Rich Man. Poor Man. Sick Man. Thief.

by Valerie Morales

Martin Shkreli was a high school dropout who became a pharmaceutical executive. He was known as PharmaBro, and when he swung big, he missed big. Then he got caught. Shkreli’s name is important in a Covid-19 context because but he recently asked a judge to release him from prison for compassionate reasons.

Compassion for the man who once told a former employee “I hope to see you and your four children homeless and will do whatever I can to assure this.”

His crimes were grotesque. Shkreli inflated the price of a drug called Daraprim. He was convicted of fraud in relation to two hedge funds and a pharmaceutical company. He was sentenced to seven years in prison.

In his plea for release, Shkreli said he wanted to begin research work on a corona vaccine as if every pharmaceutical company from here to the moon isn’t doing that very same thing. It was, I suppose, a decent enough argument if Shkreli wasn’t a corporate predator. Mercifully, Judge Kiyo Matsumato saw through his opportunism and called Shkreli delusional. “Defendant is a healthy 37-year old man with no recent history of pre-existing medical conditions that place him at a higher risk for Covid-19, and its potentially adverse effects, and he is confined in a facility where there are no Covid-19 cases.”

That Shkreli was asking for “compassion” as a reason for his get out of jail free card is the mother of all ironies since what landed Shkreli in jail was the opposite of compassion. He cheated investors out of millions. But it is what Shkreli did to AIDS patients that should have landed him in the slam longer than 7 years.

As CEO of Turing Pharmaceuticals, a company he founded, Shkreli purchased a generic drug used by AIDS patients, babies in particular. The drug Daraprim cost the average patient $13.50. Without remorse, Shkreli inflated the price to $750.00 a tablet. When that bit of malfeasance became public, Hillary Clinton and Bernie Sanders tweeted their outrage, and Donald Trump laid into him, calling him a brat.

As a business practice, Shkreli hunted for specific drugs he could inflate at the expense and affliction of those who needed the drugs, and then he rationalized his behavior by saying the drugs were old and unused by large populations.

In addition to his price inflations, Shkreli lied to investors about their money. That is what got the attention of federal investigators, not Shkreli’s greed, not what he was doing to patients by keeping the drugs they needed out of financial reach.

There is something backward about a system in which victimizing the rich is more legally relevant than victimizing the vulnerable. Consider the hypocrisy of corporate sadism. A CEO can deny medication to AIDS patients by outpricing the market and the deaths that he triggers are inconsequential. He is never penalized.

There is a powerful economics principle called Gresham’s Law which explains that bad money drives out good. The corrupt and contemptuous and greedy and immoral are so powerful they taint the system and drive the honest stewards into other professions.

When Martin Shkreli was CEO of a company called Retrophin he increased the price of the kidney medication Thiola. The drug was important in the treatment of cystinuria which 20,000 Americans are fighting, without a cure. Steve Brozak of Forbes described the disease: Patients are diagnosed at a young age. They have an abnormally high concentration of an amino acid called cysteine in the urine. It crystalizes regularly into stones that painfully travel through the kidneys, ureters or bladders. Imagine having a kidney stone form or pass once a month, tearing through your organs as it tracks its way out of your body. Brozak noted the pill’s new price was between $54,750 and $109,500 per year.

After Shkreli raised the price of Daraprim, the Infectious Diseases Society of America and the HIV Medicine Association sent his company a letter saying the increase was “unjustifiable for the medically vulnerable patient population.” The drug is used for pregnant women and people with compromised immune systems like AIDS. It also is used to treat malaria.

Shkreli was sued in civil court for using his former company Retrophin as “his private piggy bank to pay off hedge fund investors.” Literally, he had the ability to impact wellness and death. He chose the route of convenience, not for the ill and vulnerable populations, but for himself.

Perhaps if during his trial Shkreli was shamed for his craven rationalizations and contemptuous transactions that created chaos and stress, then justice would have bent at the moral arc. But no. It was greed 101. Rich people got bilked. The government stepped in as a white knight. White narcissist Martin Shkreli had to pay but had zero remorse. He portrayed himself as a feckless genius who didn’t mean harm.

2

All of us have, at one time or another, been greedy. We have wanted more and lusted after excess. But more often than not that greed doesn’t leave our own selfish orbit. However, when greed impacts public health, when deaths ensue, when remorse is lacking, it is a crime against an entire population.

Thirty years ago Purdue Frederick had a morphine molecule drug for pain. Oxycontin was a time-release drug that had a 12-hour potency window. Drug reps told doctors it was addictive less than 1% of the time. However, addicts bypassed the time-release property of the drug by sucking the coating off and then crushing the pill and snorting it or injecting it. The new substance was more powerful than Percocet. When the high ended, the desperate were left hunting for something more powerful than Oxy. They found it in Heroin. Lortrab. Opana. Dilaudid. Roxicodone. Fentanyl.

Once they realized what addicts were doing, Purdue Frederick could have pulled Oxy from the market. But they were greedy. Blinded by the rakes of money coming in via prescriptions they kept manufacturing opioids.

Here’s what convicted felon Martin Shkreli understood, this very basic precept of capitalism: it legitimizes the monetization of just about everything, even public health.

The United States paid the UK one billion dollars to develop a Covid-19 vaccine. That billion dollars is an investment that may not have a return. It is still uncertain if the vaccine that comes out of AstraZeneca pays off. The money is for Phase 3 and clinical trials. Those trials may net positive outcomes. Or there may be severe side effects that keep the vaccine in development and the human trials stopped.

In the U.S., companies are working on drugs to manage coronavirus so the ill won’t die. If successful, these drugs will be treatment options the pharmaceutical companies hope the sick will need long term. Big Pharma loves to do what Martin Shkreli did before he stole from investors. Inflate prices for their own corporate greedy gain.

Remember when the EpiPen was used as a hostage. Children with life-threatening allergies on one side. Cash on the other. For a certain population, the Covid-19 treatment drugs will be monetized and weaponized. It will be given to the privileged for free and overpriced to the struggling.

Regeneron Pharmaceuticals is working on a prevention and treatment drug called REGN-COVID 2. They expect trials by the end of August. But we know how pharmaceutical companies work, how they can paralyze the sick with their outrageous prices. If their trials are successful, who will have access to the drug?

The more than 20 U.S. Pharma companies given the green light to work on a treatment, a vaccine, a prevention drug, or all of the above have a financial incentive to create a drug cocktail that manages Covid-19. If multiple success stories appear in trials, then it is a seller's market for the corona sick or the almost sick, all around the world.

We’ve already witnessed medical disparities in the brown and black coronavirus dead. Multiple instances of people of color being turned away from the hospital and told to heal at home, only to return to the hospital sicker and near death.

In this country, we pick and choose who we think is important. It usually comes down to white, young, resourced. It leaves non-white, financially underwater, and invisible on the margins

Implied bias will affect who gets the Covid-19 drugs for no cost. Decisions will be made about who is important. Already Covid-19 decisions have been made about who lives and who dies. The vaccine will repeat those same kinds of line in the sand political reality. Us and them. Us the living and privileged. Them the dying and have no money.

3.

Martin Shkreli was born on April Fools Day and grew up in Brooklyn to working-class parents of Albanian descent. After dropping out of school, he interned on Wall Street when he was 17 and has told the story of dedicating himself to chemistry because of a family member’s struggle with depression. His flamboyant personality is what he blames his downfall on, and he never understood why he was hated so completely.

Shkreli was not indicted for harming the sick with his price inflations. He didn’t care what a steep price hike meant. At trial, he was often his own worst enemy. Complaining that he didn’t do anything wrong, he baited the government attorneys, and because Shkreli doesn’t have a shut-up button the perception of him cratered. No one was interested in mercy.

In a bizarre piece of theater, while awaiting sentencing Shkreli, in a series of Facebook posts, asked for a strand of Hillary Clinton’s hair. Judge Matsumoto wasn’t amused and ordered him to jail pronto. Although Shkreli said the Clinton hair thing was science, he wanted to clone her, the judge saw it as a violent threat. In this, Shkreli wasn’t protected by the First Amendment. Prosecutors also allege he engaged in sexual threats towards female journalists. His attorney, Benjamin Brafman tried to make the point that Shkreli was stupid, not violent, and that it was a really bad joke. Judge Matsumoto wasn’t buying that either.

When he was sentenced Shkreli was adamant it wasn’t about the money and he was half right. It wasn’t just about the money. It was the power. He could ruin people’s lives with the stroke of a pen by changing a drug price. He was God. He was a monster. He fed off of his own vile pathology.

Shkreli was relatively young when he was convicted and it would be naïve to think that when he was sent to prison no one else took his place. Blood is always in the water when corporate profits are at stake. With a corona pill to pop, there is ample opportunity to bring to market a series of drugs that will be an antidote to symptoms. It will make millions of Americans feel better while damaging thousands of Americans who have no money to spend. The Haves and the Have Nots, here we go again.

Nothing has changed in a pandemic world. The fault lines are just more visible and the fragile are more at risk. The rich have options and the poor have to pray for mercy.