Congress just painted a seriously confusing picture about prescription drugs -- here's what they got wrong

There was a lot of smirking and finger-pointing during Thursday’s congressional hearing on prescription drug pricing.

Nobody who was testifying was immune to either.

Martin Shkreli, who used his Fifth Amendment right to remain silent, was dismissed a few minutes in. But the former pharmaceutical executive, who became infamous for raising the price of a critical drug by 5,000%, still had his voice heard through his tweets and video clips used at the hearing.

With Congress taking charge and industry leaders in the hot seat, a lot was said.

Here’s what we learned:

  • Shkreli’s name is pronounced “Shh-kreli”, not “Skreli.” This was the only question he answered during the hearing.
  • Valeant’s growth in the first-quarter of 2015 was 80% a result of price increases, in part because of acquisition of products from Marathon Pharmaceuticals.
  • There’s a new code of conduct at Turing, following Shkreli’s dismissal.
  • Patients who need Daraprim (the drug whose price Turing hiked by 5,000%) may have $6,000 co-pays from their insurance companies, but Turing says they’re covering all but $10 of that co-pay.
  • Shkreli’s lawyer thinks he’s a hero, not a bad boy or villain.
  • 88% of drugs on the marketplace are generic drugs, Dr. Janet Woodcock of the FDA said.
Mica

Oversight and Reform Committee via YouTube
Rep. John Mica (R- FL) holds up his prescription during a hearing on drug prices.

Here’s what got a bit fuzzy:

Some members of Congress weren’t exactly up to speed with the day-to-day intricacies of the healthcare industry, though with props and shouting, they were able to get some interesting points across during the hearing.

  • One congressman asked how “A patient on Obamacare” would have access to Daraprim. That’s not quite how that works. Through the Affordable Care Act, Americans opt into different insurance plans, including state-funded programs like Medicare and Medicaid, which is likely what the congressman was going for.
  • One congresswoman talked about how Daraprim was $13.50 per pill for decades before Turing bought it. Technically it was even cheaper than that at $1 a tablet before its US commercial rights started passing hands. The $13.50 per pill price was set by Impax Pharmaceuticals.
  • The committee also took some shots at the FDA, which is responsible for approving and regulating drugs. The FDA doesn’t set prices, and the backlog of generic alternatives was likely caused by defunding of the agency.
  • Because it’s private, we still don’t know for sure how the $750 per pill price tag is being spent within Turing. What we do know is that the company had a “sales force meeting” on a yacht to the tune of $23,000 and promised employees some very hefty salary increases.

It’s a complicated system — one that’s easy to get upset about — and the 4-hour-plus hearing is really only just the beginning of this discussion. From pharmaceutical companies to pharmacy benefits managers to hospitals to the FDA to the Congress that funds it, there will be a lot of kinks to work out in the system before loopholes like the one that allows price gouging are closed.

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