Drug$ (2018) - full transcript

We're just a regular, you know, middle class couple.

We both had good jobs,
we both were making decent money.

Um, we had two cars,
we had a nice house.

And then all of a sudden,
I find out that I had this disease...

and it's like that life is over,
it's like all of a sudden a book got slammed shut.

I had neoadjuvant chemo.

I had a single right side mastectomy
and then 37 rounds of radiation,

after which I was placed on a drug
called Tamoxifen,

which is a maintenance drug,
and, uh, certain other drugs.

Cystic fibrosis is a genetic illness,

and, um, it is a terminal disease.



I worry about him feeling terrible,

as if it's his fault that his family
might have to go through,

you know, some financial trauma or financial strain.

At three years old, my son looked at me and said,

"Mommy, am I expensive?"

"Mommy, am I expensive?"

He was looking for a reason
to blame himself at three.

I'm a HER2-positive breast cancer patient.

I was very lucky they have a great drug.

It's a targeted therapy.

And then of course the first bills appear,

and then we started to calculate
how long our saving would last.

I tell my children all the time
that they better start saving money

because sooner or later,
you're gonna come to a point in your life



where your health needs a prescription drug,

and God forbid, because you will lose
the things that you hold most dear.

C.S. Lewis says,

"Education without values
seems rather to make man a more clever devil."

Can the same be said for modern medicine?

By the time you finish watching this film,

at least seven Americans will have died,

not because of bad luck
or genetics or tragedy,

but because they couldn't pay
what the market will bear.

If we're asking how much it costs
to keep someone alive,

maybe we are asking the wrong question.

An investigation into the cost of prescription drugs

reveals huge price hikes over the past five years.

Several brand name medications
more than doubled...

Now, let's turn to the rising price
of prescription drugs

and outcries to do something about it.

U.S. medical community is outraged
after a life-saving drug

saw a more than 5000% price hike.

Who raised prices by how much,
and who are the biggest offenders?

-Everyone.
-Why is this happening?

Well, the simple truth is
they can do anything they want

at any time they want to do it.

Let's not forget the drug industry
is the most profitable industry in America.

No other industry is even close.

Shouldn't be surprised.

'Cause it's impossible to escape
pharmaceutical ads.

Everything we were to do
was about making Wall Street happy.

All the way over.

Seventy percent of Americans
take at least one prescription drug.

Thousand dollars a pill.

Twenty thousand dollars
every three weeks.

Seven hundred and fifty thousand dollars a year.

They really are a gatekeeper.

They determine, in many cases,
who lives and who dies.

Call your doctor right away
if you experience fever,

tiredness, body aches, chills,
nausea, vomiting,

seizures, loss of vision, or weakness.

The livelihoods of Americans
are being held captive

by rising drug prices,

and there's no discernible ceiling.

A lot of Americans are being hit
by soaring prescription drug prices.

Americans spent
an estimated $450 billion with a B

on prescription drugs in 2016.

Imagine knowing your child
has a rare disease

that will slowly destroy
all the muscles in their body.

Now imagine there's a new treatment for it,

but it is so expensive
you would never be able to afford it.

There's a fundamental problem
when the price tag of contracting a disease

is more dreadful than the disease itself.

In February, Valeant Pharmaceuticals
raised prices

for two newly purchased hard drugs,
Isuprel and Nitropress,

212% and 525%.

Spinraza got FDA approval last December

and a price tag: $125,000 per dose.

Many cases, the costs add up
to a million dollars a year for a lifetime.

These drugs are priced at incredibly high levels, right,

which are unaffordable
to not only people in this country,

but people around the world.

They know that the prices they charge
for a lot of drugs

exclude people from having access
to those drugs.

It's not like they don't understand that, they do.

Insulin is a life or death medication.

Those high prices combined
with rising insurance deductibles

mean many people who rely on insulin
are feeling sticker shock.

Assuming we are able to take the humanity
and emotion out of the equation,

we're still left with the question
of economic sustainability.

Well, all you have to do is project the trends
which are already off the charts.

You'd have to tape another piece of paper
to the top of the chart

and watch them go up some more.

It is ludicrous to think that
the U.S. and healthcare in general

can go on spending about 18%
of our gross domestic product

on health in general.

The percentages of our gross domestic product
are swelling at an alarming rate.

If this trend continues,
a crash is inevitable.

If the price of milk or bread
or any other staple

went up at the same rate
that drug prices are going up,

people would be rioting in the streets.

Uh, Mr. President, I rise to discuss
one of the major crises

facing our healthcare system today,

and that is that the pharmaceutical industry itself

has become a major health hazard
to the American people.

Prices are going up outrageously.

No justification.

So you can walk into a drugstore tomorrow

and find that the price that you're paying

for the same medicine you've had for 20 years
has been doubled.

And you ask the pharmacist why.

There's no reason, they can double it
based on market needs.

So what you have is an incredibly powerful industry
charging any price they want

and the result of that is that one out of five Americans

can't afford the medicine that they need.

Can you imagine that?

So they go to the doctor,
doctor writes a prescription,

but they can't afford to fill it.

But five major companies made
$50 billion in profits last year.

Listen, you have an insane situation

in which people are dying
because they can't afford the medicine they need,

or getting much sicker than they should

just so these companies
can make outrageous profits.

Yeah, you better give yourself a shot.

In 2007, Mylan Pharmaceuticals
acquired EpiPen,

a device used for injecting measured doses
of epinephrine.

The call's growing louder for drug makers
to lower the price of the EpiPen.

Since the acquisition,
prices have risen continuously.

Pharmaceutical giant Mylan
was at the center of criticism last year

over rising drug prices.

Pressure mounting on EpiPen maker
Mylan Pharmaceutical.

A trio of senators now calling for an explanation.

The auto-injector's price has risen
by more than 480% since 2009.

My daughter Kennedy was diagnosed
with food allergies

when she was about 13 months old.

Kennedy also has asthma,

she has reflux,

and she has eosinophilic esophagitis.

So for Kennedy,
she does have a medication regimen

that she has to take every day.

She has to take maintenance meds
for her asthma.

She also has to take a maintenance
swallow medication for her EoE.

And then she carries around her EpiPen.

And Shane has a life-threatening allergy
to blueberries.

He also has mild asthma.

But Shane also has what they call
idiopathic anaphylaxis,

whereas just out of the blue,

there are times that things that we don't know yet

could actually cause him to go into
an anaphylactic reaction.

We are here with the CEO that is no doubt

the center of a national firestorm--
I think that's fair to say.

Heather Bresch, CEO of Mylan Labs.

The price hike has been labeled "outrageous"
by Hillary Clinton,

"egregious" by Bernie Sanders,

"greedy" by the White House,

and parents all over the country are outraged

that they've got to pay more for their EpiPen.

How do you respond to all that?

As a mother, I can assure you
the last thing that we would ever want

is no one to have their EpiPen
due to price.

The cost is more prohibitive than people realize.

Two kids, $600 for one set,
and I need multiple sets.

The school that they go to,
they have to have a set for themselves,

a set for the nurse,

and a set for the trainer
if they go out for any sports,

and we also have to have a set for our house.

So the cost is insane.

The American Medical Association has said

this is basically the same product it was in 2009,

and yet have raised the price 17 times.

If you follow the money,

the reason for these price hikes
comes into sharp focus.

What was your salary last year?

-About $18 million.
-About $18 million...

Sounds like you're doing pretty well on this.

When Mylan acquired EpiPen in 2007,

Heather Bresch's salary
was $2.4 million.

As the price of EpiPen swelled,
so did her salary,

all the way to $18.9 million.

Heather, you understand the headlines, right,

which is EpiPens,
which are needed by millions of children,

the price goes from 50 bucks ten years ago
to 500 or 600 today,

and you're making $18 million a year.

You understand how that looks?

Brian, look, I understand better than anyone

that facts are inconvenient to headlines.

We have given out 700,000 free EpiPens.

We stock 65,000 public schools
in this country with free EpiPens

to ensure that they're there when needed.

Heather Bresch has been vocal
about Mylan's free and discounted EpiPens,

but those who are listening closely
can hear the canary in the coalmine.

So I'm holding here a certification form

where EpiPen, where Mylan has actually said

that the school will hereby certify
that it will not, in the next 12 months,

purchase any products that are competitive
to EpiPen Auto-Injectors.

So you actually put into practice
forcing schools--

and you're so concerned about these kids,

you've raised the price to $600,

if you want it for the hundred buck price
that it used to be at,

you need to sign this and say that
you can't buy this from anybody else.

Don't answer, I'm not asking you a question.

That's what you've done here.

Sometimes I do feel like a burden.

I sometimes think that maybe if I didn't have this allergy

or maybe if I wasn't, per se, here

then maybe my mother would have
a little less stress.

Uh, she wouldn't have to carry the burden

of having to come up with that extra money

to pay for the EpiPens.

I feel bad because, like, I know it's not my fault,

but they're so expensive,
and it's, like, a lot,

even though, like, my mom says
that I'm worth it and everything.

Knowing that my kids feel like they're a burden to me,

it actually hurts and it makes me angry.

I guess the anger comes from being hurt.

Because kids should never feel like that.

And I think it's just so unfair
because it's unnecessary.

The medication inside the device
is so cheap.

It does not warrant the cost.

When journalists and lawmakers
ask pharmaceutical companies

to justify their pricing,

the same two words come up again and again:

research and development.

There are a couple of myths
that are out there

about why drugs cost what they do.

One myth is that the company spends
so much money on research

that they need to recoup
their research expenditures.

And if it wasn't for the drug company,
we wouldn't have any new drugs

because they're making all the discoveries.

We need to invest in innovation
for cures and treatments

for unmet medical need,

and we need to charge a price
for our medicines

that allow us to invest in R&D.

The reality is that much of the research
is not done by them at all.

We increase prices as part of that process

of, you know, getting back our R&D costs.

Given the number of product candidates
we have in development,

our expenses will go up.

Almost all of the innovative products,

the blockbuster drugs,

are acquired from small start-ups,

biotech companies,

from university research.

We wake up every day trying to invent new medicines

and get them to people who are sick.

And the system is complicated.

So for us it's all about innovation
from R&D,

and value for money.

The best way we can invest
in our innovation and R&D

is by growing the top line.

What makes one company
a better innovator than another?

To actually come up with a drug
takes a very sophisticated team

that understands all aspects of drug development.

If I was a drug company, I might want to take credit
for all of scientific discovery too,

because it's a way of justifying those prices.

It just happens to not be true.

David Poole is the former director
of government affairs at Gilead Sciences,

one of the most profitable pharmaceutical companies
in the world.

In the eight and a half years
that I spent with Gilead Sciences,

their investment in R&D and in the laboratories
that I visited and toured

seems very disproportionate to what the yield is.

It was more like here we have a showcase,

and when visitors come,
whether it was investors or patients

or whomever might be touring
Gilead's headquarters,

they had these beautiful, large laboratories
that they could present to people

and say, "This is where we do
all this grand research and development,"

when in fact we didn't see products
that had been innovated by Gilead,

they just were very strategic
in the companies they purchased,

then they would often take those products

and in some cases combine drugs
to make them an effective better therapy.

But from--as far as innovation
from start to finish,

I quite frankly don't think that occurred,

perhaps maybe even only once
in the 30-year history of Gilead Sciences.

So then the question is not
how do you develop the next miracle drug

but how do you get hold of it?

And that you can do through acquisitions.

So you acquire the company
that is the developing the drug,

and then try to exploit it
as much as possible.

In 2011, Gilead Sciences positioned itself
to acquire a company

that was leading the field

in the fight against the most deadly infectious disease
in the United States:

hepatitis C.

This merger between business
and miracle drug

triggered the most contentious
industry move to date.

One of the biggest controversies
that erupted in the pricing of new drugs

occurred about two to three years ago.

Was around these drugs to treat hepatitis C.

And I wouldn't say Gilead is an outlier,

it's just that they were able
to get hold of a drug

that is a miracle drug.

There is a new cure on the rise.

There is a new drug on the market
that will help cure hepatitis C.

The drug has been called a miracle drug.

It actually cures hepatitis C.

Sofosbuvir.

Sofosbuvir was designed by a chemist
called Mike Sofia

at a company called Pharmasset.

Wait a minute, so this is a definite cure
for hepatitis C?

This is a cure for hepatitis C.

-No kidding!
-Yeah.

-No kidding!
-I mean, that's amazing, right?

We did the original human studies of that drug.

I presented the data at the Berlin Liver meeting.

And I remember the meeting because
the audience was in stunned silence.

This was perhaps the only time
I've ever sat in a medical conference

where everybody went, "Ah..."

They couldn't believe it.

For the first time, tablets had cured hepatitis C.

We're not talking about a drug
with marginal benefits;

we're talking about a drug that's a game changer
for people's lives.

Gilead Sciences, making a big move
into the world of hepatitis C treatment

with its acquisition of Pharmasset,

a deal in fact expected to close
by the end of the day tomorrow.

Gilead Sciences is buying drug developer Pharmasset
for $11 billion.

Gilead's chairman and CEO, John Martin, joins us.

What gives you the confidence
that this is a company

that was worth $11 billion of Gilead's money?

The company that we're talking about, Pharmasset,

made tremendous progress,

especially over the last year,

and it's already in Phase 3 studies,

studies that lead to approval,

so we expect 7977 to be the first to market.

Now this is 2011.

By 2014,

we had combined drugs and done the clinical trials

and presented the data

that resulted in a treatment for hepatitis C

that could cure 95% of patients
with one tablet once a day

that was simple, safe, and effective.

All of a sudden it changes to,
"We have a med that works in three months,

the side effects are minimal to none,
it's there,

and let's get everybody tested,
let's get everybody cured."

There'd be no transmission of hepatitis C

if everybody started on it immediately.

I mean, this is a virus that could be cleared.

We could clear it from the planet.

But we can't because it's too expensive.

The thousand-dollar-a-day pill.

That's a lot of money for a single tablet.

In fact, that makes one tablet of sofosbuvir,
as it's called,

the most expensive substance on Earth.

So Gilead brings a cure to market.

That didn't make the headlines.

What made the headlines was their price.

And so what you saw a few days later

when it first launched,
it was somebody holding up a pill,

and it said, "The new face
of the pharmaceutical industry,

the thousand-dollar pill."

It's important to understand, you know,

something about hepatitis C and the disease.

A thousand dollars a pill sounds outrageous,

but, you know, the cost
and the investment involved,

we're talking billions of dollars were spent

to, you know, to purchase this treatment or this drug.

A lot of that development happened
at Emory University

by a faculty member who received
a lot of NIH grants.

There was also some work that happened
in the Veterans Administration Hospital.

The faculty member set up a company
called Pharmasset,

which was going to monetize that discovery,

and then Gilead Pharmaceuticals
decided to buy the company

that this faculty member had started.

They paid $11.2 billion for this product,

at the time, a price that Wall Street
viewed as excessive.

Down the road, it was proven by Gilead

that they recouped that $11.2 billion
in less than a year

from the rollout of that product.

There's an interesting ethical and political
and societal question

of who should reap the benefits
of initially that sale

if the drug really was in large part
developed with public funds,

and the answer is it certainly doesn't end up
in the pocket of the taxpayer.

They get to pay twice--
once for the discovery

and once to buy the drug if they need it.

They lofty prices forced unprecedented levels
of pharmaceutical rationing.

As demand for the life-saving drug swelled,

access continued to diminish.

Health insurers and government payers said

basically we're only gonna treat you
if you already have liver damage.

So, no, we're not gonna give you this cure

until you're already sick.

I had, um, ammonia on my brain, you know,

from having the virus in my system.

Some of the side effects are, like, brain fog,

is, like, not being able to think clearly,

poor memory.

I knew that there was a new treatment
that was gonna be available,

and I was hoping that I'd be able
to avail myself of that.

But it seemed like it was never gonna happen

because of all of the restrictions
that, um, that I had to go through to qualify.

And then even after I qualified,

I wasn't able to afford or get the medication.

And the medication was obscenely expensive.

Now anybody looking at a single pill will say,

"That couldn't possibly cost a thousand dollars,"
and they'd be right.

No way that pill costs a thousand dollars.

The cost of that drug is less than a dollar a day,

and that includes the plastic bottle it comes in.

And the price to the consumer
is a thousand dollars a day.

So I don't know, is that a reasonable profit margin?

That very question ripped through the industry
and patient groups alike.

And the answer wasn't unanimous.

Now, I think the drug was priced very fairly.

The drug was priced cheaper
than what existed,

uh, safer than what existed,

uh, and more effective than what existed.

I think that's a pretty powerful argument
to say why that price should be where it was.

I was just so scared for my daughter
because, you know,

if something were to happen to me
and I died...

...she wouldn't have me to be there for her.

And I wanted--I wanted her to be happy

and to meet a man to love her

and support her.

Go to her wedding.

See my grandchildren.

Things that I thought about a lot.

Gilead Sciences hit a home run yesterday
with its earnings

when it reported after the market closed.

Gilead delivered revenue of $5 billion.

That was almost double
what it earned last year at this time

because of its drug Sovaldi.

While hundreds of thousands of patients
lingered on waiting lists

hoping for their chance at the miracle drug,

Gilead's stock prices soared.

If anything, it's now very clear.

Gilead dramatically underpaid for Pharmasset.

They were just visionaries.

Boy, it makes me like them even more.

When you talk about these new hepatitis C drugs,

the system's working the way
it's supposed to.

Gilead comes up with a new drug
that literally cures hep C in 12 weeks.

It's expensive when it first comes out,

but you're done, you're cured.

It turned out that a number of the people
who I was in the group with

did die before they were able to qualify
or get the money together.

That made me angry
and also feeling guilty.

You know, why was it that it was me
and not one of those other people

who I had befriended in the group?

Maybe, you know, why did they have to die

and leave their families.

As someone in the industry,

do you believe that people are only driven
by massive profit?

I mean, is that the only reason
why they get up in the morning?

There's a very cynical view of what motivates people,

both in science and in medicine in particular.

And it must be very sad to be a person
who believes that,

that the only reason people get up
out of bed and go to work in the morning

is because they really want to make
as much money as possible no matter what.

I have had the good fortune,

as have most people who work
in hospitals and universities,

to be surrounded by people
who get out of bed in the morning

because they want to help other people.

And the idea that people would not do that anymore

if they didn't become bazillionaires

is a very cynical and probably incorrect view
of human nature.

Using Gilead's own documents,

the evidence shows that the company
pursued a calculated scheme

for pricing and marketing its hepatitis C drug

based on one goal:

maximizing revenue,

regardless of the human consequences.

When you look at the way in which
top executives in the United States are being paid,

the vast majority of their pay
is geared toward stock price performance.

Now, in this particular case,
there's another dimension of executive pay

which we've done research on,

and the research we've done is kind of,
as far as I'm concerned,

is a breakthrough because other people
have not noticed this,

that almost every number you read
in The Wall Street Journal,

The New York Times, and the press,

it's not what the CEOs actually get paid,

it's an estimate of what
they might make in the future

from their stock options
and stock awards.

But it's the buybacks that are the problem,

and they're huge.

Stock buybacks are when a company
buys back its own share

from the stock market.

In 2014, after the huge profits of Sovaldi kicked in,

Gilead spent $11 billion on these buybacks,

and in doing so, they sent the company's
stock price through the roof.

With such an intense spike in share values,

this opened up a window for company executives

to cash in on their stock options.

So in the case of John C. Martin,

it was reported, if you use the estimated fair value,

that he made $19 million in each year.

Now that sounds like a lot of money, and it is.

But that's not what he actually took home.

A close look at Gilead's publicly filed proxy statements
from 2014 and 2015

reveal not only John C. Martin's
estimated value of stock options

but more importantly,
the actual realized gains.

In 2014, he took home almost $193 million,

and in 2015, $232 million.

That was the whole point of being the CEO
of the company for this guy.

And the executive pay didn't stop at John Martin.

The top five executives combined
took home over $400 million

within one year of the drug's release.

To put that in perspective,

if you apply the one-year salaries
of these five individuals

towards selling Sovaldi at the company's cost
of a dollar a day,

you could completely eradicate hepatitis C

from France, Spain, Argentina,
the United Kingdom, Canada,

Australia, and the United States of America.

According to Jonas Salk,

the reward for work well done
is the opportunity to do more.

But our current culture seems to believe
that the reward for work well done

is the opportunity to take more.

Is this business as usual?

The price we pay for living in a free market?

Has it always been like this,

or have we lost our way?

Also known as infantile paralysis

because of its propensity to affect children,

polio was pandemic.

Outbreaks ravaged Europe, North America,
Australia, and New Zealand

during the first half of the 20th century.

Polio was a terrifying disease.

Parents were afraid to send out
their children to play,

especially during the summer months

where, uh, the U.S. went through
a series of epidemics

of the polio virus would spread
and affect many children.

In extreme cases,
it could lead to the death of children

and also to paralysis,
very serious respiratory defects.

Children could end up in what became famous
as iron lungs.

These were mechanical devices
that helped breathe children.

Without these devices, children would die.

So it was really terrifying and affected entire society.

There are a lot of parents
whose children are healthy and happy now

who live in fear.

I know I do.

The fear, my friends, is polio.

Mechanical respiratory aids
temporarily do the work

of the muscles required to breathe

until those muscles can recover

or until substitute muscles
can be trained to replace them.

The uninfected lived in fear.

The infected struggled to breathe.

And both could only wait as medical professionals
waged war against the disease.

1955.

A day which may well mark
the most significant event in all of medical history.

The world will very soon know
whether the battle against the disease

that has twisted hundreds of thousands of young bodies
has been won.

At just 40 years old,

Dr. Jonas Salk, a New York born virologist,

gathered with the rest of the world
to hear the results from his latest research.

If the results from the observed study areas
are employed,

the vaccine could be considered 80% to 90% effective

against paralytic poliomyelitis.

It was the end of polio.

And so when Jonas developed this drug

and had a profound impact on society,

it essentially eradicated the disease,

and one of the major achievements
of biomedical research of the last century.

Perhaps even more poignant and impactful
than the work that led to the vaccine

was the decision Salk make afterwards.

Who owns the patent on this vaccine?

Well, the people, I would say.

There is no patent.

Could you patent the sun?

The accessibility of the vaccine
had a profound effect

on the entire planet.

If Salk had patented the vaccine,

he would have profited upwards
of $7 billion.

What this answer reflect is his desire
and passion

to do work that benefits mankind
without profit and personal benefit for himself.

Salk's pioneering legacy lit the way
for modern medical innovation,

and it ushered in a new energy
for scientific and medical discovery.

The drug industry has always been
dependent on scientific breakthroughs

to really come up with innovative medicines.

And the whole first part of that process
is really driven by basic science,

the vast majority almost universally
funded by the federal government.

The NIH plays a huge role
in the development of basic science.

The United States has the largest
federally funded science program in the world,

with nearly $32.3 billion being invested annually.

NIH funds are essential
in the earliest parts of research,

which brings the basic knowledge
of how the human body works.

And that research is done generally

with support from the NIH
and academic scientists.

The trek from basic science
into the development of a pharmaceutical drug

is called translational research.

Having the capital and infrastructure

that many government and educational facilities lack,

pharmaceutical companies often step in
in the late stages of development

and prep the drug for the market.

Lastly, the drugs must get approval
from the FDA.

Food & Drug Administration

Once the FDA gives its stamp of approval,

the transformation is complete

from science into a product.

And if there's one thing America knows how to do,

it's sales.

I am ready.

Because today, there's Harvoni.

-Good afternoon.
-Hi.

I'd like to get a prescription filled.

It's for brand name Abilify.

Sleep.

-Congratulations, you're down with Crestor.
-Yes!

Prilosec OTC.

I got my first prescription free.

Ask your doctor about Farxiga.

-Tecfidera.
-Viagra.

-Eliquis.
-Otezla.

I feel better now--better now--better now.

Direct-to-consumer marketing
is a public health disaster.

Consumers who know almost nothing

about the scientific basis of their disease,

for the most part,

can only be convinced
to put pressure on their doctor

to prescribe something that they have no idea
what the impact of that's going to be.

And I'm sure you'll talk to lots of doctors who say,

"I have patients come in and ask all the time

if they should be taking a drug
for a disease they don't have."

I mean, you listen to that list
of all the bad things that can happen to you.

The companies have tested this

and they found out that saying all these scary things,

people just think you're being more truthful.

It makes it seem like it's more--
you know, they have a higher degree of confidence.

But, you know, the television advertising's
quite manipulative.

As a Brit, I do find it disconcerting
when I'm in the States

to see all the direct-to-consumer advertising.

I find that a little strange.

Every time I get surprised that, you know,
you switch the TV on

and there's people playing golf
and hugging their grandchildren

and it's beautiful.

So on British TV, you won't see adverts for medicines

which are only available by prescription
through doctors.

Pharmaceutical companies cannot market
or advertise publicly

branded drugs to the public.

On May 19th, 1983,

the American public set eyes
on a television commercial

that would spark a debate
that rages on still today.

If you're one of the many people
who take the prescription drug Motrin,

you should ask your physician or pharmacist
about Rufen.

They will tell you that both Motrin 400 milligram tablets

and Rufen 400 milligram tablets

are different brand names for the same drug:

ibuprofen.

There is only one important difference.

Rufen can cost you considerably less.

Boots Pharmaceutical aired

the first broadcast television commercial
in the United States

for a prescription drug,

and in doing so, sent the FDA reeling.

Within 48 hours, the federal government
pulled the plug.

Pharmaceutical advertising regulations
hadn't been addressed in over a decade,

and at the time, no one had anticipated

a pharmaceutical direct-to-consumer advertisement.

Ironically, even the industry was torn.

In a 1984 letter to the then-representative
John Dingell of Michigan,

vice president of Eli Lilly said
direct-to-consumer advertisements

would be "both unwise and inappropriate."

The Upjohn Company said it "would be detrimental
to the pharmaceutical industry."

And Schering-Plough claimed that "in most cases,
it cannot safely be accomplished."

The FDA responded with a set
of rigid rules and requirements.

Ads weren't outright banned,

but they had to list all applicable ingredients,

safety information,
warnings, precautions,

adverse reactions, and the like.

This rendered TV ads nearly impossible
to pull off.

This confined pharma companies
primarily to print ads for nearly a decade

until 1996, when Schering-Plough,

the same company that condemned
direct-to-consumer ads eight years earlier,

ran a divisive ad for Claritin.

The plan was simple:

Make no mention that Claritin
is a pharmaceutical drug.

-Claritin.
-It's time, it's time.

Don't wait another minute for Claritin.

Claritin. I'll ask my doctor.

It's time to see your doctor.

Mr. Wilkin, the doctor will see you now.

At last, a clear day is here.

I want to know more about Claritin.

Yes, ask your doctor for a trial of Claritin.

In a clever marketing move,

Schering-Plough used what was later coined

the "ask your doctor" loophole.

They essentially shrugged off
the required fine print,

the bold print,
and everything in between.

In its place, one clear message:

"Ask your doctor for details."

The whole purpose of that
supports an overall marketing strategy

which is to leave no stone unturned.

Make patients ask about drugs.

The Claritin campaign
once again rocked the boat,

forcing the FDA to reassess,

and in 1997,
during Bill Clinton's second term,

direct-to-consumer ads
were deregulated,

giving way to the kind
of pharmaceutical ads

that now dominate the airwaves.

President Clinton agreed
to have drugs advertised

on television, newspapers,
which had been prohibited previously.

So that just exploded
the direct-to-consumer advertising.

So now, companies are spending
more money on marketing

than they're spending
on research and development.

We don't know what companies are spending

on research and development,

but we have seen studies that show that

many companies are spending
19 times as much money

on the marketing and advertising part

than they are on the research and development part.

Now, they like to argue that
they need these high prices

to cover R&D,

but why do they need such high prices

to cover all this marketing and promotion?

Now, don't forget,

the consumer side that we see,
direct-to-consumer advertising,

has a whole other side
which is direct-to-physician marketing

that consumers never see.

Pharmaceutical companies spend a lot of money

marketing their products to doctors.

I think one estimate suggested

it was in the range of $60 billion a year.

Now, drugs, doctors, and the relationship
with the pharmaceutical industry.

Those connections
have long been the subject

of ethical and business concerns,

particularly when it comes
to the financial ties

between doctors
and the drug companies.

But this is through
the medical journals,

this is through drug reps
coming to their offices,

this is through conferences

when they go
to their professional society meetings.

The industry has just run astray.

I mean, it's gone wild.

They are throwing money
at doctors left and right,

they're paying doctors
to conduct studies,

even to ghostwrite certain articles.

What that means is

the pharmaceutical company
actually writes the article

and then slaps a doctor's name on it.

-For a medical journal?
-That's right.

When I did some initial research
on this a few years ago,

there were many, many physicians

receiving seven-figure supplements

while they still conducted
or managed a practice in their home.

So this is a disaster
from a public health point of view.

It's a pressure point
that just simply doesn't need to be there.

It serves no function whatsoever

other than to cloud clinical judgment,

and that's not good healthcare.

And in fact, if you look

at recent settlements
from the federal government,

pretty much every major drug company
in the United States

has had a finding in recent years

dealing with breaking the law
regarding the marketing of drugs.

Who wants to be a millionaire?

You do the math.

There are people in this room

who are going to make
an ungodly sum of money

selling Advair.

The last two decades
have ushered in an era

of unprecedented healthcare fraud.

GSK will plead guilty to criminal charges.

Janssen Pharmaceuticals will plead guilty.

Eli Lilly pleading guilty to criminal conduct

after skating under the radar for years.

Off-label promotion,

failure to disclose safety information,

physician kickbacks.

Nearly every major pharmaceutical company

has been caught over and over again.

For nearly a decade,

Allergan illegally promoted Botox
for uses that were not approved

as safe and effective by the FDA.

That's the way it should be:

When GSK makes money,
you make money.

The more you sell,
the more you make.

GSK engaged
in an illegal marketing campaign

where drugs were promoted
for disorders

where there was no medical evidence
they would help.

Put simply, the alleged conduct is shameful.

Um, we do occasionally make mistakes.

By pushing Seroquel for unapproved purposes,

AstraZeneca made patients into guinea pigs

in an unsupervised drug test.

The Virginia Attorney General announcing

a $100 million settlement

involving off-label marketing.

The settlement includes criminal fines
totaling $485 million.

Pfizer has agreed to pay $2.3 billion,

which makes it
the largest criminal fine in history.

GlaxoSmithKline is paying
a $3 billion fine.

Fraudulently marketing nine drugs off-label,

including Advair, Lemictal, Imitrex.

The company's also accused
of paying kickbacks to doctors

to prescribe the drug.

So let me tell you
some of the perks that they received.

They would give doctors

basketball tickets, yacht trips.

Hawaiian vacations, tickets to Madonna.

They're paying doctors millions of dollars
to go on speaking tours.

NASCAR races,
Knicks games, Celtics games,

tennis lessons,
Crosby, Stills & Nash tickets,

pheasant hunting!

Okay, all the ways
they would bribe the doctors

to do this to their own patients.

From the years 2009 to 2016,

the Justice Department
recovered $19.3 billion

in settlements in judgments
related to healthcare fraud.

In fact, just last year,
the Justice Department reached

an all-time high in the number
of healthcare fraud defendants charged

with more than 800 indictments
and more than 580 convictions.

Whatever they're fined,

they're just gonna charge it back to us.

It just becomes a cost of doing business.

God bless America,
free enterprise is a wonderful concept.

Most people have no idea

how much any drugs they take cost

unless it's over the counter, basically--

because they have insurance,

they have a copay, but it's not very big--

until the drug they're taking is $20,000,

and then they look at the bill
and they're like, "What?"

It's very strange to see money
becoming so important for me

because money has never been
very important to me,

but right now it's $20,000 for one drug,

for one treatment,

and I know that I have to take it
every three weeks

for the rest of my life.

How is that possible?

But if we can't pay for it,
I wouldn't last very long.

The premium of everybody goes up too.

I mean, it's something that people don't see
because it's not on their bill,

but they're all complaining
about the insurance premium going up.

Why is it going up?

It's because, yeah,
it's because of people like me,

because my drug is too expensive.

And then you get into anxiety,
how do I pay for it,

or am I worth it?

Should I resign myself?

I saw my mother die,
so I know, I know what happens.

It's the ultimate side effect.

Mr. President, it is unacceptable

that the monthly cost of cancer drugs

has more than doubled over the last ten years.

In the United States of America,

you should not be forced into bankruptcy

because you are diagnosed with cancer.

When I first recurred
to stage 4 metastatic breast cancer,

within a couple of months,

my insurance company
started pushing me to apply for disability,

so then in two years
I'd have to go on Medicare,

and they hired some third-party consulting firm

that would call me at night and send me paperwork

and push me to do this.

So, I did it because they threatened
to cancel my insurance.

And then in December,
the Friday before Christmas,

I was hooked up to an IV getting treatment,

and my broker calls from my health insurance

and tells me that the insurance company
found a small little caveat

and cancelled my policy.

Thank goodness I was able to apply for the ACA,

but because of our insurance premiums

and my copays for my drugs,

now we have our house on the market

because we really can't afford
to live where we live anymore

because my healthcare costs
are just too high and devastating for us.

The only thing worse than finding out
there's no cure for your disease

is finding out there's a cure
but you can't afford it.

They come back
from having run your credit and say,

"You don't have enough money
to have this disease."

A lot of these drug companies
will give you their drug,

but you have to be within a certain
income restriction for those plans.

So, for example, I don't work,

I can't work, I'm sick, I've been sick.

My husband works,
my husband works very hard

to keep us in our home
which we've had to remortgage

because of my disease.

And your spouse's income now
knocks you out of those programs,

so you have to get divorced

so that your income is the zero that it is,

and that's usually referred to
as involuntary divorce.

So now you're getting your copays
kind of taken care of through these programs,

but now you die.

Your spouse has to be left your assets

and now has to pay tax on those assets,

so it's like you end up paying
one way or another.

Either way, the diagnosis comes
with the price tag of losing everything,

not just for you but whoever survives you.

Well, before we discuss

whether a particular company
is charging too much or making too much,

let's remember that they're just playing
the game that they're handed.

So, if a company charges a lot of money,

they're basically just doing
what the system is inviting them to do anyway.

It's basically capitalism.

So, are there other areas of the economy

where we tell people,
"You can't make that much"?

We have invited them
to innovate these new therapies

and then gouge the system,

but it is the system
that they were handed to work with.

The system needs to change.

The United States grants patents for inventions,

which are essentially lawful monopolies

that last up to 20 years.

This is absolutely in step with the American spirit

to encourage and embolden innovation,

but these patents become complicated

when their management
causes suffering or death.

Drug patents are a financing mechanism.

It's a way we finance research and development.

It's not working.

There's no question that brand name manufacturers

engage in what are called evergreening techniques

or life cycle management

where they'll take a drug that is very profitable

and they'll do everything they can

to extend their patent.

So if you make a small tweak to a molecule

or if you come up
with a slightly different development process,

then you can earn a new patent.

And that way, when a drug's patent
is getting ready to expire,

the company seeks patents
not on the drug,

but on all these externalities,

and then gets another bunch of years
of patent protection.

How is it okay that a drug company can take,

instead of the right-handed version of the molecule,

take the left-handed version of the molecule,

which is basically a mirror image
of the same molecule,

get it patented as a brand new discovery,

and then market it as a new drug?

And we saw when Prilosec became Nexium,

the old purple pill became the new purple pill.

Essentially no clinical advantage,

virtually no molecular difference
of any consequence.

That type of evergreening strategy
I think is inappropriate and wasteful.

And what governments have to realize
is that companies

have become so powerful
through these monopolies

that they can't even regulate them anymore.

Can the governments regulate
legal monopolies on drugs

in a way that benefits the public?

No. The evidence is no.

Insulin prices on the rise,
and it could have a big impact

on the growing number
of people with diabetes.

A new report finds the price of insulin
has tripled in ten years' time,

a painful price for many
of the 29 million people

in the United States with diabetes.

Those high prices combined
with rising insurance deductibles

mean many people who rely on insulin
are left facing impossible choices.

I always remember insulin being

a very easy-to-obtain, cheap drug.

I remember my mom would pay $15
every three months.

Whereas, you know, fast forward to today,

the most recent price I heard was $342.99 for a vial.

That's unheard of.

You know, I'll never have a choice
not to buy insulin.

I'll always have to pay what they charge.

I have to have insulin

every second of every day to stay alive.

I've calculated up the price of my life.

It will cost over $7.5 million,

just in insulin, just for me,

to keep me alive till I'm 70 years old.

Insulin is a life-or-death medication.

Between 2002 and 2013,

the price of insulin more than tripled

to more than $700 per patient.

Federal lawsuit accuses
the three insulin manufacturers

of conspiring to raise their prices.

Just coincidentally,

it happens that the three major suppliers of insulin

seem to be raising their prices

at the same exact time at the same level.

So I think you have to be very naive
not to believe that there is collusion.

Put a critical eye on the pricing history

of two primary insulin drugs

and you'll notice a pattern.

Since 2001, the cost of both drugs

has risen simultaneously,

making their price history nearly indistinguishable.

At least when it comes to insulin,

where the original discoverers, Banting and Best,

gave away the insulin patent for $3

so that this wouldn't happen.

In 1923, Frederick Banting,
Charles Best, and James Collip,

the team that first discovered and refined
what is now known as insulin,

made a move for the common good:

They sold the patent for insulin
to the University of Toronto

for just $1 each.

Much like Jonas Salk,
their intent was to let the world benefit

from their discovery, stating,

"When the details of the method
of preparation are published,

anyone would be free to prepare the extract,

but no one could secure a profitable monopoly."

Shortly after, the University of Toronto
teamed up with Eli Lilly

to mass-produce insulin
under a royalty-free agreement.

The profits would then be put back
into research and development

at the university.

It wasn't long, however,
before drug companies

had figured out a way
to turn a good profit on insulin.

By 1941, Eli Lilly
and two other pharmaceutical companies

were indicted for an alleged
insulin price-fixing scheme.

It was a charge that Lilly would settle
in a no-contest agreement.

Sadly, after the development of insulin,

Eli Lilly would start to make
small adjustments to the research

in order to seek
their own patents on the drug

and completely undermine
the intention of the inventors.

Somehow, with really no innovations,

the same drug, insulin,
the prices keep escalating.

That makes no sense at all,

and yet this diabetes is an illness that we've seen

that Americans suffer from young and old.

So what I see is, people all over my state,

seniors that come up to me
and say that they're saving

the injectors from their insulin

just so they have a few more drops in each tube.

That is happening right now.

This is the United States of America.

Our seniors shouldn't be having to do that.

What's even more shocking,

to this day, there are still
no low-priced generics on the market.

Somehow, these three manufacturers
have figured out a way

to extend their patent lives
for nearly a century.

One of the things that is really distasteful

is that the big pharmaceutical companies
currently pay off generics

to keep their products off the market.

It's called pay-for-delay,
and it screws people all the time.

But I mean, how long can they keep doing that?

-Indefinitely?
-It's just gonna keep escalating.

Look, if you're a company in any industry,

and a monopoly is just put on your lap,

you're gonna go for it,
that's just the facts.

These evergreening techniques
are becoming common practice.

If there's a loophole,
the pharmaceutical industry will find it.

Check out shares of Allergan.

They've been rising higher this afternoon

on an announcement about patents

around one of their big eye drugs, Restasis.

Now, this is a bit of a complicated story,

but it's absolutely amazing when you really dig into it.

So what they've done, somewhat incredibly,

is they've transferred the patent
to an Indian tribe in northern New York,

and then the tribe is licensing the patent
back to Allergan,

and then the tribe is arguing that,
as a sovereign nation,

as a sovereign entity,
the patent office no longer has the right

to be involved in a patent dispute

because it can't override
the sovereignty of the Indian tribe.

This strategy potentially allows Allergan

to dodge patent challenges from rival companies.

I just spoke with Allergan CEO Brent Saunders.

He says he thinks this is the first time
this system has ever been used in this way.

I think there's a lot of misunderstanding
on why we did it.

It wasn't desperation, it was tenacity.

You describe this as offensive behavior.

I think it's terribly offensive.

I think it violates the spirit of the law,

I think it really sticks it to American consumers,

and I think in particular,
Allergan is a company that talks a good game

about wanting to be good to consumers

and they have a social contract, yadda-yadda-yadda,

and then they do things like this.

I solemnly pledge to dedicate my life
in the service of humanity.

I will practice medicine
with conscience and dignity.

The health and life of my patient
will be my first consideration.

Doctors swear the Hippocratic Oath,

a pledge that they will uphold a certain morality

when it comes to their practice.

Is it reasonable to expect
pharmaceutical companies

to be held to the same standards?

Do you think pharmaceutical companies

should operate under a different moral code

compared to other companies?

Well...

Should pharmaceutical companies
be guided by a moral compass?

Should pharmaceutical companies
have a moral compass?

That's a good question.

Pharmaceutical companies
absolutely should have a moral compass.

Absolutely, pharmaceutical companies
should act with moral integrity

when they are dealing with drugs

that make the difference
between life and death for patients.

The notion of a moral code
governing what they do

doesn't make much sense to me.

I think companies should have some morals.

I mean, there are some lines
that they shouldn't cross.

I think all of healthcare is a right, okay.

There's a long discussion behind that.

They are not like medicine.

They are a company.

They are no different than big oil,

Coca-Cola,

maybe the tobacco industry.

The sad reality is that they are corporations,

and they are answerable to their shareholders,

and that doesn't make it right or good,

but it's a little naive to think
that a company that makes drugs

is somehow gonna have
a different set of morals

than a company that makes
gasoline or computers or cars.

Corporations are nothing more
than a conglomeration of individuals,

and those individuals
have their own moral compasses,

and oftentimes we see that,
for some reason,

people check those at the door

when they walk into their offices
and they're making decisions

because they put something else
ahead of what is right.

Imagine, for a moment,
popping a pill before bed

that costs about $13.50.

Now imagine waking up the next morning

to find that the price of the exact same pill
jumped to $750 overnight.

When Shkreli increased Daraprim's price 5000%,

he complained that he was being unfairly vilified.

There are literally a dozen companies just like ours

that raise prices dramatically,
and higher, might I add, than our company,

and I don't see those companies
getting the criticism that I got.

Why do they keep coming after you?

You know, I just can't fathom.

I guess it might have something to do
with me being very handsome,

very wealthy, and very funny.

Last time you heard the name
Martin Shkreli on this broadcast,

he drastically raised the price
of a life-saving drug.

Tonight, the head of a drug company,

who's accused of gouging patients,

says he should be thanked.

There's no doubt I'm a capitalist,

I'm trying to create a big drug company,
a profitable drug company.

I now walk down the streets of Manhattan,

people ask me for autographs,
they want selfies, I have a lot of fans.

He is a brash self-promoter

who's called himself
the world's most eligible bachelor.

This is a city where success is prized.

It is a city if you make it here,
you can make it anywhere.

I wonder if you would do anything differently.

I probably would have raised the price higher

is probably what I would have done.

I'm a child of immigrants
that are janitors from Brooklyn.

I've made myself into an enormous fortune.

In response to all of this attention,

and doctors and patient groups
saying they can't access this drug,

are you gonna change the price?

No.

When Martin Shkreli, the infamous "Pharma Bro"

who took a one-dollar-a-day pill

and raised that pill to $750

for no rationale other than he could

because he was the only manufacturer,
or provided the only source,

that's not illegal, but it is immoral.

People's lives are at stake
because of the price increases you impose

and the access problems
that have been created.

You've been viewed as
a so-called bad boy of pharma.

Are you listening?

Yes.

The way I see it,
you can go down in history

as the poster boy
for greedy drug company executives,

or you can change the system.

In this industry, sadly,

they say something like this:

"Yeah, we'll go in and we will take
the blows of the Congress

because they'll be upset for a little while,

but all we gotta do is basically rope-a-dope."

A 30% discount on a 500% price increase

hardly makes a dent.

Does that sound like a good deal to you?

What we try to do is address the issue

from a portfolio point of view.

Let's talk about R&D.

How much did Mylan spend

on research and development products in 2015?

Actually, we've spent, over the years,

trying to do several things that failed and trying to--

That's not what I asked you,
I said how much did you spend

on R&D in 2015?

I mean, I feel like you're just--

you're not giving me answers, ma'am.

That's pharma's philosophy.

They know they're gonna take the blow,

so they'll come in and the chief executive
will get hit a few times,

and then they'll leave and say...

Then we can go right back

and just continue to do what we've been doing.

I think when people look back
in 10 or 20 or 30 years

and write the history of drug pricing
in the early 21st century,

they're gonna be struck by two remarkable
and often inexcusable trends.

Between the gaming of the patent system

or the exclusivity and licensing system

for the old drugs, which is unconscionable,

and the charging of hundreds
of thousands of dollars a year

for a new drug that's still on patent,
which is also very, very troubling,

people will look back and say,

"That is where the industry
began slitting its own throat

and basically begging to be regulated

because people are just fed up
with those kinds of prices."

Be it a single-payer system,

collective bargaining, or pricing committees,

there are many ways government
can regulate drug prices.

The United States is the only
industrialized country in the world

that operates on a system
of whatever the traffic will bear.

Aside from everything else,

the government just doesn't negotiate for prices.

I mean, some people know that, for example,

that Medicare is forbidden to negotiate,

but I don't think the majority of people understand that.

I mean, that would be such an easy fix.

The reason we pay more

is because all the other countries
negotiate with the drug companies

and we don't.

Canada, Britain, Germany, Switzerland.

Pick any developed country,
they all negotiate.

Take the hepatitis C drug, sofosbuvir, for example.

In 2016, the same drug cost 37% less in the U.K.,

66% less in Spain, and 99% less in Egypt and India.

It appears that there's an opinion in the U.S.

that medicines made overseas
are inferior or even dangerous.

Well, all of the factories
that are manufacturing these generics

are licensed by the FDA
and the World Health Organization,

and in the case of hep C meds,
they're licensed by Gilead anyway,

so they're absolutely identical
in every way to the expensive product,

and the reality is that probably 50%
of the prescription medicines in the U.S.

are made in India anyway.

Is it that somehow we're carrying
a greater load because we're richer

or because we're financing R&D
for the rest of the world?

No. We're carrying a greater load

because the drug companies
built a system that precludes us

from negotiating over prices
in this country.

Everybody else does,
so we pay more.

As a rule,
pharmaceutical industry always wins.

Last November in 2016,

we had an initiative on the ballot
in California, Prop 61,

that said they could negotiate for prices.

Do you have any idea
what the pharmaceutical industry is spending

against Proposition 61?

They are spending $126 million!

$126 million

to defeat a proposal that will lower drug costs

for the people of California.

It is incomprehensible!

The time is long overdue
for the American people

to stand up to the greed
of the pharmaceutical industry.

We should be doing it here in Washington,

but they own Washington, unfortunately.

Well, they have spent, since 1998,

over $3 billion in lobbying.

$3 billion in lobbying,

not to mention enormous amounts of money
in campaign contributions.

Not only are they the top lobbying industry,

but they outspend every other American industry

by at least 44%.

This gives them unparalleled lobbying power.

Donald Trump got elected
to drain the swamp in Washington.

If anybody ever did drain the swamp,

what they would find lying around the bottom

is four or five drug industry lobbyists
for every representative in Washington.

The New York Times sort of intimated
this morning in their op-ed

that Congress yells a lot but does nothing.

I couldn't agree more.

Because the lobbying,
and you guys lobby too.

You lobby.

Is Congress too close
to the biotech and pharma industry?

They've got lobbyists everywhere

pushing for what they want.

The unfortunate realities
of politics in America

is that the larger
your lobbying trade group is

and the more money you can wield,

and they often call it dark money,

the dark money goes
to support electing politicians,

and that money absolutely influences
decisions that are made.

The reach of pharma's financial contributions
is staggering.

In 2016, out of the 100 members of the Senate,

93 senators accepted money from pharma.

A lobbyist has a lot of money at their disposal.

First of all, you can give contributions,

which is really the mother's milk of politics,

to virtually every congressman you need to impact,

and not just contributions,

you can raise significant sums of money for them

if you have a lot of resources.

You can, in essence,
buy your way through your issue

if you do it carefully.

The Congress of the United States of America

should be put up for malpractice
for not addressing this issue.

Mr. President, let us be frank, let us be honest.

The current political campaign finance system
is corrupt

and amounts to legalized bribery.

The pharmaceutical industry
has prevailed for almost a decade

here in Washington
in just wiping this issue off the agenda.

There's no discussion,
there are no votes,

we have not really done anything
to even try to act

on pharmaceutical prices
with a vote on the floor of the House

since 2007.

Last month, federal lawmakers from both parties

helped the industry block Senate legislation

to let Americans purchase lower-priced
FDA-approved medicines from Canada.

Right, so, that is absurd,
and by the way, again,

let's emphasize that it wasn't just Republicans,
it was Democrats as well.

Pharma's gone back and forth
as to whether or not they want to be partisan.

So in some eras,
you see pharma weighing in very much

for the Republican Party.

In other years, it was more equal
between the Democrats and the Republicans.

The reality is,
if you're a congressman,

they let you know
that if you do things that they like,

they will give you money;

if you do things they don't like,

they will give money to your opponent.

Just the threat of a campaign contribution
to an opponent

is all that's necessary
to be able to control a politician,

and it's why it's so difficult
to get any meaningful legislation advanced

at either the state or federal level
is because of all the money.

We have members here
who just love free trade.

We can bring any product you want in
from China,

you can get lettuce and tomato
coming from farms in Mexico,

but for some strange reason,

we cannot bring in brand-name drugs from Canada.

Just can't do it, can't figure out how to do it.

And everybody here knows what the reason is.

So you have a very wrong system,

a very immoral, at some level, system

that really, in essence,
comes down to bribery that is legal,

and that's what's gotta be changed,

but to change it, you've gotta get
the very members of Congress

who benefit from these bribes
to agree not to take them.

It's very, very hard

because of the reach
and influence and the money

that the drug corporations have
to do this work,

but there is enough anger
and there is enough energy

that we are making progress.

The era of modern medical research

has brought us undeniable breakthroughs

that have curbed illness and extended lifespans,

but at what cost?

Everyone looks gorgeous!

I feel like it's my calling--
if you want to call it that--

I feel like it's my job
to effect change

because I think it's really unfair

to have to be your own advocate to this level.

The drug companies are almost holding

people that are sick or chronically ill

or have some sort of a disease
or cancer or whatever,

they're holding us hostage.

Somewhere along the way,
the pharmaceutical industry

turned its back
on the very society that it serves,

pledging its loyalty to profit,
corrupting our political system,

and testing the breaking point
of our economy.

I'm not sure what a revolution
for sick people would look like,

but I do know that we need one.

If the healthy and well
could stand up with the sick,

we could get a lot done,

and we need to figure this one out together.

It can't go on.

It's not just that our healthcare
is way more expensive

than any other country on earth,

it's that there is no good end
to this path that we're on.

We have Stockholm syndrome,
we're just sort of like,

people are accepting horrible consequences
from the current system

because they think there's no alternative.

The important thing is
there is an alternative.

The alternative is to do something different
than what we're doing right now.

Something has to change.

Price regulation, patent reform,

industry transparency,

single-payer system, negotiation reform,

marketing regulations, anything has to change.

We are exposing to the world

just how greedy this pharmaceutical industry is.

Somebody has to say no.

Somebody has to react and say,
"It's not acceptable.

We can do better.
As a society, we can do better."

Everyone knows somebody who's sick,
who's been sick.

They want that person
to have better treatment options,

as I do, but it can't be a conversation
about what's that person worth to you?

It can't be that kind of conversation.

They will fight it,

they will try to buy our Congress,

they will stifle legislation,

and they will spend billions of dollars

to hang onto the system
that has given them their power.

Do not concentrate on, so much,
who you're fighting against;

concentrate on what you're fighting for.

One person can make a difference.

I think people need to get on the phone,

call their congressman, and say,

"Look, I want something done
about this drug pricing.

It's ridiculous."

They can be beaten.

They will be beaten if patients
and consumers stand up and say,

"No more, we're not gonna do this anymore."

It's the only way we have a chance to push back

against all the money and influence
that the drug companies have.

We have lost control of the industry

that holds our lives in the palm of their hand.

What, then, are we willing to do to get it back?

The answer can't be nothing!