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What happened to the $750 pill that catapulted Martin Shkreli to infamy

Martin Shkreli, former chief executive officer of Turing Pharmaceuticals AG, left, arrives at federal court in the Brooklyn. (Peter Foley/Bloomberg)

Martin Shkreli awaits a verdict on securities fraud charges that could land him in prison for up to 20 years, depending on whether prosecutors have convinced the jury that he lied to his investors about how he used their money.

But at this fateful juncture, it's worth remembering why so many people in America have such strong feelings about Shkreli, whose Congress-taunting smirk became a meme. America loves to hate Martin Shkreli, not because of his alleged investor fraud, but because as former chief executive of a little-known company, Turing Pharmaceuticals, he bought a drug invented before he was born and raised the price astronomically.

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That drug, called Daraprim, went from $13.50 a pill to $750 a pill in the summer of 2015. Now that the outrage over access to that lifesaving medicine has died down, guess how much the pill costs? $750. There is still no generic version.

A Turing spokeswoman did not immediately respond to messages requesting comment.

The fact that Daraprim's price never budged, despite the furor it set off, underscores a hard truth about drug prices. Anger and concern flare up periodically — when drug prices increase, a new drug launches with an astounding price or patients have trouble getting access to a medicine because of cost.

Politicians may make angry speeches. Stories about people who can't access their drugs will almost certainly show up in the media. But “drug prices” is a more complicated topic than most people appreciate, and the solutions are wonky and complicated compared to the simple project of getting furious about the problem. Attention tends to drift elsewhere.

Shkreli helped with that, as he live-streamed his life, bought a one-of-a-kind Wu-Tang Clan album and called Congress “imbeciles” on Twitter after refusing to answer their questions.

Here's the thing about Daraprim: The size of the price increase and the brazen attitude of Shkreli were both unusual, but the underlying dynamics were not. The pharmaceuticals industry has taken great lengths to distinguish itself from Shkreli and his bad tactics, pointing out that companies that invent drugs are different from those that just jack up the prices of old ones.

Price hikes on old and new drugs are common, but commonly ignored — because insurance kicks in to help pay and people find a way to get access. This is true of all types of drugs: Old drugs that are used by small populations are vulnerable to price hikes. New drugs are introduced at prices that are ratcheted up over time without explanation.

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The true access problems tend to hit those who generally have less of a voice in the system: people without good insurance. Daraprim got so much attention because it is often used by patients with HIV, who have a long history of effective activism.

“Daraprim was first approved by the FDA in 1953. This is not a new medicine,” said Carlos del Rio, co-director of the Emory Center for AIDS Research. “It's as if all of a sudden I have the market on televisions and I say, 'Now a television costs $10,000. If you want a television, you have to buy it from me, and its $10,000,' because I can.”

Del Rio thinks he may have prescribed Daraprim perhaps one time since the price went up in 2015. Instead, he's turned to another drug, Bactrim. Studies suggest it may not be quite as good a drug as Daraprim, but it works.

“Why should I help people get themselves wealthy?” del Rio said.

But the story doesn't end there. Recently, del Rio had a patient with a tapeworm infection who needed another old drug, called albendazole. It cost a mind-blowing $300 a pill — and has to be taken twice a day for more than a month. The person's insurance simply paid the outrageous price, as far as del Rio knows.

But when del Rio was in Mexico, he saw the same medicine — a box of 10 tablets selling for $19.

“People wonder why is insurance so expensive? Part of it is we’re paying ridiculous drug prices,” del Rio said.

A 2016 government analysis found that prescription drugs made up 17 percent of overall health-care spending.