Pharma, Policy

Martin Shkreli’s biggest sin (and it’s not drug-price gouging)

He spoke too much at the wrong time.

Martin Shkreli has thrown the mob a bone by saying Turing Pharmaceuticals will cut the price of Daraprim (now we wait for how low it will go).

He’s been crucified for increasing the price 5,000 percent. But the thing that has gotten his name on the healthcare blacklist has nothing to do with price (because drug-price gouging has been done early and often).

His big sin in the industry is that he was loud about it at the wrong time. As a result, he’s given presidential candidates a way to tie a national debate on wealth disparity and wage equality directly to healthcare (and not just pharma).

Big healthcare follows the rule of the wise, old-school movie mobster: Don’t attract attention. It’s a smart one – businesswise.

Beyond Obamacare, it’s hard to find a wedge issue in medicine. It’s a complicated, compartmentalized industry. You can’t get mad at one drugmaker, one insurance company or one hospital (each sector is pretty good at blaming the other). Enough people have been saved by a drug or doctor that it’s hard to complain.

In short: it’s a grey area.

Shkreli, suddenly, made it black and white. Here was one brash dude bro who fed the trolls online and boasted about caring little beyond the bottom line. He’s a lifelong 1 percenter who came off as gaming the system even further to his benefit.

Gordon Gekko was cool 12 months ago. But not today.

This is not going to go away. It’s too good of an issue not to. Hillary Clinton is bringing in big insurance – and that means Aetna and Anthem will take some shrapnel. Sovaldi is already getting linked to Shkeli and Daraprim, along with Rodelis Therapeutics and Valeant.

The drug-pricing issue is all the rage only in the Democratic primary. But the Republicans will join in during the general election (how can you be in favor a 5,000 percent price spike?). There’s plenty of time between then and now for legislators and regulators to help whichever side of the aisle they are on.

Things start to change when a issue gets a face. Drug-price spiking had become business as usual. But now it has a face.