Turing Pharmaceuticals AG CEO Martin Shkreli shrugged off the angry criticism he has received for sharply hiking the price of the antiparasitic Daraprim (pyrimethamine), saying he had a duty to shareholders to maximize their profit.

Shkreli took the stage at the Forbes Healthcare Summit Dec. 3 to answer questions about his company’s pricing strategy. Turing bought the decades-old drug from Impax Laboratories Inc. in August and a month later raised its price from $13.50 per pill to $750 per pill, sparking a political firestorm and bringing unwelcome attention to industry. The drug is used to treat toxoplasmosis in people with HIV, pregnant women and others with weakened immune systems.

Matthew Herper, Forbes; Martin Shkreli, Turing Pharmaceuticals CEO

Photo by Brenda Sandburg

Questioning Shkreli, moderator Matthew Herper, senior editor of Forbes Media, noted that the executive had said a couple of months ago that he was considering lowering the price and decided not to do so significantly. He asked why the drug should be expensive.

“There are a number of reasons,” Shkreli replied. “The first is our shareholders expect us to make as much money as possible. That’s the ugly dirty truth.”

Shkreli also said that Turing is investing profits from Daraprim in research. He noted that the company is developing three new drugs for toxoplasmosis, which he said will be very expensive if they ever get approved.

An audience member asked if he would do anything differently, and he responded that he probably would have raised the price even higher. “No one wants to say it, no one’s proud of it, but this is a capitalist society, capitalist system [with] capitalist rules, and my investors expect me to maximize my profits,” he said.

In a remarkable exchange, Express Scripts Chief Medical Officer Steve Miller spoke from the audience noting that the pharmacy benefit manager supported distribution of Daraprim when it cost $13.50 but did not support distribution at the current price.

“I actually think you guys do support it because you are not excluding our drug, are you?” Shkreli stated.

Miller acknowledged that if doctors want to use the drug they can.

“So if someone writes a prescription right now for Daraprim you are still accepting it?” Shkreli said.

“That’s correct,” Miller replied.

“Awesome man. Thanks for your business,” Shkreli said.

While not excluding the drug, Express Scripts is encouraging providers to prescribe a compounded alternative to Daraprim. The company announced on Dec. 1 that it is partnering with Imprimis Pharmaceuticals Inc. to compound a version of the drug that will cost only $1 per capsule Also see "Express Scripts Turns To Compounding To Fight High-Priced Off-Patent Drugs" - Pink Sheet, 1 December, 2015..

Herper also asked why Daraprim is sold under a closed distribution system, noting that this system is used for drugs that are unsafe or have significant side effects. Shkreli said most expensive drugs are sold this way because of the complicated reimbursement process.

“So your closed distribution system is to counter the financial toxicity that you’ve created?” Herper asked.

Questioned about whether patients have the same access to the drug that they previously had, Shkreli commented that 65% of the drug is sold for a penny and that 200 people at Turing are dedicated to making sure everyone gets the medicine.

Others in industry have criticized Turing’s price increase, and the Biotechnology Industry Organization even revoked Turing’s membership ([A#00150928024]).

A panel of CEOs spoke after Shkreli and they made a distinction between their companies and his.

“I think it’s really important for all of us to make it clear that he is not us,” Merck Chairman and CEO Kenneth Frazier stated. “We are a research-based pharmaceutical industry. Every company in this line up spends substantial amounts of money in the hopes of coming up with new, important cures and treatments for unmet medical need.”

Shkreli said his company has not been hurt by the negative commentary from others in industry. He noted that Turing is in negotiations with a major pharma company to acquire a drug.

Turing’s Shkreli Tussels With Express Scripts About ‘Ugly, Dirty Truth’ Of Drug Pricing

More from Pricing Debate

More from Market Access