Los Angeles Times

Drug firms prey on the sick

- DAVID LAZARUS

Congress tried to show it feels America’s pain over high prescripti­on- drug costs by calling Martin Shkreli to account Thursday.

Shkreli is the former head of Turing Pharmaceut­icals, currently out on $ 5 million bail after being charged with securities fraud and conspiracy. He became the face of Big Pharma greed after jacking up the price of a one- of- a- kind infection medication by 5,000%.

Shkreli clammed up Thursday by citing his 5th Amendment right against self- incriminat­ion. He did tweet, however, that lawmakers are “imbeciles.”

“I don’t think I’ve ever seen the committee treated with such contempt,” fumed Rep. John Mica, a Florida Republican.

Politician­s can skip the phony outrage. Shkreli may be the poster boy for drugindust­ry rip- offs, but he’s by no means alone. Pharmaceut­ical companies are crawling with profit seekers preying on the sick, and Congress has done nothing to fix that.

I had a chat the other day with Dinesh Ghiya, a Whittier pediatrici­an who wanted me to know what’s going on with Cortispori­nTC Otic Suspension, an eardrop that’s used to treat what’s commonly known as swimmer’s ear.

“A vial used to cost about $ 6,” Ghiya said. “I got some for a patient recently and it was a lot more. I called my pharmacist and was told that the price will probably go up again this year.”

He said he treats dozens of local kids with Cortispori­n every summer.

There are cheaper generic alternativ­es available, but pediatrici­ans often prefer the brand- name original because it’s formulated thicker and doesn’t drip out of the ear. Basically, it works better.

“If kids can’t afford Cortispori­n, that can mean

pain, excruciati­ng pain,” Ghiya said. “If the infection goes deeper into the ear, it can mean surgery.”

I asked Ghiya why the cost of Cortispori­n has risen so much.

“I don’t know,” he replied. “Because it can.”

The answer is actually more troubling — and illustrate­s multiple problems with the U. S. healthcare industry, including unwarrante­d markups as a result of repeated corporate acquisitio­ns and the slimy practice of ducking U. S. taxes by relocating abroad.

Unlike the drug for parasitic infections Shkreli cashed in on, which is more exotic in nature, Cortispori­n couldn’t be more banal. That a remedy for something as ubiquitous as kids’ ear infections can become a profit center speaks volumes about what healthcare consumers are up against.

Cortispori­n was originally developed by Glaxo Wellcome and was approved by the Food and Drug Administra­tion in 1975.

“It’s been around since the dawn of time,” said Robert Hamilton, a Santa Monica pediatrici­an. “There’s nothing complicate­d about it.”

As best as I can tell, Cortispori­n originally cost just a few bucks for a 10- milliliter vial, which is about a month’s supply and sufficient to treat even the most stubborn ear infection.

Sarah Spencer, a Glaxo spokeswoma­n, said Cortispori­n has been on the market for so long, no one at the company even remembers how much it used to cost. “We no longer own the medicine,” she noted.

Indeed, Cortispori­n has had a decidedly tumultuous life considerin­g how mundane it is.

Glaxo sold the U. S. rights to Monarch Pharmaceut­icals, a subsidiary of King Pharmaceut­icals, in 1997. Ten years later, King sold Cortispori­n to JHP Pharmaceut­icals. JHP Pharmaceut­icals was acquired by Par Pharmaceut­ical in 2014.

Last year, Par was acquired by the drug company Endo Internatio­nal for a hefty $ 8 billion.

Endo underwent its own transforma­tion in 2014, changing its name from Endo Health Solutions and moving from Pennsylvan­ia to Ireland to avoid paying millions of dollars in U. S. business taxes.

Rajiv De Silva, Endo’s chief executive, said at the time that “strategic acquisitio­ns” will “play a key role in maximizing our growth potential and creating value for Endo Internatio­nal shareholde­rs.”

That’s pharma- speak for “we’re going to buy other drug companies and mark up the price of their meds so we can make a lot more money.”

Heather Zoumas Lubeski, Endo’s senior director of corporate affairs, told me that the company “is committed to providing top- quality products to patients to improve lives” and believes its pricing “is rational and appropriat­e.”

Regarding Cortispori­n, she said, “Endo has taken price increases in line with market conditions and competitor product pricing.”

Pharmacist­s say otherwise. Benjamin Khorsandi, a Santa Monica pharmacist, said he could recall that “only a few years ago, Cortispori­n was selling for about $ 10.”

Last year, he said, the price surged to about $ 100, “and now it’s going for double that.”

Greg Avale, a Century City pharmacist, confirmed Khorsandi’s experience. “Cortispori­n is selling for $ 195,” he said. “The generic version costs $ 144.”

Remember, we’re talking about a drug that’s been around more than 40 years. It doesn’t fight cancer. It won’t cure hepatitis. It helps kids get over ear infections from summertime swims.

“It blows my mind,” said Ben Kadkhoda, a Brentwood pharmacist. “It seems like all the brands go up in price at least once a year.” Why? “Because they can.” Which is exactly what Dr. Ghiya said.

I understand people who insist that you can’t have price controls for prescripti­on meds. It would stif le innovation, they say, and undermine research into new treatments. There’s something to that.

But then there are the Cortispori­ns — everyday drugs that have been around forever but that keep going up in price for no better reason than because a new owner figures he can wring more profit from it than the last guy. What to do? Here’s a start: Allow Medicare/ Medicaid to negotiate drug prices with manufactur­ers. This is how other developed countries keep drug prices at reasonable levels. It’s nuts that we prohibit our biggest public insurance system from applying the same market muscle.

Instead, we’re stuck with an imbalanced playing field where a guy like Shkreli can f leece consumers and then smirk and giggle his way through what should have been a public f logging.

“It’s not funny, Mr. Shkreli, people are dying,” admonished Rep. Elijah Cummings ( D- Md.).

Like that has anything to do with maximizing growth potential and creating value for shareholde­rs.

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