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We're just a regular, you know, middle class couple.
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We both had good jobs,
we both were making decent money.
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Um, we had two cars,
we had a nice house.
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And then all of a sudden,
I find out that I had this disease...
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and it's like that life is over,
it's like all of a sudden a book got slammed shut.
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I had neoadjuvant chemo.
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I had a single right side mastectomy
and then 37 rounds of radiation,
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after which I was placed on a drug
called Tamoxifen,
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which is a maintenance drug,
and, uh, certain other drugs.
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Cystic fibrosis is a genetic illness,
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and, um, it is a terminal disease.
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I worry about him feeling terrible,
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as if it's his fault that his family
might have to go through,
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you know, some financial trauma or financial strain.
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At three years old, my son looked at me and said,
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"Mommy, am I expensive?"
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"Mommy, am I expensive?"
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He was looking for a reason
to blame himself at three.
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I'm a HER2-positive breast cancer patient.
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I was very lucky they have a great drug.
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It's a targeted therapy.
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And then of course the first bills appear,
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and then we started to calculate
how long our saving would last.
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I tell my children all the time
that they better start saving money
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because sooner or later,
you're gonna come to a point in your life
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where your health needs a prescription drug,
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and God forbid, because you will lose
the things that you hold most dear.
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C.S. Lewis says,
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"Education without values
seems rather to make man a more clever devil."
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Can the same be said for modern medicine?
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By the time you finish watching this film,
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at least seven Americans will have died,
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not because of bad luck
or genetics or tragedy,
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but because they couldn't pay
what the market will bear.
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If we're asking how much it costs
to keep someone alive,
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maybe we are asking the wrong question.
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An investigation into the cost of prescription drugs
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reveals huge price hikes over the past five years.
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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
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and outcries to do something about it.
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U.S. medical community is outraged
after a life-saving drug
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saw a more than 5000% price hike.
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Who raised prices by how much,
and who are the biggest offenders?
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-Everyone.
-Why is this happening?
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Well, the simple truth is
they can do anything they want
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at any time they want to do it.
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Let's not forget the drug industry
is the most profitable industry in America.
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No other industry is even close.
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Shouldn't be surprised.
51
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'Cause it's impossible to escape
pharmaceutical ads.
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Everything we were to do
was about making Wall Street happy.
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All the way over.
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Seventy percent of Americans
take at least one prescription drug.
55
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Thousand dollars a pill.
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Twenty thousand dollars
every three weeks.
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Seven hundred and fifty thousand dollars a year.
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They really are a gatekeeper.
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They determine, in many cases,
who lives and who dies.
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Call your doctor right away
if you experience fever,
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tiredness, body aches, chills,
nausea, vomiting,
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seizures, loss of vision, or weakness.
63
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The livelihoods of Americans
are being held captive
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by rising drug prices,
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and there's no discernible ceiling.
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A lot of Americans are being hit
by soaring prescription drug prices.
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Americans spent
an estimated $450 billion with a B
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on prescription drugs in 2016.
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Imagine knowing your child
has a rare disease
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that will slowly destroy
all the muscles in their body.
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Now imagine there's a new treatment for it,
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but it is so expensive
you would never be able to afford it.
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There's a fundamental problem
when the price tag of contracting a disease
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is more dreadful than the disease itself.
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00:05:01,468 --> 00:05:04,513
In February, Valeant Pharmaceuticals
raised prices
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00:05:04,513 --> 00:05:08,767
for two newly purchased hard drugs,
Isuprel and Nitropress,
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212% and 525%.
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Spinraza got FDA approval last December
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and a price tag: $125,000 per dose.
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Many cases, the costs add up
to a million dollars a year for a lifetime.
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These drugs are priced at incredibly high levels, right,
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which are unaffordable
to not only people in this country,
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but people around the world.
84
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They know that the prices they charge
for a lot of drugs
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exclude people from having access
to those drugs.
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It's not like they don't understand that, they do.
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Insulin is a life or death medication.
88
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Those high prices combined
with rising insurance deductibles
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mean many people who rely on insulin
are feeling sticker shock.
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Assuming we are able to take the humanity
and emotion out of the equation,
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we're still left with the question
of economic sustainability.
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Well, all you have to do is project the trends
which are already off the charts.
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You'd have to tape another piece of paper
to the top of the chart
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00:06:08,368 --> 00:06:10,370
and watch them go up some more.
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It is ludicrous to think that
the U.S. and healthcare in general
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can go on spending about 18%
of our gross domestic product
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on health in general.
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The percentages of our gross domestic product
are swelling at an alarming rate.
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If this trend continues,
a crash is inevitable.
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If the price of milk or bread
or any other staple
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went up at the same rate
that drug prices are going up,
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people would be rioting in the streets.
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Uh, Mr. President, I rise to discuss
one of the major crises
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facing our healthcare system today,
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and that is that the pharmaceutical industry itself
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has become a major health hazard
to the American people.
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Prices are going up outrageously.
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No justification.
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So you can walk into a drugstore tomorrow
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and find that the price that you're paying
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for the same medicine you've had for 20 years
has been doubled.
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And you ask the pharmacist why.
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There's no reason, they can double it
based on market needs.
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So what you have is an incredibly powerful industry
charging any price they want
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and the result of that is that one out of five Americans
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can't afford the medicine that they need.
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Can you imagine that?
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So they go to the doctor,
doctor writes a prescription,
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but they can't afford to fill it.
120
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But five major companies made
$50 billion in profits last year.
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Listen, you have an insane situation
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in which people are dying
because they can't afford the medicine they need,
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or getting much sicker than they should
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just so these companies
can make outrageous profits.
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Yeah, you better give yourself a shot.
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In 2007, Mylan Pharmaceuticals
acquired EpiPen,
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a device used for injecting measured doses
of epinephrine.
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The call's growing louder for drug makers
to lower the price of the EpiPen.
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Since the acquisition,
prices have risen continuously.
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Pharmaceutical giant Mylan
was at the center of criticism last year
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over rising drug prices.
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Pressure mounting on EpiPen maker
Mylan Pharmaceutical.
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A trio of senators now calling for an explanation.
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00:09:07,464 --> 00:09:12,969
The auto-injector's price has risen
by more than 480% since 2009.
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My daughter Kennedy was diagnosed
with food allergies
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when she was about 13 months old.
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Kennedy also has asthma,
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she has reflux,
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and she has eosinophilic esophagitis.
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So for Kennedy,
she does have a medication regimen
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that she has to take every day.
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She has to take maintenance meds
for her asthma.
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She also has to take a maintenance
swallow medication for her EoE.
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And then she carries around her EpiPen.
145
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And Shane has a life-threatening allergy
to blueberries.
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He also has mild asthma.
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But Shane also has what they call
idiopathic anaphylaxis,
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whereas just out of the blue,
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there are times that things that we don't know yet
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could actually cause him to go into
an anaphylactic reaction.
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00:10:04,938 --> 00:10:06,606
We are here with the CEO that is no doubt
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the center of a national firestorm--
I think that's fair to say.
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Heather Bresch, CEO of Mylan Labs.
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The price hike has been labeled "outrageous"
by Hillary Clinton,
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"egregious" by Bernie Sanders,
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"greedy" by the White House,
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and parents all over the country are outraged
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that they've got to pay more for their EpiPen.
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How do you respond to all that?
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As a mother, I can assure you
the last thing that we would ever want
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is no one to have their EpiPen
due to price.
162
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The cost is more prohibitive than people realize.
163
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Two kids, $600 for one set,
and I need multiple sets.
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The school that they go to,
they have to have a set for themselves,
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a set for the nurse,
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and a set for the trainer
if they go out for any sports,
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and we also have to have a set for our house.
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So the cost is insane.
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The American Medical Association has said
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this is basically the same product it was in 2009,
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and yet have raised the price 17 times.
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If you follow the money,
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the reason for these price hikes
comes into sharp focus.
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What was your salary last year?
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-About $18 million.
-About $18 million...
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Sounds like you're doing pretty well on this.
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When Mylan acquired EpiPen in 2007,
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Heather Bresch's salary
was $2.4 million.
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As the price of EpiPen swelled,
so did her salary,
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all the way to $18.9 million.
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Heather, you understand the headlines, right,
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which is EpiPens,
which are needed by millions of children,
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the price goes from 50 bucks ten years ago
to 500 or 600 today,
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and you're making $18 million a year.
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You understand how that looks?
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Brian, look, I understand better than anyone
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that facts are inconvenient to headlines.
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We have given out 700,000 free EpiPens.
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We stock 65,000 public schools
in this country with free EpiPens
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to ensure that they're there when needed.
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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.
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So I'm holding here a certification form
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where EpiPen, where Mylan has actually said
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that the school will hereby certify
that it will not, in the next 12 months,
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purchase any products that are competitive
to EpiPen Auto-Injectors.
197
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So you actually put into practice
forcing schools--
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and you're so concerned about these kids,
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you've raised the price to $600,
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if you want it for the hundred buck price
that it used to be at,
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you need to sign this and say that
you can't buy this from anybody else.
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Don't answer, I'm not asking you a question.
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That's what you've done here.
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Sometimes I do feel like a burden.
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I sometimes think that maybe if I didn't have this allergy
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or maybe if I wasn't, per se, here
207
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then maybe my mother would have
a little less stress.
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Uh, she wouldn't have to carry the burden
209
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of having to come up with that extra money
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to pay for the EpiPens.
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I feel bad because, like, I know it's not my fault,
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but they're so expensive,
and it's, like, a lot,
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00:13:12,125 --> 00:13:16,087
even though, like, my mom says
that I'm worth it and everything.
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Knowing that my kids feel like they're a burden to me,
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it actually hurts and it makes me angry.
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I guess the anger comes from being hurt.
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Because kids should never feel like that.
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And I think it's just so unfair
because it's unnecessary.
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The medication inside the device
is so cheap.
220
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It does not warrant the cost.
221
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When journalists and lawmakers
ask pharmaceutical companies
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to justify their pricing,
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the same two words come up again and again:
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research and development.
225
00:13:55,793 --> 00:13:58,629
There are a couple of myths
that are out there
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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
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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
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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
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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
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We increase prices as part of that process
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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,
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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.
118025
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