the 20th century.

516
00:30:24,364 --> 00:30:27,284
Polio was a terrifying disease.

517
00:30:27,284 --> 00:30:31,872
Parents were afraid to send out
their children to play,

518
00:30:31,872 --> 00:30:33,290
especially during the summer months

519
00:30:33,290 --> 00:30:37,753
where, uh, the U.S. went through
a series of epidemics

520
00:30:37,753 --> 00:30:42,507
of the polio virus would spread
and affect many children.

521
00:30:42,507 --> 00:30:45,719
In extreme cases,
it could lead to the death of children

522
00:30:45,719 --> 00:30:49,848
and also to paralysis,
very serious respiratory defects.

523
00:30:49,848 --> 00:30:53,643
Children could end up in what became famous
as iron lungs.

524
00:30:53,643 --> 00:30:56,563
These were mechanical devices
that helped breathe children.

525
00:30:56,563 --> 00:30:58,774
Without these devices, children would die.

526
00:30:58,774 --> 00:31:02,152
So it was really terrifying and affected entire society.

527
00:31:02,152 --> 00:31:05,655
There are a lot of parents
whose children are healthy and happy now

528
00:31:05,655 --> 00:31:06,990
who live in fear.

529
00:31:06,990 --> 00:31:08,408
I know I do.

530
00:31:08,408 --> 00:31:11,078
The fear, my friends, is polio.

531
00:31:11,078 --> 00:31:14,414
Mechanical respiratory aids
temporarily do the work

532
00:31:14,414 --> 00:31:16,958
of the muscles required to breathe

533
00:31:16,958 --> 00:31:19,419
until those muscles can recover

534
00:31:19,419 --> 00:31:24,007
or until substitute muscles
can be trained to replace them.

535
00:31:24,007 --> 00:31:27,260
The uninfected lived in fear.

536
00:31:27,260 --> 00:31:30,889
The infected struggled to breathe.

537
00:31:30,889 --> 00:31:36,561
And both could only wait as medical professionals
waged war against the disease.

538
00:31:36,561 --> 00:31:38,396
1955.

539
00:31:38,396 --> 00:31:42,609
A day which may well mark
the most significant event in all of medical history.

540
00:31:42,609 --> 00:31:45,195
The world will very soon know
whether the battle against the disease

541
00:31:45,195 --> 00:31:49,950
that has twisted hundreds of thousands of young bodies
has been won.

542
00:31:49,950 --> 00:31:51,743
At just 40 years old,

543
00:31:51,743 --> 00:31:55,080
Dr. Jonas Salk, a New York born virologist,

544
00:31:55,080 --> 00:32:00,252
gathered with the rest of the world
to hear the results from his latest research.

545
00:32:00,252 --> 00:32:04,297
If the results from the observed study areas
are employed,

546
00:32:04,297 --> 00:32:08,176
the vaccine could be considered 80% to 90% effective

547
00:32:08,176 --> 00:32:11,096
against paralytic poliomyelitis.

548
00:32:11,096 --> 00:32:13,640
It was the end of polio.

549
00:32:13,640 --> 00:32:16,852
And so when Jonas developed this drug

550
00:32:16,852 --> 00:32:20,188
and had a profound impact on society,

551
00:32:20,188 --> 00:32:23,316
it essentially eradicated the disease,

552
00:32:23,316 --> 00:32:28,363
and one of the major achievements
of biomedical research of the last century.

553
00:32:28,363 --> 00:32:33,285
Perhaps even more poignant and impactful
than the work that led to the vaccine

554
00:32:33,285 --> 00:32:36,580
was the decision Salk make afterwards.

555
00:32:36,580 --> 00:32:39,249
Who owns the patent on this vaccine?

556
00:32:39,249 --> 00:32:41,293
Well, the people, I would say.

557
00:32:41,293 --> 00:32:42,878
There is no patent.

558
00:32:42,878 --> 00:32:45,964
Could you patent the sun?

559
00:32:45,964 --> 00:32:49,593
The accessibility of the vaccine
had a profound effect

560
00:32:49,593 --> 00:32:50,844
on the entire planet.

561
00:32:52,012 --> 00:32:54,472
If Salk had patented the vaccine,

562
00:32:54,472 --> 00:32:58,476
he would have profited upwards
of $7 billion.

563
00:32:58,476 --> 00:33:03,231
What this answer reflect is his desire
and passion

564
00:33:03,231 --> 00:33:09,112
to do work that benefits mankind
without profit and personal benefit for himself.

565
00:33:09,112 --> 00:33:14,451
Salk's pioneering legacy lit the way
for modern medical innovation,

566
00:33:14,451 --> 00:33:19,497
and it ushered in a new energy
for scientific and medical discovery.

567
00:33:19,497 --> 00:33:25,462
The drug industry has always been
dependent on scientific breakthroughs

568
00:33:25,462 --> 00:33:28,715
to really come up with innovative medicines.

569
00:33:28,715 --> 00:33:34,179
And the whole first part of that process
is really driven by basic science,

570
00:33:34,179 --> 00:33:39,226
the vast majority almost universally
funded by the federal government.

571
00:33:39,226 --> 00:33:43,605
The NIH plays a huge role
in the development of basic science.

572
00:33:43,605 --> 00:33:48,401
The United States has the largest
federally funded science program in the world,

573
00:33:48,401 --> 00:33:53,406
with nearly $32.3 billion being invested annually.

574
00:33:53,406 --> 00:33:58,912
NIH funds are essential
in the earliest parts of research,

575
00:33:58,912 --> 00:34:03,458
which brings the basic knowledge
of how the human body works.

576
00:34:03,458 --> 00:34:05,252
And that research is done generally

577
00:34:05,252 --> 00:34:08,129
with support from the NIH
and academic scientists.

578
00:34:09,631 --> 00:34:14,761
The trek from basic science
into the development of a pharmaceutical drug

579
00:34:14,761 --> 00:34:18,682
is called translational research.

580
00:34:18,682 --> 00:34:20,600
Having the capital and infrastructure

581
00:34:20,600 --> 00:34:24,229
that many government and educational facilities lack,

582
00:34:24,229 --> 00:34:29,067
pharmaceutical companies often step in
in the late stages of development

583
00:34:29,067 --> 00:34:31,528
and prep the drug for the market.

584
00:34:31,528 --> 00:34:34,906
Lastly, the drugs must get approval
from the FDA.

585
00:34:34,906 --> 00:34:36,324
Food & Drug Administration

586
00:34:36,324 --> 00:34:39,077
Once the FDA gives its stamp of approval,

587
00:34:39,077 --> 00:34:41,496
the transformation is complete

588
00:34:41,496 --> 00:34:44,874
from science into a product.

589
00:34:44,874 --> 00:34:47,961
And if there's one thing America knows how to do,

590
00:34:47,961 --> 00:34:50,922
it's sales.

591
00:34:50,922 --> 00:34:52,590
I am ready.

592
00:34:52,590 --> 00:34:54,342
Because today, there's Harvoni.

593
00:34:54,342 --> 00:34:55,593
-Good afternoon.
-Hi.

594
00:34:55,593 --> 00:34:57,304
I'd like to get a prescription filled.

595
00:34:57,304 --> 00:34:59,973
It's for brand name Abilify.

596
00:34:59,973 --> 00:35:01,641
Sleep.

597
00:35:01,641 --> 00:35:04,894
-Congratulations, you're down with Crestor.
-Yes!

598
00:35:04,894 --> 00:35:06,813
Prilosec OTC.

599
00:35:06,813 --> 00:35:08,231
I got my first prescription free.

600
00:35:08,231 --> 00:35:09,816
Ask your doctor about Farxiga.

601
00:35:09,816 --> 00:35:10,984
-Tecfidera.
-Viagra.

602
00:35:10,984 --> 00:35:13,528
-Eliquis.
-Otezla.

603
00:35:13,528 --> 00:35:16,197
I feel better now--better now--better now.

604
00:35:24,456 --> 00:35:29,002
Direct-to-consumer marketing
is a public health disaster.

605
00:35:29,002 --> 00:35:32,422
Consumers who know almost nothing

606
00:35:32,422 --> 00:35:35,342
about the scientific basis of their disease,

607
00:35:35,342 --> 00:35:36,718
for the most part,

608
00:35:36,718 --> 00:35:40,722
can only be convinced
to put pressure on their doctor

609
00:35:40,722 --> 00:35:44,476
to prescribe something that they have no idea
what the impact of that's going to be.

610
00:35:44,476 --> 00:35:46,686
And I'm sure you'll talk to lots of doctors who say,

611
00:35:46,686 --> 00:35:48,647
"I have patients come in and ask all the time

612
00:35:48,647 --> 00:35:52,901
if they should be taking a drug
for a disease they don't have."

613
00:35:52,901 --> 00:35:56,696
I mean, you listen to that list
of all the bad things that can happen to you.

614
00:35:56,696 --> 00:35:58,656
The companies have tested this

615
00:35:58,656 --> 00:36:01,993
and they found out that saying all these scary things,

616
00:36:01,993 --> 00:36:04,079
people just think you're being more truthful.

617
00:36:04,079 --> 00:36:07,457
It makes it seem like it's more--
you know, they have a higher degree of confidence.

618
00:36:07,457 --> 00:36:10,752
But, you know, the television advertising's
quite manipulative.

619
00:36:12,504 --> 00:36:15,882
As a Brit, I do find it disconcerting
when I'm in the States

620
00:36:15,882 --> 00:36:18,635
to see all the direct-to-consumer advertising.

621
00:36:18,635 --> 00:36:20,470
I find that a little strange.

622
00:36:20,470 --> 00:36:23,390
Every time I get surprised that, you know,
you switch the TV on

623
00:36:23,390 --> 00:36:27,185
and there's people playing golf
and hugging their grandchildren

624
00:36:27,185 --> 00:36:28,561
and it's beautiful.

625
00:36:28,561 --> 00:36:31,606
So on British TV, you won't see adverts for medicines

626
00:36:31,606 --> 00:36:35,110
which are only available by prescription
through doctors.

627
00:36:35,110 --> 00:36:39,280
Pharmaceutical companies cannot market
or advertise publicly

628
00:36:39,280 --> 00:36:41,408
branded drugs to the public.

629
00:36:44,702 --> 00:36:47,831
On May 19th, 1983,

630
00:36:47,831 --> 00:36:50,917
the American public set eyes
on a television commercial

631
00:36:50,917 --> 00:36:55,672
that would spark a debate
that rages on still today.

632
00:36:55,672 --> 00:36:59,259
If you're one of the many people
who take the prescription drug Motrin,

633
00:36:59,259 --> 00:37:02,178
you should ask your physician or pharmacist
about Rufen.

634
00:37:02,178 --> 00:37:05,223
They will tell you that both Motrin 400 milligram tablets

635
00:37:05,223 --> 00:37:07,392
and Rufen 400 milligram tablets

636
00:37:07,392 --> 00:37:10,311
are different brand names for the same drug:

637
00:37:10,311 --> 00:37:11,688
ibuprofen.

638
00:37:11,688 --> 00:37:14,232
There is only one important difference.

639
00:37:14,232 --> 00:37:17,235
Rufen can cost you considerably less.

640
00:37:17,235 --> 00:37:18,611
Boots Pharmaceutical aired

641
00:37:18,611 --> 00:37:21,906
the first broadcast television commercial
in the United States

642
00:37:21,906 --> 00:37:23,658
for a prescription drug,

643
00:37:23,658 --> 00:37:26,911
and in doing so, sent the FDA reeling.

644
00:37:26,911 --> 00:37:30,707
Within 48 hours, the federal government
pulled the plug.

645
00:37:30,707 --> 00:37:35,211
Pharmaceutical advertising regulations
hadn't been addressed in over a decade,

646
00:37:35,211 --> 00:37:37,297
and at the time, no one had anticipated

647
00:37:37,297 --> 00:37:41,468
a pharmaceutical direct-to-consumer advertisement.

648
00:37:41,468 --> 00:37:44,512
Ironically, even the industry was torn.

649
00:37:44,512 --> 00:37:48,975
In a 1984 letter to the then-representative
John Dingell of Michigan,

650
00:37:48,975 --> 00:37:53,062
vice president of Eli Lilly said
direct-to-consumer advertisements

651
00:37:53,062 --> 00:37:56,566
would be "both unwise and inappropriate."

652
00:37:56,566 --> 00:38:01,029
The Upjohn Company said it "would be detrimental
to the pharmaceutical industry."

653
00:38:01,029 --> 00:38:05,575
And Schering-Plough claimed that "in most cases,
it cannot safely be accomplished."

654
00:38:06,576 --> 00:38:10,538
The FDA responded with a set
of rigid rules and requirements.

655
00:38:10,538 --> 00:38:12,373
Ads weren't outright banned,

656
00:38:12,373 --> 00:38:15,293
but they had to list all applicable ingredients,

657
00:38:15,293 --> 00:38:18,713
safety information,
warnings, precautions,

658
00:38:18,713 --> 00:38:20,924
adverse reactions, and the like.

659
00:38:20,924 --> 00:38:24,719
This rendered TV ads nearly impossible
to pull off.

660
00:38:24,719 --> 00:38:29,182
This confined pharma companies
primarily to print ads for nearly a decade

661
00:38:29,182 --> 00:38:31,935
until 1996, when Schering-Plough,

662
00:38:31,935 --> 00:38:36,439
the same company that condemned
direct-to-consumer ads eight years earlier,

663
00:38:36,439 --> 00:38:39,275
ran a divisive ad for Claritin.

664
00:38:39,275 --> 00:38:40,568
The plan was simple:

665
00:38:40,568 --> 00:38:43,821
Make no mention that Claritin
is a pharmaceutical drug.

666
00:38:46,074 --> 00:38:48,701
-Claritin.
-It's time, it's time.

667
00:38:48,701 --> 00:38:50,787
Don't wait another minute for Claritin.

668
00:38:50,787 --> 00:38:52,664
Claritin. I'll ask my doctor.

669
00:38:52,664 --> 00:38:53,998
It's time to see your doctor.

670
00:38:53,998 --> 00:38:55,750
Mr. Wilkin, the doctor will see you now.

671
00:38:55,750 --> 00:38:58,378
At last, a clear day is here.

672
00:38:58,378 --> 00:39:02,507
I want to know more about Claritin.

673
00:39:02,507 --> 00:39:05,218
Yes, ask your doctor for a trial of Claritin.

674
00:39:07,345 --> 00:39:09,430
In a clever marketing move,

675
00:39:09,430 --> 00:39:11,891
Schering-Plough used what was later coined

676
00:39:11,891 --> 00:39:14,894
the "ask your doctor" loophole.

677
00:39:14,894 --> 00:39:17,855
They essentially shrugged off
the required fine print,

678
00:39:17,855 --> 00:39:20,024
the bold print,
and everything in between.

679
00:39:20,024 --> 00:39:22,068
In its place, one clear message:

680
00:39:22,068 --> 00:39:24,404
"Ask your doctor for details."

681
00:39:24,404 --> 00:39:27,699
The whole purpose of that
supports an overall marketing strategy

682
00:39:27,699 --> 00:39:30,743
which is to leave no stone unturned.

683
00:39:30,743 --> 00:39:33,955
Make patients ask about drugs.

684
00:39:33,955 --> 00:39:36,833
The Claritin campaign
once again rocked the boat,

685
00:39:36,833 --> 00:39:39,252
forcing the FDA to reassess,

686
00:39:39,252 --> 00:39:42,630
and in 1997,
during Bill Clinton's second term,

687
00:39:42,630 --> 00:39:45,508
direct-to-consumer ads
were deregulated,

688
00:39:45,508 --> 00:39:48,052
giving way to the kind
of pharmaceutical ads

689
00:39:48,052 --> 00:39:50,096
that now dominate the airwaves.

690
00:39:50,096 --> 00:39:55,059
President Clinton agreed
to have drugs advertised

691
00:39:55,059 --> 00:39:59,314
on television, newspapers,
which had been prohibited previously.

692
00:39:59,314 --> 00:40:03,318
So that just exploded
the direct-to-consumer advertising.

693
00:40:03,318 --> 00:40:05,695
So now, companies are spending
more money on marketing

694
00:40:05,695 --> 00:40:07,739
than they're spending
on research and development.

695
00:40:07,739 --> 00:40:10,366
We don't know what companies are spending

696
00:40:10,366 --> 00:40:11,618
on research and development,

697
00:40:11,618 --> 00:40:14,287
but we have seen studies that show that

698
00:40:14,287 --> 00:40:18,041
many companies are spending
19 times as much money

699
00:40:18,041 --> 00:40:20,335
on the marketing and advertising part

700
00:40:20,335 --> 00:40:22,837
than they are on the research and development part.

701
00:40:22,837 --> 00:40:26,424
Now, they like to argue that
they need these high prices

702
00:40:26,424 --> 00:40:29,010
to cover R&D,

703
00:40:29,010 --> 00:40:31,137
but why do they need such high prices

704
00:40:31,137 --> 00:40:34,098
to cover all this marketing and promotion?

705
00:40:39,437 --> 00:40:40,813
Now, don't forget,

706
00:40:40,813 --> 00:40:44,484
the consumer side that we see,
direct-to-consumer advertising,

707
00:40:44,484 --> 00:40:48,321
has a whole other side
which is direct-to-physician marketing

708
00:40:48,321 --> 00:40:50,073
that consumers never see.

709
00:40:50,073 --> 00:40:52,450
Pharmaceutical companies spend a lot of money

710
00:40:52,450 --> 00:40:54,243
marketing their products to doctors.

711
00:40:54,243 --> 00:40:55,745
I think one estimate suggested

712
00:40:55,745 --> 00:40:58,289
it was in the range of $60 billion a year.

713
00:40:58,289 --> 00:41:02,877
Now, drugs, doctors, and the relationship
with the pharmaceutical industry.

714
00:41:02,877 --> 00:41:05,296
Those connections
have long been the subject

715
00:41:05,296 --> 00:41:07,298
of ethical and business concerns,

716
00:41:07,298 --> 00:41:10,009
particularly when it comes
to the financial ties

717
00:41:10,009 --> 00:41:12,428
between doctors
and the drug companies.

718
00:41:12,428 --> 00:41:14,305
But this is through
the medical journals,

719
00:41:14,305 --> 00:41:17,433
this is through drug reps
coming to their offices,

720
00:41:17,433 --> 00:41:19,352
this is through conferences

721
00:41:19,352 --> 00:41:21,938
when they go
to their professional society meetings.

722
00:41:21,938 --> 00:41:24,440
The industry has just run astray.

723
00:41:24,440 --> 00:41:26,317
I mean, it's gone wild.

724
00:41:26,317 --> 00:41:29,237
They are throwing money
at doctors left and right,

725
00:41:29,237 --> 00:41:31,864
they're paying doctors
to conduct studies,

726
00:41:31,864 --> 00:41:33,658
even to ghostwrite certain articles.

727
00:41:33,658 --> 00:41:34,992
What that means is

728
00:41:34,992 --> 00:41:37,954
the pharmaceutical company
actually writes the article

729
00:41:37,954 --> 00:41:40,206
and then slaps a doctor's name on it.

730
00:41:40,206 --> 00:41:41,958
-For a medical journal?
-That's right.

731
00:41:41,958 --> 00:41:45,044
When I did some initial research
on this a few years ago,

732
00:41:45,044 --> 00:41:46,921
there were many, many physicians

733
00:41:46,921 --> 00:41:49,340
receiving seven-figure supplements

734
00:41:49,340 --> 00:41:53,720
while they still conducted
or managed a practice in their home.

735
00:41:53,720 --> 00:41:57,140
So this is a disaster
from a public health point of view.

736
00:41:57,140 --> 00:42:00,935
It's a pressure point
that just simply doesn't need to be there.

737
00:42:00,935 --> 00:42:03,062
It serves no function whatsoever

738
00:42:03,062 --> 00:42:05,356
other than to cloud clinical judgment,

739
00:42:05,356 --> 00:42:06,816
and that's not good healthcare.

740
00:42:06,816 --> 00:42:08,568
And in fact, if you look

741
00:42:08,568 --> 00:42:11,821
at recent settlements
from the federal government,

742
00:42:11,821 --> 00:42:15,116
pretty much every major drug company
in the United States

743
00:42:15,116 --> 00:42:17,994
has had a finding in recent years

744
00:42:17,994 --> 00:42:21,956
dealing with breaking the law
regarding the marketing of drugs.

745
00:42:23,124 --> 00:42:25,877
Who wants to be a millionaire?

746
00:42:27,920 --> 00:42:29,255
You do the math.

747
00:42:29,255 --> 00:42:31,507
There are people in this room

748
00:42:31,507 --> 00:42:35,261
who are going to make
an ungodly sum of money

749
00:42:35,261 --> 00:42:36,637
selling Advair.

750
00:42:39,766 --> 00:42:42,435
The last two decades
have ushered in an era

751
00:42:42,435 --> 00:42:45,313
of unprecedented healthcare fraud.

752
00:42:45,313 --> 00:42:48,191
GSK will plead guilty to criminal charges.

753
00:42:48,191 --> 00:42:50,151
Janssen Pharmaceuticals will plead guilty.

754
00:42:50,151 --> 00:42:53,154
Eli Lilly pleading guilty to criminal conduct

755
00:42:53,154 --> 00:42:55,656
after skating under the radar for years.

756
00:42:55,656 --> 00:42:57,366
Off-label promotion,

757
00:42:57,366 --> 00:42:59,869
failure to disclose safety information,

758
00:42:59,869 --> 00:43:01,454
physician kickbacks.

759
00:43:01,454 --> 00:43:04,040
Nearly every major pharmaceutical company

760
00:43:04,040 --> 00:43:06,959
has been caught over and over again.

761
00:43:06,959 --> 00:43:08,669
For nearly a decade,

762
00:43:08,669 --> 00:43:13,091
Allergan illegally promoted Botox
for uses that were not approved

763
00:43:13,091 --> 00:43:16,177
as safe and effective by the FDA.

764
00:43:16,177 --> 00:43:17,929
That's the way it should be:

765
00:43:17,929 --> 00:43:20,431
When GSK makes money,
you make money.

766
00:43:20,431 --> 00:43:22,600
The more you sell,
the more you make.

767
00:43:22,600 --> 00:43:25,937
GSK engaged
in an illegal marketing campaign

768
00:43:25,937 --> 00:43:27,939
where drugs were promoted
for disorders

769
00:43:27,939 --> 00:43:30,149
where there was no medical evidence
they would help.

770
00:43:30,149 --> 00:43:33,027
Put simply, the alleged conduct is shameful.

771
00:43:33,027 --> 00:43:35,905
Um, we do occasionally make mistakes.

772
00:43:35,905 --> 00:43:38,825
By pushing Seroquel for unapproved purposes,

773
00:43:38,825 --> 00:43:41,869
AstraZeneca made patients into guinea pigs

774
00:43:41,869 --> 00:43:43,871
in an unsupervised drug test.

775
00:43:43,871 --> 00:43:46,374
The Virginia Attorney General announcing

776
00:43:46,374 --> 00:43:48,459
a $100 million settlement

777
00:43:48,459 --> 00:43:50,294
involving off-label marketing.

778
00:43:50,294 --> 00:43:54,298
The settlement includes criminal fines
totaling $485 million.

779
00:43:54,298 --> 00:43:57,426
Pfizer has agreed to pay $2.3 billion,

780
00:43:57,426 --> 00:43:59,929
which makes it
the largest criminal fine in history.

781
00:43:59,929 --> 00:44:03,933
GlaxoSmithKline is paying
a $3 billion fine.

782
00:44:03,933 --> 00:44:07,144
Fraudulently marketing nine drugs off-label,

783
00:44:07,144 --> 00:44:09,355
including Advair, Lemictal, Imitrex.

784
00:44:09,355 --> 00:44:12,441
The company's also accused
of paying kickbacks to doctors

785
00:44:12,441 --> 00:44:13,651
to prescribe the drug.

786
00:44:13,651 --> 00:44:15,945
So let me tell you
some of the perks that they received.

787
00:44:15,945 --> 00:44:17,154
They would give doctors

788
00:44:17,154 --> 00:44:19,156
basketball tickets, yacht trips.

789
00:44:19,156 --> 00:44:21,158
Hawaiian vacations, tickets to Madonna.

790
00:44:21,158 --> 00:44:24,328
They're paying doctors millions of dollars
to go on speaking tours.

791
00:44:24,328 --> 00:44:27,123
NASCAR races,
Knicks games, Celtics games,

792
00:44:27,123 --> 00:44:30,042
tennis lessons,
Crosby, Stills & Nash tickets,

793
00:44:30,042 --> 00:44:31,586
pheasant hunting!

794
00:44:31,586 --> 00:44:34,463
Okay, all the ways
they would bribe the doctors

795
00:44:34,463 --> 00:44:36,048
to do this to their own patients.

796
00:44:37,967 --> 00:44:40,720
From the years 2009 to 2016,

797
00:44:40,720 --> 00:44:44,599
the Justice Department
recovered $19.3 billion

798
00:44:44,599 --> 00:44:48,811
in settlements in judgments
related to healthcare fraud.

799
00:44:59,655 --> 00:45:02,116
In fact, just last year,
the Justice Department reached

800
00:45:02,116 --> 00:45:06,203
an all-time high in the number
of healthcare fraud defendants charged

801
00:45:06,203 --> 00:45:11,751
with more than 800 indictments
and more than 580 convictions.

802
00:45:11,751 --> 00:45:13,628
Whatever they're fined,

803
00:45:13,628 --> 00:45:16,047
they're just gonna charge it back to us.

804
00:45:16,047 --> 00:45:18,132
It just becomes a cost of doing business.

805
00:45:18,132 --> 00:45:22,303
God bless America,
free enterprise is a wonderful concept.

806
00:45:34,190 --> 00:45:37,360
Most people have no idea

807
00:45:37,360 --> 00:45:40,279
how much any drugs they take cost

808
00:45:40,279 --> 00:45:42,657
unless it's over the counter, basically--

809
00:45:42,657 --> 00:45:44,241
because they have insurance,

810
00:45:44,241 --> 00:45:46,702
they have a copay, but it's not very big--

811
00:45:46,702 --> 00:45:52,249
until the drug they're taking is $20,000,

812
00:45:52,249 --> 00:45:56,379
and then they look at the bill
and they're like, "What?"

813
00:45:58,339 --> 00:46:02,468
It's very strange to see money
becoming so important for me

814
00:46:02,468 --> 00:46:05,429
because money has never been
very important to me,

815
00:46:05,429 --> 00:46:10,017
but right now it's $20,000 for one drug,

816
00:46:10,017 --> 00:46:11,560
for one treatment,

817
00:46:11,560 --> 00:46:15,231
and I know that I have to take it
every three weeks

818
00:46:15,231 --> 00:46:16,732
for the rest of my life.

819
00:46:16,732 --> 00:46:18,567
How is that possible?

820
00:46:18,567 --> 00:46:21,904
But if we can't pay for it,
I wouldn't last very long.

821
00:46:23,739 --> 00:46:26,242
The premium of everybody goes up too.

822
00:46:26,242 --> 00:46:30,204
I mean, it's something that people don't see
because it's not on their bill,

823
00:46:30,204 --> 00:46:33,332
but they're all complaining
about the insurance premium going up.

824
00:46:33,332 --> 00:46:34,792
Why is it going up?

825
00:46:34,792 --> 00:46:37,670
It's because, yeah,
it's because of people like me,

826
00:46:37,670 --> 00:46:40,548
because my drug is too expensive.

827
00:46:40,548 --> 00:46:43,968
And then you get into anxiety,
how do I pay for it,

828
00:46:43,968 --> 00:46:45,678
or am I worth it?

829
00:46:45,678 --> 00:46:47,763
Should I resign myself?

830
00:46:49,223 --> 00:46:52,601
I saw my mother die,
so I know, I know what happens.

831
00:46:52,601 --> 00:46:55,396
It's the ultimate side effect.

832
00:46:58,065 --> 00:47:00,693
Mr. President, it is unacceptable

833
00:47:00,693 --> 00:47:03,821
that the monthly cost of cancer drugs

834
00:47:03,821 --> 00:47:07,366
has more than doubled over the last ten years.

835
00:47:07,366 --> 00:47:09,452
In the United States of America,

836
00:47:09,452 --> 00:47:12,663
you should not be forced into bankruptcy

837
00:47:12,663 --> 00:47:16,250
because you are diagnosed with cancer.

838
00:47:16,250 --> 00:47:20,504
When I first recurred
to stage 4 metastatic breast cancer,

839
00:47:20,504 --> 00:47:22,131
within a couple of months,

840
00:47:22,131 --> 00:47:27,261
my insurance company
started pushing me to apply for disability,

841
00:47:27,261 --> 00:47:31,265
so then in two years
I'd have to go on Medicare,

842
00:47:31,265 --> 00:47:35,811
and they hired some third-party consulting firm

843
00:47:35,811 --> 00:47:38,522
that would call me at night and send me paperwork

844
00:47:38,522 --> 00:47:41,567
and push me to do this.

845
00:47:41,567 --> 00:47:47,156
So, I did it because they threatened
to cancel my insurance.

846
00:47:47,156 --> 00:47:50,117
And then in December,
the Friday before Christmas,

847
00:47:50,117 --> 00:47:53,245
I was hooked up to an IV getting treatment,

848
00:47:53,245 --> 00:47:57,958
and my broker calls from my health insurance

849
00:47:57,958 --> 00:48:02,630
and tells me that the insurance company
found a small little caveat

850
00:48:02,630 --> 00:48:05,341
and cancelled my policy.

851
00:48:05,341 --> 00:48:09,929
Thank goodness I was able to apply for the ACA,

852
00:48:09,929 --> 00:48:13,057
but because of our insurance premiums

853
00:48:13,057 --> 00:48:17,394
and my copays for my drugs,

854
00:48:17,394 --> 00:48:19,105
now we have our house on the market

855
00:48:19,105 --> 00:48:23,567
because we really can't afford
to live where we live anymore

856
00:48:23,567 --> 00:48:29,532
because my healthcare costs
are just too high and devastating for us.

857
00:48:36,080 --> 00:48:41,210
The only thing worse than finding out
there's no cure for your disease

858
00:48:41,210 --> 00:48:44,713
is finding out there's a cure
but you can't afford it.

859
00:48:44,713 --> 00:48:48,509
They come back
from having run your credit and say,

860
00:48:48,509 --> 00:48:52,388
"You don't have enough money
to have this disease."

861
00:48:52,388 --> 00:48:56,225
A lot of these drug companies
will give you their drug,

862
00:48:56,225 --> 00:49:01,021
but you have to be within a certain
income restriction for those plans.

863
00:49:01,021 --> 00:49:04,692
So, for example, I don't work,

864
00:49:04,692 --> 00:49:07,903
I can't work, I'm sick, I've been sick.

865
00:49:07,903 --> 00:49:10,364
My husband works,
my husband works very hard

866
00:49:10,364 --> 00:49:13,742
to keep us in our home
which we've had to remortgage

867
00:49:13,742 --> 00:49:16,328
because of my disease.

868
00:49:16,328 --> 00:49:21,375
And your spouse's income now
knocks you out of those programs,

869
00:49:21,375 --> 00:49:25,171
so you have to get divorced

870
00:49:25,171 --> 00:49:28,465
so that your income is the zero that it is,

871
00:49:28,465 --> 00:49:33,012
and that's usually referred to
as involuntary divorce.

872
00:49:33,012 --> 00:49:37,016
So now you're getting your copays
kind of taken care of through these programs,

873
00:49:37,016 --> 00:49:39,852
but now you die.

874
00:49:39,852 --> 00:49:44,565
Your spouse has to be left your assets

875
00:49:44,565 --> 00:49:47,443
and now has to pay tax on those assets,

876
00:49:47,443 --> 00:49:51,238
so it's like you end up paying
one way or another.

877
00:49:51,238 --> 00:49:55,743
Either way, the diagnosis comes
with the price tag of losing everything,

878
00:49:55,743 --> 00:49:59,038
not just for you but whoever survives you.

879
00:50:08,422 --> 00:50:11,675
Well, before we discuss

880
00:50:11,675 --> 00:50:16,805
whether a particular company
is charging too much or making too much,

881
00:50:16,805 --> 00:50:20,267
let's remember that they're just playing
the game that they're handed.

882
00:50:20,267 --> 00:50:24,521
So, if a company charges a lot of money,

883
00:50:24,521 --> 00:50:28,692
they're basically just doing
what the system is inviting them to do anyway.

884
00:50:28,692 --> 00:50:31,237
It's basically capitalism.

885
00:50:31,237 --> 00:50:34,073
So, are there other areas of the economy

886
00:50:34,073 --> 00:50:36,617
where we tell people,
"You can't make that much"?

887
00:50:36,617 --> 00:50:40,663
We have invited them
to innovate these new therapies

888
00:50:40,663 --> 00:50:42,331
and then gouge the system,

889
00:50:42,331 --> 00:50:46,001
but it is the system
that they were handed to work with.

890
00:50:46,001 --> 00:50:47,753
The system needs to change.

891
00:50:51,382 --> 00:50:54,510
The United States grants patents for inventions,

892
00:50:54,510 --> 00:50:56,637
which are essentially lawful monopolies

893
00:50:56,637 --> 00:50:59,098
that last up to 20 years.

894
00:50:59,098 --> 00:51:02,101
This is absolutely in step with the American spirit

895
00:51:02,101 --> 00:51:05,062
to encourage and embolden innovation,

896
00:51:05,062 --> 00:51:07,022
but these patents become complicated

897
00:51:07,022 --> 00:51:10,192
when their management
causes suffering or death.

898
00:51:10,192 --> 00:51:12,403
Drug patents are a financing mechanism.

899
00:51:12,403 --> 00:51:15,364
It's a way we finance research and development.

900
00:51:15,364 --> 00:51:16,532
It's not working.

901
00:51:16,532 --> 00:51:20,452
There's no question that brand name manufacturers

902
00:51:20,452 --> 00:51:23,914
engage in what are called evergreening techniques

903
00:51:23,914 --> 00:51:25,916
or life cycle management

904
00:51:25,916 --> 00:51:30,212
where they'll take a drug that is very profitable

905
00:51:30,212 --> 00:51:33,132
and they'll do everything they can

906
00:51:33,132 --> 00:51:36,010
to extend their patent.

907
00:51:36,010 --> 00:51:38,637
So if you make a small tweak to a molecule

908
00:51:38,637 --> 00:51:42,266
or if you come up
with a slightly different development process,

909
00:51:42,266 --> 00:51:44,518
then you can earn a new patent.

910
00:51:44,518 --> 00:51:48,689
And that way, when a drug's patent
is getting ready to expire,

911
00:51:48,689 --> 00:51:51,233
the company seeks patents
not on the drug,

912
00:51:51,233 --> 00:51:53,027
but on all these externalities,

913
00:51:53,027 --> 00:51:56,238
and then gets another bunch of years
of patent protection.

914
00:51:56,238 --> 00:51:59,533
How is it okay that a drug company can take,

915
00:51:59,533 --> 00:52:02,745
instead of the right-handed version of the molecule,

916
00:52:02,745 --> 00:52:04,788
take the left-handed version of the molecule,

917
00:52:04,788 --> 00:52:07,541
which is basically a mirror image
of the same molecule,

918
00:52:07,541 --> 00:52:10,586
get it patented as a brand new discovery,

919
00:52:10,586 --> 00:52:12,629
and then market it as a new drug?

920
00:52:12,629 --> 00:52:15,841
And we saw when Prilosec became Nexium,

921
00:52:15,841 --> 00:52:18,719
the old purple pill became the new purple pill.

922
00:52:18,719 --> 00:52:21,889
Essentially no clinical advantage,

923
00:52:21,889 --> 00:52:24,641
virtually no molecular difference
of any consequence.

924
00:52:24,641 --> 00:52:29,855
That type of evergreening strategy
I think is inappropriate and wasteful.

925
00:52:29,855 --> 00:52:33,192
And what governments have to realize
is that companies

926
00:52:33,192 --> 00:52:35,861
have become so powerful
through these monopolies

927
00:52:35,861 --> 00:52:37,654
that they can't even regulate them anymore.

928
00:52:37,654 --> 00:52:41,784
Can the governments regulate
legal monopolies on drugs

929
00:52:41,784 --> 00:52:44,787
in a way that benefits the public?

930
00:52:44,787 --> 00:52:47,206
No. The evidence is no.

931
00:52:49,500 --> 00:52:53,003
Insulin prices on the rise,
and it could have a big impact

932
00:52:53,003 --> 00:52:57,049
on the growing number
of people with diabetes.

933
00:52:57,049 --> 00:53:01,512
A new report finds the price of insulin
has tripled in ten years' time,

934
00:53:01,512 --> 00:53:04,890
a painful price for many
of the 29 million people

935
00:53:04,890 --> 00:53:06,975
in the United States with diabetes.

936
00:53:06,975 --> 00:53:10,896
Those high prices combined
with rising insurance deductibles

937
00:53:10,896 --> 00:53:15,818
mean many people who rely on insulin
are left facing impossible choices.

938
00:53:27,329 --> 00:53:31,250
I always remember insulin being

939
00:53:31,250 --> 00:53:36,004
a very easy-to-obtain, cheap drug.

940
00:53:36,004 --> 00:53:43,095
I remember my mom would pay $15
every three months.

941
00:53:43,095 --> 00:53:46,098
Whereas, you know, fast forward to today,

942
00:53:46,098 --> 00:53:52,020
the most recent price I heard was $342.99 for a vial.

943
00:53:53,063 --> 00:53:54,773
That's unheard of.

944
00:53:54,773 --> 00:53:57,526
You know, I'll never have a choice
not to buy insulin.

945
00:53:57,526 --> 00:54:00,195
I'll always have to pay what they charge.

946
00:54:00,195 --> 00:54:02,489
I have to have insulin

947
00:54:02,489 --> 00:54:05,576
every second of every day to stay alive.

948
00:54:07,369 --> 00:54:10,873
I've calculated up the price of my life.

949
00:54:10,873 --> 00:54:16,503
It will cost over $7.5 million,

950
00:54:16,503 --> 00:54:18,672
just in insulin, just for me,

951
00:54:18,672 --> 00:54:21,967
to keep me alive till I'm 70 years old.

952
00:54:21,967 --> 00:54:25,012
Insulin is a life-or-death medication.

953
00:54:25,012 --> 00:54:27,264
Between 2002 and 2013,

954
00:54:27,264 --> 00:54:29,558
the price of insulin more than tripled

955
00:54:29,558 --> 00:54:32,352
to more than $700 per patient.

956
00:54:32,352 --> 00:54:35,397
Federal lawsuit accuses
the three insulin manufacturers

957
00:54:35,397 --> 00:54:37,357
of conspiring to raise their prices.

958
00:54:37,357 --> 00:54:38,942
Just coincidentally,

959
00:54:38,942 --> 00:54:41,904
it happens that the three major suppliers of insulin

960
00:54:41,904 --> 00:54:43,947
seem to be raising their prices

961
00:54:43,947 --> 00:54:46,992
at the same exact time at the same level.

962
00:54:46,992 --> 00:54:51,079
So I think you have to be very naive
not to believe that there is collusion.

963
00:54:53,123 --> 00:54:56,001
Put a critical eye on the pricing history

964
00:54:56,001 --> 00:54:58,629
of two primary insulin drugs

965
00:54:58,629 --> 00:55:01,006
and you'll notice a pattern.

966
00:55:01,006 --> 00:55:05,135
Since 2001, the cost of both drugs

967
00:55:05,135 --> 00:55:08,388
has risen simultaneously,

968
00:55:08,388 --> 00:55:12,809
making their price history nearly indistinguishable.

969
00:55:12,809 --> 00:55:14,811
At least when it comes to insulin,

970
00:55:14,811 --> 00:55:18,649
where the original discoverers, Banting and Best,

971
00:55:18,649 --> 00:55:21,527
gave away the insulin patent for $3

972
00:55:21,527 --> 00:55:24,154
so that this wouldn't happen.

973
00:55:24,154 --> 00:55:28,450
In 1923, Frederick Banting,
Charles Best, and James Collip,

974
00:55:28,450 --> 00:55:32,579
the team that first discovered and refined
what is now known as insulin,

975
00:55:32,579 --> 00:55:34,790
made a move for the common good:

976
00:55:34,790 --> 00:55:38,544
They sold the patent for insulin
to the University of Toronto

977
00:55:38,544 --> 00:55:40,879
for just $1 each.

978
00:55:40,879 --> 00:55:44,508
Much like Jonas Salk,
their intent was to let the world benefit

979
00:55:44,508 --> 00:55:46,635
from their discovery, stating,

980
00:55:46,635 --> 00:55:50,222
"When the details of the method
of preparation are published,

981
00:55:50,222 --> 00:55:53,308
anyone would be free to prepare the extract,

982
00:55:53,308 --> 00:55:56,895
but no one could secure a profitable monopoly."

983
00:55:56,895 --> 00:56:00,607
Shortly after, the University of Toronto
teamed up with Eli Lilly

984
00:56:00,607 --> 00:56:04,361
to mass-produce insulin
under a royalty-free agreement.

985
00:56:04,361 --> 00:56:07,739
The profits would then be put back
into research and development

986
00:56:07,739 --> 00:56:10,075
at the university.

987
00:56:10,075 --> 00:56:13,203
It wasn't long, however,
before drug companies

988
00:56:13,203 --> 00:56:16,665
had figured out a way
to turn a good profit on insulin.

989
00:56:16,665 --> 00:56:20,502
By 1941, Eli Lilly
and two other pharmaceutical companies

990
00:56:20,502 --> 00:56:24,756
were indicted for an alleged
insulin price-fixing scheme.

991
00:56:24,756 --> 00:56:29,553
It was a charge that Lilly would settle
in a no-contest agreement.

992
00:56:29,553 --> 00:56:32,306
Sadly, after the development of insulin,

993
00:56:32,306 --> 00:56:35,934
Eli Lilly would start to make
small adjustments to the research

994
00:56:35,934 --> 00:56:38,854
in order to seek
their own patents on the drug

995
00:56:38,854 --> 00:56:43,025
and completely undermine
the intention of the inventors.

996
00:56:43,025 --> 00:56:46,320
Somehow, with really no innovations,

997
00:56:46,320 --> 00:56:49,656
the same drug, insulin,
the prices keep escalating.

998
00:56:49,656 --> 00:56:51,533
That makes no sense at all,

999
00:56:51,533 --> 00:56:54,828
and yet this diabetes is an illness that we've seen

1000
00:56:54,828 --> 00:56:57,205
that Americans suffer from young and old.

1001
00:56:57,205 --> 00:57:00,584
So what I see is, people all over my state,

1002
00:57:00,584 --> 00:57:03,920
seniors that come up to me
and say that they're saving

1003
00:57:03,920 --> 00:57:07,466
the injectors from their insulin

1004
00:57:07,466 --> 00:57:10,677
just so they have a few more drops in each tube.

1005
00:57:10,677 --> 00:57:12,554
That is happening right now.

1006
00:57:12,554 --> 00:57:14,640
This is the United States of America.

1007
00:57:14,640 --> 00:57:17,893
Our seniors shouldn't be having to do that.

1008
00:57:17,893 --> 00:57:19,561
What's even more shocking,

1009
00:57:19,561 --> 00:57:24,858
to this day, there are still
no low-priced generics on the market.

1010
00:57:24,858 --> 00:57:27,986
Somehow, these three manufacturers
have figured out a way

1011
00:57:27,986 --> 00:57:32,282
to extend their patent lives
for nearly a century.

1012
00:57:32,282 --> 00:57:35,077
One of the things that is really distasteful

1013
00:57:35,077 --> 00:57:40,332
is that the big pharmaceutical companies
currently pay off generics

1014
00:57:40,332 --> 00:57:42,834
to keep their products off the market.

1015
00:57:42,834 --> 00:57:46,546
It's called pay-for-delay,
and it screws people all the time.

1016
00:57:46,546 --> 00:57:48,924
But I mean, how long can they keep doing that?

1017
00:57:48,924 --> 00:57:50,967
-Indefinitely?
-It's just gonna keep escalating.

1018
00:57:50,967 --> 00:57:53,261
Look, if you're a company in any industry,

1019
00:57:53,261 --> 00:57:55,347
and a monopoly is just put on your lap,

1020
00:57:55,347 --> 00:57:58,392
you're gonna go for it,
that's just the facts.

1021
00:57:58,392 --> 00:58:02,437
These evergreening techniques
are becoming common practice.

1022
00:58:02,437 --> 00:58:06,316
If there's a loophole,
the pharmaceutical industry will find it.

1023
00:58:06,316 --> 00:58:08,193
Check out shares of Allergan.

1024
00:58:08,193 --> 00:58:10,278
They've been rising higher this afternoon

1025
00:58:10,278 --> 00:58:12,072
on an announcement about patents

1026
00:58:12,072 --> 00:58:14,574
around one of their big eye drugs, Restasis.

1027
00:58:14,574 --> 00:58:16,535
Now, this is a bit of a complicated story,

1028
00:58:16,535 --> 00:58:19,079
but it's absolutely amazing when you really dig into it.

1029
00:58:19,079 --> 00:58:22,374
So what they've done, somewhat incredibly,

1030
00:58:22,374 --> 00:58:27,212
is they've transferred the patent
to an Indian tribe in northern New York,

1031
00:58:27,212 --> 00:58:31,174
and then the tribe is licensing the patent
back to Allergan,

1032
00:58:31,174 --> 00:58:34,344
and then the tribe is arguing that,
as a sovereign nation,

1033
00:58:34,344 --> 00:58:39,224
as a sovereign entity,
the patent office no longer has the right

1034
00:58:39,224 --> 00:58:41,268
to be involved in a patent dispute

1035
00:58:41,268 --> 00:58:45,230
because it can't override
the sovereignty of the Indian tribe.

1036
00:58:45,230 --> 00:58:48,275
This strategy potentially allows Allergan

1037
00:58:48,275 --> 00:58:51,403
to dodge patent challenges from rival companies.

1038
00:58:51,403 --> 00:58:53,321
I just spoke with Allergan CEO Brent Saunders.

1039
00:58:53,321 --> 00:58:57,826
He says he thinks this is the first time
this system has ever been used in this way.

1040
00:58:57,826 --> 00:59:00,954
I think there's a lot of misunderstanding
on why we did it.

1041
00:59:00,954 --> 00:59:03,165
It wasn't desperation, it was tenacity.

1042
00:59:03,165 --> 00:59:05,751
You describe this as offensive behavior.

1043
00:59:05,751 --> 00:59:07,419
I think it's terribly offensive.

1044
00:59:07,419 --> 00:59:10,172
I think it violates the spirit of the law,

1045
00:59:10,172 --> 00:59:13,425
I think it really sticks it to American consumers,

1046
00:59:13,425 --> 00:59:17,095
and I think in particular,
Allergan is a company that talks a good game

1047
00:59:17,095 --> 00:59:20,056
about wanting to be good to consumers

1048
00:59:20,056 --> 00:59:23,059
and they have a social contract, yadda-yadda-yadda,

1049
00:59:23,059 --> 00:59:25,270
and then they do things like this.

1050
00:59:29,483 --> 00:59:34,404
I solemnly pledge to dedicate my life
in the service of humanity.

1051
00:59:34,404 --> 00:59:37,783
I will practice medicine
with conscience and dignity.

1052
00:59:37,783 --> 00:59:42,704
The health and life of my patient
will be my first consideration.

1053
00:59:44,414 --> 00:59:47,334
Doctors swear the Hippocratic Oath,

1054
00:59:47,334 --> 00:59:50,045
a pledge that they will uphold a certain morality

1055
00:59:50,045 --> 00:59:53,006
when it comes to their practice.

1056
00:59:53,006 --> 00:59:55,884
Is it reasonable to expect
pharmaceutical companies

1057
00:59:55,884 --> 00:59:58,428
to be held to the same standards?

1058
00:59:58,428 --> 01:00:01,223
Do you think pharmaceutical companies

1059
01:00:01,223 --> 01:00:04,059
should operate under a different moral code

1060
01:00:04,059 --> 01:00:05,769
compared to other companies?

1061
01:00:05,769 --> 01:00:07,813
Well...

1062
01:00:07,813 --> 01:00:12,359
Should pharmaceutical companies
be guided by a moral compass?

1063
01:00:13,985 --> 01:00:17,030
Should pharmaceutical companies
have a moral compass?

1064
01:00:21,034 --> 01:00:23,495
That's a good question.

1065
01:00:23,495 --> 01:00:26,540
Pharmaceutical companies
absolutely should have a moral compass.

1066
01:00:26,540 --> 01:00:31,253
Absolutely, pharmaceutical companies
should act with moral integrity

1067
01:00:31,253 --> 01:00:32,796
when they are dealing with drugs

1068
01:00:32,796 --> 01:00:35,590
that make the difference
between life and death for patients.

1069
01:00:35,590 --> 01:00:39,719
The notion of a moral code
governing what they do

1070
01:00:39,719 --> 01:00:41,513
doesn't make much sense to me.

1071
01:00:41,513 --> 01:00:44,224
I think companies should have some morals.

1072
01:00:44,224 --> 01:00:48,311
I mean, there are some lines
that they shouldn't cross.

1073
01:00:48,311 --> 01:00:52,023
I think all of healthcare is a right, okay.

1074
01:00:52,023 --> 01:00:55,652
There's a long discussion behind that.

1075
01:00:55,652 --> 01:00:57,320
They are not like medicine.

1076
01:00:57,320 --> 01:00:58,530
They are a company.

1077
01:00:58,530 --> 01:01:02,534
They are no different than big oil,

1078
01:01:02,534 --> 01:01:05,328
Coca-Cola,

1079
01:01:05,328 --> 01:01:07,622
maybe the tobacco industry.

1080
01:01:07,622 --> 01:01:10,959
The sad reality is that they are corporations,

1081
01:01:10,959 --> 01:01:13,503
and they are answerable to their shareholders,

1082
01:01:13,503 --> 01:01:16,506
and that doesn't make it right or good,

1083
01:01:16,506 --> 01:01:20,010
but it's a little naive to think
that a company that makes drugs

1084
01:01:20,010 --> 01:01:22,929
is somehow gonna have
a different set of morals

1085
01:01:22,929 --> 01:01:26,808
than a company that makes
gasoline or computers or cars.

1086
01:01:26,808 --> 01:01:32,314
Corporations are nothing more
than a conglomeration of individuals,

1087
01:01:32,314 --> 01:01:35,734
and those individuals
have their own moral compasses,

1088
01:01:35,734 --> 01:01:38,486
and oftentimes we see that,
for some reason,

1089
01:01:38,486 --> 01:01:40,405
people check those at the door

1090
01:01:40,405 --> 01:01:43,283
when they walk into their offices
and they're making decisions

1091
01:01:43,283 --> 01:01:46,953
because they put something else
ahead of what is right.

1092
01:01:48,580 --> 01:01:50,832
Imagine, for a moment,
popping a pill before bed

1093
01:01:50,832 --> 01:01:53,126
that costs about $13.50.

1094
01:01:53,126 --> 01:01:55,295
Now imagine waking up the next morning

1095
01:01:55,295 --> 01:02:00,258
to find that the price of the exact same pill
jumped to $750 overnight.

1096
01:02:00,258 --> 01:02:03,803
When Shkreli increased Daraprim's price 5000%,

1097
01:02:03,803 --> 01:02:06,473
he complained that he was being unfairly vilified.

1098
01:02:06,473 --> 01:02:09,059
There are literally a dozen companies just like ours

1099
01:02:09,059 --> 01:02:12,812
that raise prices dramatically,
and higher, might I add, than our company,

1100
01:02:12,812 --> 01:02:15,899
and I don't see those companies
getting the criticism that I got.

1101
01:02:15,899 --> 01:02:17,484
Why do they keep coming after you?

1102
01:02:17,484 --> 01:02:19,527
You know, I just can't fathom.

1103
01:02:19,527 --> 01:02:21,655
I guess it might have something to do
with me being very handsome,

1104
01:02:21,655 --> 01:02:24,115
very wealthy, and very funny.

1105
01:02:24,115 --> 01:02:27,702
Last time you heard the name
Martin Shkreli on this broadcast,

1106
01:02:27,702 --> 01:02:30,789
he drastically raised the price
of a life-saving drug.

1107
01:02:30,789 --> 01:02:32,499
Tonight, the head of a drug company,

1108
01:02:32,499 --> 01:02:34,834
who's accused of gouging patients,

1109
01:02:34,834 --> 01:02:36,711
says he should be thanked.

1110
01:02:36,711 --> 01:02:38,505
There's no doubt I'm a capitalist,

1111
01:02:38,505 --> 01:02:41,174
I'm trying to create a big drug company,
a profitable drug company.

1112
01:02:41,174 --> 01:02:42,801
I now walk down the streets of Manhattan,

1113
01:02:42,801 --> 01:02:45,887
people ask me for autographs,
they want selfies, I have a lot of fans.

1114
01:02:47,847 --> 01:02:49,766
He is a brash self-promoter

1115
01:02:49,766 --> 01:02:52,894
who's called himself
the world's most eligible bachelor.

1116
01:02:52,894 --> 01:02:55,689
This is a city where success is prized.

1117
01:02:55,689 --> 01:02:58,608
It is a city if you make it here,
you can make it anywhere.

1118
01:02:58,608 --> 01:03:00,735
I wonder if you would do anything differently.

1119
01:03:00,735 --> 01:03:03,071
I probably would have raised the price higher

1120
01:03:03,071 --> 01:03:05,615
is probably what I would have done.

1121
01:03:05,615 --> 01:03:08,660
I'm a child of immigrants
that are janitors from Brooklyn.

1122
01:03:08,660 --> 01:03:10,578
I've made myself into an enormous fortune.

1123
01:03:10,578 --> 01:03:12,831
In response to all of this attention,

1124
01:03:12,831 --> 01:03:15,667
and doctors and patient groups
saying they can't access this drug,

1125
01:03:15,667 --> 01:03:17,377
are you gonna change the price?

1126
01:03:17,377 --> 01:03:18,586
No.

1127
01:03:21,006 --> 01:03:24,217
When Martin Shkreli, the infamous "Pharma Bro"

1128
01:03:24,217 --> 01:03:26,469
who took a one-dollar-a-day pill

1129
01:03:26,469 --> 01:03:29,639
and raised that pill to $750

1130
01:03:29,639 --> 01:03:31,558
for no rationale other than he could

1131
01:03:31,558 --> 01:03:35,020
because he was the only manufacturer,
or provided the only source,

1132
01:03:35,020 --> 01:03:37,814
that's not illegal, but it is immoral.

1133
01:03:37,814 --> 01:03:42,235
People's lives are at stake
because of the price increases you impose

1134
01:03:42,235 --> 01:03:45,488
and the access problems
that have been created.

1135
01:03:45,488 --> 01:03:49,492
You've been viewed as
a so-called bad boy of pharma.

1136
01:03:49,492 --> 01:03:51,036
Are you listening?

1137
01:03:51,036 --> 01:03:52,203
Yes.

1138
01:03:52,203 --> 01:03:55,749
The way I see it,
you can go down in history

1139
01:03:55,749 --> 01:04:00,670
as the poster boy
for greedy drug company executives,

1140
01:04:00,670 --> 01:04:03,048
or you can change the system.

1141
01:04:03,048 --> 01:04:06,593
In this industry, sadly,

1142
01:04:06,593 --> 01:04:10,096
they say something like this:

1143
01:04:10,096 --> 01:04:14,976
"Yeah, we'll go in and we will take
the blows of the Congress

1144
01:04:14,976 --> 01:04:17,437
because they'll be upset for a little while,

1145
01:04:17,437 --> 01:04:20,106
but all we gotta do is basically rope-a-dope."

1146
01:04:20,106 --> 01:04:26,112
A 30% discount on a 500% price increase

1147
01:04:26,112 --> 01:04:27,614
hardly makes a dent.

1148
01:04:27,614 --> 01:04:29,741
Does that sound like a good deal to you?

1149
01:04:29,741 --> 01:04:32,619
What we try to do is address the issue

1150
01:04:32,619 --> 01:04:34,662
from a portfolio point of view.

1151
01:04:34,662 --> 01:04:36,039
Let's talk about R&D.

1152
01:04:36,039 --> 01:04:38,124
How much did Mylan spend

1153
01:04:38,124 --> 01:04:40,710
on research and development products in 2015?

1154
01:04:40,710 --> 01:04:42,712
Actually, we've spent, over the years,

1155
01:04:42,712 --> 01:04:46,132
trying to do several things that failed and trying to--

1156
01:04:46,132 --> 01:04:50,136
That's not what I asked you,
I said how much did you spend

1157
01:04:50,136 --> 01:04:55,100
on R&D in 2015?

1158
01:04:55,100 --> 01:04:56,810
I mean, I feel like you're just--

1159
01:04:56,810 --> 01:04:59,145
you're not giving me answers, ma'am.

1160
01:04:59,145 --> 01:05:01,106
That's pharma's philosophy.

1161
01:05:01,106 --> 01:05:04,400
They know they're gonna take the blow,

1162
01:05:04,400 --> 01:05:08,947
so they'll come in and the chief executive
will get hit a few times,

1163
01:05:08,947 --> 01:05:12,700
and then they'll leave and say...

1164
01:05:12,700 --> 01:05:14,327
Then we can go right back

1165
01:05:14,327 --> 01:05:16,704
and just continue to do what we've been doing.

1166
01:05:16,704 --> 01:05:19,415
I think when people look back
in 10 or 20 or 30 years

1167
01:05:19,415 --> 01:05:23,336
and write the history of drug pricing
in the early 21st century,

1168
01:05:23,336 --> 01:05:29,425
they're gonna be struck by two remarkable
and often inexcusable trends.

1169
01:05:29,425 --> 01:05:32,262
Between the gaming of the patent system

1170
01:05:32,262 --> 01:05:34,848
or the exclusivity and licensing system

1171
01:05:34,848 --> 01:05:37,642
for the old drugs, which is unconscionable,

1172
01:05:37,642 --> 01:05:40,603
and the charging of hundreds
of thousands of dollars a year

1173
01:05:40,603 --> 01:05:45,608
for a new drug that's still on patent,
which is also very, very troubling,

1174
01:05:45,608 --> 01:05:46,901
people will look back and say,

1175
01:05:46,901 --> 01:05:49,863
"That is where the industry
began slitting its own throat

1176
01:05:49,863 --> 01:05:52,073
and basically begging to be regulated

1177
01:05:52,073 --> 01:05:54,951
because people are just fed up
with those kinds of prices."

1178
01:05:59,122 --> 01:06:01,332
Be it a single-payer system,

1179
01:06:01,332 --> 01:06:04,544
collective bargaining, or pricing committees,

1180
01:06:04,544 --> 01:06:08,339
there are many ways government
can regulate drug prices.

1181
01:06:08,339 --> 01:06:13,094
The United States is the only
industrialized country in the world

1182
01:06:13,094 --> 01:06:17,432
that operates on a system
of whatever the traffic will bear.

1183
01:06:17,432 --> 01:06:19,684
Aside from everything else,

1184
01:06:19,684 --> 01:06:21,895
the government just doesn't negotiate for prices.

1185
01:06:21,895 --> 01:06:23,980
I mean, some people know that, for example,

1186
01:06:23,980 --> 01:06:26,274
that Medicare is forbidden to negotiate,

1187
01:06:26,274 --> 01:06:28,776
but I don't think the majority of people understand that.

1188
01:06:28,776 --> 01:06:30,653
I mean, that would be such an easy fix.

1189
01:06:30,653 --> 01:06:32,071
The reason we pay more

1190
01:06:32,071 --> 01:06:35,533
is because all the other countries
negotiate with the drug companies

1191
01:06:35,533 --> 01:06:36,701
and we don't.

1192
01:06:36,701 --> 01:06:39,871
Canada, Britain, Germany, Switzerland.

1193
01:06:39,871 --> 01:06:42,999
Pick any developed country,
they all negotiate.

1194
01:06:42,999 --> 01:06:47,128
Take the hepatitis C drug, sofosbuvir, for example.

1195
01:06:47,128 --> 01:06:52,675
In 2016, the same drug cost 37% less in the U.K.,

1196
01:06:52,675 --> 01:06:59,349
66% less in Spain, and 99% less in Egypt and India.

1197
01:06:59,349 --> 01:07:02,560
It appears that there's an opinion in the U.S.

1198
01:07:02,560 --> 01:07:06,397
that medicines made overseas
are inferior or even dangerous.

1199
01:07:06,397 --> 01:07:09,651
Well, all of the factories
that are manufacturing these generics

1200
01:07:09,651 --> 01:07:14,072
are licensed by the FDA
and the World Health Organization,

1201
01:07:14,072 --> 01:07:18,451
and in the case of hep C meds,
they're licensed by Gilead anyway,

1202
01:07:18,451 --> 01:07:23,414
so they're absolutely identical
in every way to the expensive product,

1203
01:07:23,414 --> 01:07:28,419
and the reality is that probably 50%
of the prescription medicines in the U.S.

1204
01:07:28,419 --> 01:07:29,963
are made in India anyway.

1205
01:07:29,963 --> 01:07:34,509
Is it that somehow we're carrying
a greater load because we're richer

1206
01:07:34,509 --> 01:07:37,220
or because we're financing R&D
for the rest of the world?

1207
01:07:37,220 --> 01:07:38,930
No. We're carrying a greater load

1208
01:07:38,930 --> 01:07:43,351
because the drug companies
built a system that precludes us

1209
01:07:43,351 --> 01:07:46,312
from negotiating over prices
in this country.

1210
01:07:46,312 --> 01:07:48,940
Everybody else does,
so we pay more.

1211
01:07:48,940 --> 01:07:52,652
As a rule,
pharmaceutical industry always wins.

1212
01:07:52,652 --> 01:07:54,404
Last November in 2016,

1213
01:07:54,404 --> 01:07:58,574
we had an initiative on the ballot
in California, Prop 61,

1214
01:07:58,574 --> 01:08:01,744
that said they could negotiate for prices.

1215
01:08:01,744 --> 01:08:06,416
Do you have any idea
what the pharmaceutical industry is spending

1216
01:08:06,416 --> 01:08:09,252
against Proposition 61?

1217
01:08:09,252 --> 01:08:16,634
They are spending $126 million!

1218
01:08:16,634 --> 01:08:22,223
$126 million

1219
01:08:22,223 --> 01:08:26,978
to defeat a proposal that will lower drug costs

1220
01:08:26,978 --> 01:08:28,896
for the people of California.

1221
01:08:28,896 --> 01:08:31,816
It is incomprehensible!

1222
01:08:31,816 --> 01:08:35,361
The time is long overdue
for the American people

1223
01:08:35,361 --> 01:08:38,114
to stand up to the greed
of the pharmaceutical industry.

1224
01:08:38,114 --> 01:08:40,742
We should be doing it here in Washington,

1225
01:08:40,742 --> 01:08:42,493
but they own Washington, unfortunately.

1226
01:08:52,670 --> 01:08:56,215
Well, they have spent, since 1998,

1227
01:08:56,215 --> 01:08:59,135
over $3 billion in lobbying.

1228
01:08:59,135 --> 01:09:02,680
$3 billion in lobbying,

1229
01:09:02,680 --> 01:09:06,476
not to mention enormous amounts of money
in campaign contributions.

1230
01:09:06,476 --> 01:09:08,853
Not only are they the top lobbying industry,

1231
01:09:08,853 --> 01:09:11,814
but they outspend every other American industry

1232
01:09:11,814 --> 01:09:14,567
by at least 44%.

1233
01:09:14,567 --> 01:09:17,695
This gives them unparalleled lobbying power.

1234
01:09:17,695 --> 01:09:22,075
Donald Trump got elected
to drain the swamp in Washington.

1235
01:09:22,075 --> 01:09:24,410
If anybody ever did drain the swamp,

1236
01:09:24,410 --> 01:09:26,537
what they would find lying around the bottom

1237
01:09:26,537 --> 01:09:30,833
is four or five drug industry lobbyists
for every representative in Washington.

1238
01:09:30,833 --> 01:09:33,795
The New York Times sort of intimated
this morning in their op-ed

1239
01:09:33,795 --> 01:09:36,297
that Congress yells a lot but does nothing.

1240
01:09:36,297 --> 01:09:37,632
I couldn't agree more.

1241
01:09:37,632 --> 01:09:39,884
Because the lobbying,
and you guys lobby too.

1242
01:09:39,884 --> 01:09:40,968
You lobby.

1243
01:09:40,968 --> 01:09:44,931
Is Congress too close
to the biotech and pharma industry?

1244
01:09:44,931 --> 01:09:49,519
They've got lobbyists everywhere

1245
01:09:49,519 --> 01:09:51,938
pushing for what they want.

1246
01:09:51,938 --> 01:09:54,941
The unfortunate realities
of politics in America

1247
01:09:54,941 --> 01:09:57,902
is that the larger
your lobbying trade group is

1248
01:09:57,902 --> 01:10:00,196
and the more money you can wield,

1249
01:10:00,196 --> 01:10:02,573
and they often call it dark money,

1250
01:10:02,573 --> 01:10:05,827
the dark money goes
to support electing politicians,

1251
01:10:05,827 --> 01:10:10,039
and that money absolutely influences
decisions that are made.

1252
01:10:11,707 --> 01:10:16,462
The reach of pharma's financial contributions
is staggering.

1253
01:10:16,462 --> 01:10:20,675
In 2016, out of the 100 members of the Senate,

1254
01:10:20,675 --> 01:10:25,054
93 senators accepted money from pharma.

1255
01:10:25,054 --> 01:10:27,432
A lobbyist has a lot of money at their disposal.

1256
01:10:27,432 --> 01:10:29,559
First of all, you can give contributions,

1257
01:10:29,559 --> 01:10:32,061
which is really the mother's milk of politics,

1258
01:10:32,061 --> 01:10:35,106
to virtually every congressman you need to impact,

1259
01:10:35,106 --> 01:10:36,858
and not just contributions,

1260
01:10:36,858 --> 01:10:39,318
you can raise significant sums of money for them

1261
01:10:39,318 --> 01:10:41,529
if you have a lot of resources.

1262
01:10:41,529 --> 01:10:45,199
You can, in essence,
buy your way through your issue

1263
01:10:45,199 --> 01:10:46,784
if you do it carefully.

1264
01:10:46,784 --> 01:10:51,581
The Congress of the United States of America

1265
01:10:51,581 --> 01:10:57,211
should be put up for malpractice
for not addressing this issue.

1266
01:10:57,211 --> 01:11:00,923
Mr. President, let us be frank, let us be honest.

1267
01:11:00,923 --> 01:11:06,304
The current political campaign finance system
is corrupt

1268
01:11:06,304 --> 01:11:08,848
and amounts to legalized bribery.

1269
01:11:08,848 --> 01:11:12,268
The pharmaceutical industry
has prevailed for almost a decade

1270
01:11:12,268 --> 01:11:15,980
here in Washington
in just wiping this issue off the agenda.

1271
01:11:15,980 --> 01:11:18,483
There's no discussion,
there are no votes,

1272
01:11:18,483 --> 01:11:22,111
we have not really done anything
to even try to act

1273
01:11:22,111 --> 01:11:25,865
on pharmaceutical prices
with a vote on the floor of the House

1274
01:11:25,865 --> 01:11:27,575
since 2007.

1275
01:11:29,327 --> 01:11:31,829
Last month, federal lawmakers from both parties

1276
01:11:31,829 --> 01:11:33,831
helped the industry block Senate legislation

1277
01:11:33,831 --> 01:11:37,543
to let Americans purchase lower-priced
FDA-approved medicines from Canada.

1278
01:11:37,543 --> 01:11:40,880
Right, so, that is absurd,
and by the way, again,

1279
01:11:40,880 --> 01:11:44,342
let's emphasize that it wasn't just Republicans,
it was Democrats as well.

1280
01:11:44,342 --> 01:11:49,055
Pharma's gone back and forth
as to whether or not they want to be partisan.

1281
01:11:49,055 --> 01:11:51,933
So in some eras,
you see pharma weighing in very much

1282
01:11:51,933 --> 01:11:53,434
for the Republican Party.

1283
01:11:53,434 --> 01:11:58,356
In other years, it was more equal
between the Democrats and the Republicans.

1284
01:11:58,356 --> 01:12:01,275
The reality is,
if you're a congressman,

1285
01:12:01,275 --> 01:12:04,612
they let you know
that if you do things that they like,

1286
01:12:04,612 --> 01:12:06,989
they will give you money;

1287
01:12:06,989 --> 01:12:09,492
if you do things they don't like,

1288
01:12:09,492 --> 01:12:11,244
they will give money to your opponent.

1289
01:12:11,244 --> 01:12:15,873
Just the threat of a campaign contribution
to an opponent

1290
01:12:15,873 --> 01:12:18,960
is all that's necessary
to be able to control a politician,

1291
01:12:18,960 --> 01:12:23,631
and it's why it's so difficult
to get any meaningful legislation advanced

1292
01:12:23,631 --> 01:12:27,176
at either the state or federal level
is because of all the money.

1293
01:12:27,176 --> 01:12:30,429
We have members here
who just love free trade.

1294
01:12:30,429 --> 01:12:33,641
We can bring any product you want in
from China,

1295
01:12:33,641 --> 01:12:37,603
you can get lettuce and tomato
coming from farms in Mexico,

1296
01:12:37,603 --> 01:12:40,523
but for some strange reason,

1297
01:12:40,523 --> 01:12:45,528
we cannot bring in brand-name drugs from Canada.

1298
01:12:45,528 --> 01:12:48,990
Just can't do it, can't figure out how to do it.

1299
01:12:48,990 --> 01:12:51,701
And everybody here knows what the reason is.

1300
01:12:51,701 --> 01:12:54,870
So you have a very wrong system,

1301
01:12:54,870 --> 01:12:56,956
a very immoral, at some level, system

1302
01:12:56,956 --> 01:13:00,918
that really, in essence,
comes down to bribery that is legal,

1303
01:13:00,918 --> 01:13:02,795
and that's what's gotta be changed,

1304
01:13:02,795 --> 01:13:06,007
but to change it, you've gotta get
the very members of Congress

1305
01:13:06,007 --> 01:13:09,176
who benefit from these bribes
to agree not to take them.

1306
01:13:15,141 --> 01:13:17,101
It's very, very hard

1307
01:13:17,101 --> 01:13:20,521
because of the reach
and influence and the money

1308
01:13:20,521 --> 01:13:24,025
that the drug corporations have
to do this work,

1309
01:13:24,025 --> 01:13:28,404
but there is enough anger
and there is enough energy

1310
01:13:28,404 --> 01:13:30,281
that we are making progress.

1311
01:13:30,281 --> 01:13:32,491
The era of modern medical research

1312
01:13:32,491 --> 01:13:35,161
has brought us undeniable breakthroughs

1313
01:13:35,161 --> 01:13:38,914
that have curbed illness and extended lifespans,

1314
01:13:38,914 --> 01:13:40,374
but at what cost?

1315
01:13:40,374 --> 01:13:43,044
Everyone looks gorgeous!

1316
01:13:43,044 --> 01:13:47,089
I feel like it's my calling--
if you want to call it that--

1317
01:13:47,089 --> 01:13:51,010
I feel like it's my job
to effect change

1318
01:13:51,010 --> 01:13:53,554
because I think it's really unfair

1319
01:13:53,554 --> 01:13:56,098
to have to be your own advocate to this level.

1320
01:13:59,602 --> 01:14:02,271
The drug companies are almost holding

1321
01:14:02,271 --> 01:14:04,440
people that are sick or chronically ill

1322
01:14:04,440 --> 01:14:06,776
or have some sort of a disease
or cancer or whatever,

1323
01:14:06,776 --> 01:14:08,319
they're holding us hostage.

1324
01:14:08,319 --> 01:14:11,530
Somewhere along the way,
the pharmaceutical industry

1325
01:14:11,530 --> 01:14:15,076
turned its back
on the very society that it serves,

1326
01:14:15,076 --> 01:14:19,413
pledging its loyalty to profit,
corrupting our political system,

1327
01:14:19,413 --> 01:14:22,500
and testing the breaking point
of our economy.

1328
01:14:22,500 --> 01:14:26,003
I'm not sure what a revolution
for sick people would look like,

1329
01:14:26,003 --> 01:14:29,048
but I do know that we need one.

1330
01:14:29,048 --> 01:14:32,301
If the healthy and well
could stand up with the sick,

1331
01:14:32,301 --> 01:14:33,844
we could get a lot done,

1332
01:14:33,844 --> 01:14:36,138
and we need to figure this one out together.

1333
01:14:36,138 --> 01:14:37,431
It can't go on.

1334
01:14:37,431 --> 01:14:41,227
It's not just that our healthcare
is way more expensive

1335
01:14:41,227 --> 01:14:43,145
than any other country on earth,

1336
01:14:43,145 --> 01:14:46,732
it's that there is no good end
to this path that we're on.

1337
01:14:46,732 --> 01:14:49,902
We have Stockholm syndrome,
we're just sort of like,

1338
01:14:49,902 --> 01:14:53,406
people are accepting horrible consequences
from the current system

1339
01:14:53,406 --> 01:14:55,491
because they think there's no alternative.

1340
01:14:55,491 --> 01:14:58,327
The important thing is
there is an alternative.

1341
01:14:58,327 --> 01:15:02,873
The alternative is to do something different
than what we're doing right now.

1342
01:15:02,873 --> 01:15:05,584
Something has to change.

1343
01:15:05,584 --> 01:15:08,671
Price regulation, patent reform,

1344
01:15:08,671 --> 01:15:10,756
industry transparency,

1345
01:15:10,756 --> 01:15:14,260
single-payer system, negotiation reform,

1346
01:15:14,260 --> 01:15:18,472
marketing regulations, anything has to change.

1347
01:15:18,472 --> 01:15:21,350
We are exposing to the world

1348
01:15:21,350 --> 01:15:26,105
just how greedy this pharmaceutical industry is.

1349
01:15:26,105 --> 01:15:28,315
Somebody has to say no.

1350
01:15:28,315 --> 01:15:32,528
Somebody has to react and say,
"It's not acceptable.

1351
01:15:32,528 --> 01:15:35,823
We can do better.
As a society, we can do better."

1352
01:15:35,823 --> 01:15:38,701
Everyone knows somebody who's sick,
who's been sick.

1353
01:15:38,701 --> 01:15:42,913
They want that person
to have better treatment options,

1354
01:15:42,913 --> 01:15:50,379
as I do, but it can't be a conversation
about what's that person worth to you?

1355
01:15:50,379 --> 01:15:53,799
It can't be that kind of conversation.

1356
01:15:53,799 --> 01:15:55,718
They will fight it,

1357
01:15:55,718 --> 01:15:58,512
they will try to buy our Congress,

1358
01:15:58,512 --> 01:16:01,140
they will stifle legislation,

1359
01:16:01,140 --> 01:16:03,726
and they will spend billions of dollars

1360
01:16:03,726 --> 01:16:07,521
to hang onto the system
that has given them their power.

1361
01:16:07,521 --> 01:16:11,734
Do not concentrate on, so much,
who you're fighting against;

1362
01:16:11,734 --> 01:16:14,320
concentrate on what you're fighting for.

1363
01:16:14,320 --> 01:16:16,655
One person can make a difference.

1364
01:16:16,655 --> 01:16:19,283
I think people need to get on the phone,

1365
01:16:19,283 --> 01:16:21,035
call their congressman, and say,

1366
01:16:21,035 --> 01:16:25,456
"Look, I want something done
about this drug pricing.

1367
01:16:25,456 --> 01:16:27,583
It's ridiculous."

1368
01:16:27,583 --> 01:16:29,668
They can be beaten.

1369
01:16:29,668 --> 01:16:34,965
They will be beaten if patients
and consumers stand up and say,

1370
01:16:34,965 --> 01:16:37,426
"No more, we're not gonna do this anymore."

1371
01:16:37,426 --> 01:16:40,387
It's the only way we have a chance to push back

1372
01:16:40,387 --> 01:16:43,849
against all the money and influence
that the drug companies have.

1373
01:16:45,768 --> 01:16:48,479
We have lost control of the industry

1374
01:16:48,479 --> 01:16:52,942
that holds our lives in the palm of their hand.

1375
01:16:52,942 --> 01:16:58,155
What, then, are we willing to do to get it back?

1376
01:16:58,155 --> 01:17:02,326
The answer can't be nothing!