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These are the user uploaded subtitles that are being translated: 1 00:00:13,472 --> 00:00:16,308 We're just a regular, you know, middle class couple. 2 00:00:16,308 --> 00:00:19,770 We both had good jobs, we both were making decent money. 3 00:00:19,770 --> 00:00:23,148 Um, we had two cars, we had a nice house. 4 00:00:23,148 --> 00:00:27,277 And then all of a sudden, I find out that I had this disease... 5 00:00:27,277 --> 00:00:31,240 and it's like that life is over, it's like all of a sudden a book got slammed shut. 6 00:00:33,450 --> 00:00:36,787 I had neoadjuvant chemo. 7 00:00:36,787 --> 00:00:42,542 I had a single right side mastectomy and then 37 rounds of radiation, 8 00:00:42,542 --> 00:00:46,421 after which I was placed on a drug called Tamoxifen, 9 00:00:46,421 --> 00:00:51,093 which is a maintenance drug, and, uh, certain other drugs. 10 00:00:51,093 --> 00:00:54,179 Cystic fibrosis is a genetic illness, 11 00:00:54,179 --> 00:00:58,558 and, um, it is a terminal disease. 12 00:00:58,558 --> 00:01:02,562 I worry about him feeling terrible, 13 00:01:02,562 --> 00:01:06,358 as if it's his fault that his family might have to go through, 14 00:01:06,358 --> 00:01:09,569 you know, some financial trauma or financial strain. 15 00:01:09,569 --> 00:01:11,738 At three years old, my son looked at me and said, 16 00:01:11,738 --> 00:01:13,073 "Mommy, am I expensive?" 17 00:01:14,741 --> 00:01:16,535 "Mommy, am I expensive?" 18 00:01:16,535 --> 00:01:20,664 He was looking for a reason to blame himself at three. 19 00:01:25,127 --> 00:01:28,714 I'm a HER2-positive breast cancer patient. 20 00:01:28,714 --> 00:01:31,925 I was very lucky they have a great drug. 21 00:01:31,925 --> 00:01:33,552 It's a targeted therapy. 22 00:01:33,552 --> 00:01:36,388 And then of course the first bills appear, 23 00:01:36,388 --> 00:01:42,561 and then we started to calculate how long our saving would last. 24 00:01:44,354 --> 00:01:49,443 I tell my children all the time that they better start saving money 25 00:01:49,443 --> 00:01:52,487 because sooner or later, you're gonna come to a point in your life 26 00:01:52,487 --> 00:01:56,825 where your health needs a prescription drug, 27 00:01:56,825 --> 00:02:04,541 and God forbid, because you will lose the things that you hold most dear. 28 00:02:11,506 --> 00:02:13,216 C.S. Lewis says, 29 00:02:13,216 --> 00:02:20,474 "Education without values seems rather to make man a more clever devil." 30 00:02:20,474 --> 00:02:23,310 Can the same be said for modern medicine? 31 00:02:25,562 --> 00:02:28,982 By the time you finish watching this film, 32 00:02:28,982 --> 00:02:33,487 at least seven Americans will have died, 33 00:02:33,487 --> 00:02:38,575 not because of bad luck or genetics or tragedy, 34 00:02:38,575 --> 00:02:43,538 but because they couldn't pay what the market will bear. 35 00:02:43,538 --> 00:02:49,836 If we're asking how much it costs to keep someone alive, 36 00:02:49,836 --> 00:02:53,924 maybe we are asking the wrong question. 37 00:02:55,217 --> 00:02:57,969 An investigation into the cost of prescription drugs 38 00:02:57,969 --> 00:03:00,889 reveals huge price hikes over the past five years. 39 00:03:00,889 --> 00:03:02,766 Several brand name medications more than doubled... 40 00:03:02,766 --> 00:03:06,186 Now, let's turn to the rising price of prescription drugs 41 00:03:06,186 --> 00:03:08,105 and outcries to do something about it. 42 00:03:08,105 --> 00:03:12,109 U.S. medical community is outraged after a life-saving drug 43 00:03:12,109 --> 00:03:15,153 saw a more than 5000% price hike. 44 00:03:15,153 --> 00:03:19,074 Who raised prices by how much, and who are the biggest offenders? 45 00:03:19,074 --> 00:03:21,201 -Everyone. -Why is this happening? 46 00:03:21,201 --> 00:03:25,080 Well, the simple truth is they can do anything they want 47 00:03:25,080 --> 00:03:27,582 at any time they want to do it. 48 00:03:27,582 --> 00:03:32,838 Let's not forget the drug industry is the most profitable industry in America. 49 00:03:32,838 --> 00:03:34,548 No other industry is even close. 50 00:03:34,548 --> 00:03:36,049 Shouldn't be surprised. 51 00:03:36,049 --> 00:03:39,177 'Cause it's impossible to escape pharmaceutical ads. 52 00:03:39,177 --> 00:03:42,973 Everything we were to do was about making Wall Street happy. 53 00:03:42,973 --> 00:03:45,350 All the way over. 54 00:03:45,350 --> 00:03:49,229 Seventy percent of Americans take at least one prescription drug. 55 00:03:49,229 --> 00:03:50,689 Thousand dollars a pill. 56 00:03:50,689 --> 00:03:53,108 Twenty thousand dollars every three weeks. 57 00:03:53,108 --> 00:03:56,236 Seven hundred and fifty thousand dollars a year. 58 00:03:56,236 --> 00:03:58,155 They really are a gatekeeper. 59 00:03:58,155 --> 00:04:01,032 They determine, in many cases, who lives and who dies. 60 00:04:04,744 --> 00:04:07,414 Call your doctor right away if you experience fever, 61 00:04:07,414 --> 00:04:11,209 tiredness, body aches, chills, nausea, vomiting, 62 00:04:11,209 --> 00:04:13,670 seizures, loss of vision, or weakness. 63 00:04:20,594 --> 00:04:24,306 The livelihoods of Americans are being held captive 64 00:04:24,306 --> 00:04:26,892 by rising drug prices, 65 00:04:26,892 --> 00:04:29,478 and there's no discernible ceiling. 66 00:04:29,478 --> 00:04:33,064 A lot of Americans are being hit by soaring prescription drug prices. 67 00:04:33,064 --> 00:04:37,152 Americans spent an estimated $450 billion with a B 68 00:04:37,152 --> 00:04:39,488 on prescription drugs in 2016. 69 00:04:39,488 --> 00:04:42,491 Imagine knowing your child has a rare disease 70 00:04:42,491 --> 00:04:45,702 that will slowly destroy all the muscles in their body. 71 00:04:45,702 --> 00:04:47,787 Now imagine there's a new treatment for it, 72 00:04:47,787 --> 00:04:52,209 but it is so expensive you would never be able to afford it. 73 00:04:52,209 --> 00:04:57,839 There's a fundamental problem when the price tag of contracting a disease 74 00:04:57,839 --> 00:05:01,468 is more dreadful than the disease itself. 75 00:05:01,468 --> 00:05:04,513 In February, Valeant Pharmaceuticals raised prices 76 00:05:04,513 --> 00:05:08,767 for two newly purchased hard drugs, Isuprel and Nitropress, 77 00:05:08,767 --> 00:05:12,103 212% and 525%. 78 00:05:12,103 --> 00:05:14,648 Spinraza got FDA approval last December 79 00:05:14,648 --> 00:05:19,611 and a price tag: $125,000 per dose. 80 00:05:19,611 --> 00:05:24,199 Many cases, the costs add up to a million dollars a year for a lifetime. 81 00:05:24,199 --> 00:05:28,286 These drugs are priced at incredibly high levels, right, 82 00:05:28,286 --> 00:05:30,831 which are unaffordable to not only people in this country, 83 00:05:30,831 --> 00:05:32,749 but people around the world. 84 00:05:32,749 --> 00:05:35,335 They know that the prices they charge for a lot of drugs 85 00:05:35,335 --> 00:05:37,504 exclude people from having access to those drugs. 86 00:05:37,504 --> 00:05:39,548 It's not like they don't understand that, they do. 87 00:05:39,548 --> 00:05:42,342 Insulin is a life or death medication. 88 00:05:42,342 --> 00:05:46,221 Those high prices combined with rising insurance deductibles 89 00:05:46,221 --> 00:05:49,891 mean many people who rely on insulin are feeling sticker shock. 90 00:05:50,767 --> 00:05:56,648 Assuming we are able to take the humanity and emotion out of the equation, 91 00:05:56,648 --> 00:06:01,069 we're still left with the question of economic sustainability. 92 00:06:01,069 --> 00:06:05,240 Well, all you have to do is project the trends which are already off the charts. 93 00:06:05,240 --> 00:06:08,368 You'd have to tape another piece of paper to the top of the chart 94 00:06:08,368 --> 00:06:10,370 and watch them go up some more. 95 00:06:10,370 --> 00:06:14,457 It is ludicrous to think that the U.S. and healthcare in general 96 00:06:14,457 --> 00:06:19,546 can go on spending about 18% of our gross domestic product 97 00:06:19,546 --> 00:06:21,381 on health in general. 98 00:06:23,049 --> 00:06:28,555 The percentages of our gross domestic product are swelling at an alarming rate. 99 00:06:29,764 --> 00:06:34,477 If this trend continues, a crash is inevitable. 100 00:06:36,062 --> 00:06:39,232 If the price of milk or bread or any other staple 101 00:06:39,232 --> 00:06:43,570 went up at the same rate that drug prices are going up, 102 00:06:43,570 --> 00:06:45,864 people would be rioting in the streets. 103 00:06:45,864 --> 00:06:51,745 Uh, Mr. President, I rise to discuss one of the major crises 104 00:06:51,745 --> 00:06:55,040 facing our healthcare system today, 105 00:06:55,040 --> 00:07:00,253 and that is that the pharmaceutical industry itself 106 00:07:00,253 --> 00:07:05,216 has become a major health hazard to the American people. 107 00:07:06,384 --> 00:07:08,178 Prices are going up outrageously. 108 00:07:08,178 --> 00:07:09,596 No justification. 109 00:07:09,596 --> 00:07:11,890 So you can walk into a drugstore tomorrow 110 00:07:11,890 --> 00:07:13,433 and find that the price that you're paying 111 00:07:13,433 --> 00:07:16,686 for the same medicine you've had for 20 years has been doubled. 112 00:07:16,686 --> 00:07:18,480 And you ask the pharmacist why. 113 00:07:18,480 --> 00:07:21,149 There's no reason, they can double it based on market needs. 114 00:07:21,149 --> 00:07:26,738 So what you have is an incredibly powerful industry charging any price they want 115 00:07:26,738 --> 00:07:29,532 and the result of that is that one out of five Americans 116 00:07:29,532 --> 00:07:32,410 can't afford the medicine that they need. 117 00:07:32,410 --> 00:07:33,745 Can you imagine that? 118 00:07:33,745 --> 00:07:36,581 So they go to the doctor, doctor writes a prescription, 119 00:07:36,581 --> 00:07:38,458 but they can't afford to fill it. 120 00:07:38,458 --> 00:07:41,378 But five major companies made $50 billion in profits last year. 121 00:07:41,378 --> 00:07:43,672 Listen, you have an insane situation 122 00:07:43,672 --> 00:07:48,301 in which people are dying because they can't afford the medicine they need, 123 00:07:48,301 --> 00:07:49,844 or getting much sicker than they should 124 00:07:49,844 --> 00:07:52,055 just so these companies can make outrageous profits. 125 00:08:06,528 --> 00:08:08,196 Yeah, you better give yourself a shot. 126 00:08:41,271 --> 00:08:45,483 In 2007, Mylan Pharmaceuticals acquired EpiPen, 127 00:08:45,483 --> 00:08:49,362 a device used for injecting measured doses of epinephrine. 128 00:08:49,362 --> 00:08:53,992 The call's growing louder for drug makers to lower the price of the EpiPen. 129 00:08:53,992 --> 00:08:57,704 Since the acquisition, prices have risen continuously. 130 00:08:57,704 --> 00:09:00,457 Pharmaceutical giant Mylan was at the center of criticism last year 131 00:09:00,457 --> 00:09:01,875 over rising drug prices. 132 00:09:01,875 --> 00:09:04,461 Pressure mounting on EpiPen maker Mylan Pharmaceutical. 133 00:09:04,461 --> 00:09:07,464 A trio of senators now calling for an explanation. 134 00:09:07,464 --> 00:09:12,969 The auto-injector's price has risen by more than 480% since 2009. 135 00:09:15,096 --> 00:09:18,266 My daughter Kennedy was diagnosed with food allergies 136 00:09:18,266 --> 00:09:20,226 when she was about 13 months old. 137 00:09:20,226 --> 00:09:22,729 Kennedy also has asthma, 138 00:09:22,729 --> 00:09:24,898 she has reflux, 139 00:09:24,898 --> 00:09:27,484 and she has eosinophilic esophagitis. 140 00:09:27,484 --> 00:09:30,862 So for Kennedy, she does have a medication regimen 141 00:09:30,862 --> 00:09:32,530 that she has to take every day. 142 00:09:32,530 --> 00:09:35,492 She has to take maintenance meds for her asthma. 143 00:09:35,492 --> 00:09:41,372 She also has to take a maintenance swallow medication for her EoE. 144 00:09:41,372 --> 00:09:44,125 And then she carries around her EpiPen. 145 00:09:44,125 --> 00:09:49,923 And Shane has a life-threatening allergy to blueberries. 146 00:09:49,923 --> 00:09:52,926 He also has mild asthma. 147 00:09:52,926 --> 00:09:57,096 But Shane also has what they call idiopathic anaphylaxis, 148 00:09:57,096 --> 00:09:59,474 whereas just out of the blue, 149 00:09:59,474 --> 00:10:02,060 there are times that things that we don't know yet 150 00:10:02,060 --> 00:10:04,938 could actually cause him to go into an anaphylactic reaction. 151 00:10:04,938 --> 00:10:06,606 We are here with the CEO that is no doubt 152 00:10:06,606 --> 00:10:09,567 the center of a national firestorm-- I think that's fair to say. 153 00:10:09,567 --> 00:10:12,028 Heather Bresch, CEO of Mylan Labs. 154 00:10:12,028 --> 00:10:15,573 The price hike has been labeled "outrageous" by Hillary Clinton, 155 00:10:15,573 --> 00:10:17,450 "egregious" by Bernie Sanders, 156 00:10:17,450 --> 00:10:20,161 "greedy" by the White House, 157 00:10:20,161 --> 00:10:22,080 and parents all over the country are outraged 158 00:10:22,080 --> 00:10:23,748 that they've got to pay more for their EpiPen. 159 00:10:23,748 --> 00:10:24,833 How do you respond to all that? 160 00:10:24,833 --> 00:10:29,462 As a mother, I can assure you the last thing that we would ever want 161 00:10:29,462 --> 00:10:31,464 is no one to have their EpiPen due to price. 162 00:10:31,464 --> 00:10:35,969 The cost is more prohibitive than people realize. 163 00:10:35,969 --> 00:10:40,890 Two kids, $600 for one set, and I need multiple sets. 164 00:10:40,890 --> 00:10:44,853 The school that they go to, they have to have a set for themselves, 165 00:10:44,853 --> 00:10:46,771 a set for the nurse, 166 00:10:46,771 --> 00:10:50,149 and a set for the trainer if they go out for any sports, 167 00:10:50,149 --> 00:10:52,610 and we also have to have a set for our house. 168 00:10:52,610 --> 00:10:54,863 So the cost is insane. 169 00:10:54,863 --> 00:10:57,323 The American Medical Association has said 170 00:10:57,323 --> 00:11:00,827 this is basically the same product it was in 2009, 171 00:11:00,827 --> 00:11:03,955 and yet have raised the price 17 times. 172 00:11:03,955 --> 00:11:05,748 If you follow the money, 173 00:11:05,748 --> 00:11:09,294 the reason for these price hikes comes into sharp focus. 174 00:11:09,294 --> 00:11:11,296 What was your salary last year? 175 00:11:11,296 --> 00:11:13,965 -About $18 million. -About $18 million... 176 00:11:13,965 --> 00:11:16,885 Sounds like you're doing pretty well on this. 177 00:11:16,885 --> 00:11:20,179 When Mylan acquired EpiPen in 2007, 178 00:11:20,179 --> 00:11:24,100 Heather Bresch's salary was $2.4 million. 179 00:11:24,100 --> 00:11:27,353 As the price of EpiPen swelled, so did her salary, 180 00:11:27,353 --> 00:11:30,398 all the way to $18.9 million. 181 00:11:30,398 --> 00:11:32,650 Heather, you understand the headlines, right, 182 00:11:32,650 --> 00:11:36,946 which is EpiPens, which are needed by millions of children, 183 00:11:36,946 --> 00:11:41,618 the price goes from 50 bucks ten years ago to 500 or 600 today, 184 00:11:41,618 --> 00:11:43,703 and you're making $18 million a year. 185 00:11:43,703 --> 00:11:46,247 You understand how that looks? 186 00:11:46,247 --> 00:11:49,417 Brian, look, I understand better than anyone 187 00:11:49,417 --> 00:11:52,378 that facts are inconvenient to headlines. 188 00:11:52,378 --> 00:11:55,423 We have given out 700,000 free EpiPens. 189 00:11:55,423 --> 00:12:00,136 We stock 65,000 public schools in this country with free EpiPens 190 00:12:00,136 --> 00:12:02,430 to ensure that they're there when needed. 191 00:12:02,430 --> 00:12:06,559 Heather Bresch has been vocal about Mylan's free and discounted EpiPens, 192 00:12:06,559 --> 00:12:11,105 but those who are listening closely can hear the canary in the coalmine. 193 00:12:11,105 --> 00:12:13,232 So I'm holding here a certification form 194 00:12:13,232 --> 00:12:15,944 where EpiPen, where Mylan has actually said 195 00:12:15,944 --> 00:12:20,406 that the school will hereby certify that it will not, in the next 12 months, 196 00:12:20,406 --> 00:12:24,202 purchase any products that are competitive to EpiPen Auto-Injectors. 197 00:12:24,202 --> 00:12:28,998 So you actually put into practice forcing schools-- 198 00:12:28,998 --> 00:12:30,917 and you're so concerned about these kids, 199 00:12:30,917 --> 00:12:32,585 you've raised the price to $600, 200 00:12:32,585 --> 00:12:35,171 if you want it for the hundred buck price that it used to be at, 201 00:12:35,171 --> 00:12:39,092 you need to sign this and say that you can't buy this from anybody else. 202 00:12:39,092 --> 00:12:40,927 Don't answer, I'm not asking you a question. 203 00:12:40,927 --> 00:12:42,261 That's what you've done here. 204 00:12:43,972 --> 00:12:45,974 Sometimes I do feel like a burden. 205 00:12:45,974 --> 00:12:49,102 I sometimes think that maybe if I didn't have this allergy 206 00:12:49,102 --> 00:12:52,313 or maybe if I wasn't, per se, here 207 00:12:52,313 --> 00:12:54,607 then maybe my mother would have a little less stress. 208 00:12:54,607 --> 00:12:56,818 Uh, she wouldn't have to carry the burden 209 00:12:56,818 --> 00:13:00,780 of having to come up with that extra money 210 00:13:00,780 --> 00:13:04,283 to pay for the EpiPens. 211 00:13:04,283 --> 00:13:07,286 I feel bad because, like, I know it's not my fault, 212 00:13:07,286 --> 00:13:12,125 but they're so expensive, and it's, like, a lot, 213 00:13:12,125 --> 00:13:16,087 even though, like, my mom says that I'm worth it and everything. 214 00:13:18,339 --> 00:13:24,137 Knowing that my kids feel like they're a burden to me, 215 00:13:24,137 --> 00:13:25,888 it actually hurts and it makes me angry. 216 00:13:25,888 --> 00:13:28,016 I guess the anger comes from being hurt. 217 00:13:28,016 --> 00:13:29,892 Because kids should never feel like that. 218 00:13:29,892 --> 00:13:33,062 And I think it's just so unfair because it's unnecessary. 219 00:13:33,062 --> 00:13:37,775 The medication inside the device is so cheap. 220 00:13:37,775 --> 00:13:40,570 It does not warrant the cost. 221 00:13:43,948 --> 00:13:47,452 When journalists and lawmakers ask pharmaceutical companies 222 00:13:47,452 --> 00:13:49,454 to justify their pricing, 223 00:13:49,454 --> 00:13:52,999 the same two words come up again and again: 224 00:13:52,999 --> 00:13:55,793 research and development. 225 00:13:55,793 --> 00:13:58,629 There are a couple of myths that are out there 226 00:13:58,629 --> 00:14:00,631 about why drugs cost what they do. 227 00:14:00,631 --> 00:14:04,052 One myth is that the company spends so much money on research 228 00:14:04,052 --> 00:14:07,138 that they need to recoup their research expenditures. 229 00:14:07,138 --> 00:14:10,266 And if it wasn't for the drug company, we wouldn't have any new drugs 230 00:14:10,266 --> 00:14:12,226 because they're making all the discoveries. 231 00:14:12,226 --> 00:14:15,480 We need to invest in innovation for cures and treatments 232 00:14:15,480 --> 00:14:16,689 for unmet medical need, 233 00:14:16,689 --> 00:14:19,025 and we need to charge a price for our medicines 234 00:14:19,025 --> 00:14:21,194 that allow us to invest in RandD. 235 00:14:21,194 --> 00:14:26,407 The reality is that much of the research is not done by them at all. 236 00:14:26,407 --> 00:14:29,118 We increase prices as part of that process 237 00:14:29,118 --> 00:14:30,953 of, you know, getting back our RandD costs. 238 00:14:30,953 --> 00:14:33,790 Given the number of product candidates we have in development, 239 00:14:33,790 --> 00:14:34,999 our expenses will go up. 240 00:14:34,999 --> 00:14:38,044 Almost all of the innovative products, 241 00:14:38,044 --> 00:14:39,962 the blockbuster drugs, 242 00:14:39,962 --> 00:14:43,966 are acquired from small start-ups, 243 00:14:43,966 --> 00:14:45,468 biotech companies, 244 00:14:45,468 --> 00:14:47,470 from university research. 245 00:14:47,470 --> 00:14:49,430 We wake up every day trying to invent new medicines 246 00:14:49,430 --> 00:14:51,349 and get them to people who are sick. 247 00:14:51,349 --> 00:14:52,892 And the system is complicated. 248 00:14:52,892 --> 00:14:55,019 So for us it's all about innovation from RandD, 249 00:14:55,019 --> 00:14:56,312 and value for money. 250 00:14:56,312 --> 00:15:00,108 The best way we can invest in our innovation and RandD 251 00:15:00,108 --> 00:15:02,360 is by growing the top line. 252 00:15:02,360 --> 00:15:07,323 What makes one company a better innovator than another? 253 00:15:07,323 --> 00:15:11,536 To actually come up with a drug takes a very sophisticated team 254 00:15:11,536 --> 00:15:14,288 that understands all aspects of drug development. 255 00:15:14,288 --> 00:15:18,167 If I was a drug company, I might want to take credit for all of scientific discovery too, 256 00:15:18,167 --> 00:15:20,795 because it's a way of justifying those prices. 257 00:15:20,795 --> 00:15:22,547 It just happens to not be true. 258 00:15:24,924 --> 00:15:30,304 David Poole is the former director of government affairs at Gilead Sciences, 259 00:15:30,304 --> 00:15:34,684 one of the most profitable pharmaceutical companies in the world. 260 00:15:34,684 --> 00:15:38,104 In the eight and a half years that I spent with Gilead Sciences, 261 00:15:38,104 --> 00:15:42,233 their investment in RandD and in the laboratories that I visited and toured 262 00:15:42,233 --> 00:15:45,736 seems very disproportionate to what the yield is. 263 00:15:45,736 --> 00:15:48,739 It was more like here we have a showcase, 264 00:15:48,739 --> 00:15:52,076 and when visitors come, whether it was investors or patients 265 00:15:52,076 --> 00:15:54,745 or whomever might be touring Gilead's headquarters, 266 00:15:54,745 --> 00:15:58,708 they had these beautiful, large laboratories that they could present to people 267 00:15:58,708 --> 00:16:02,420 and say, "This is where we do all this grand research and development," 268 00:16:02,420 --> 00:16:07,216 when in fact we didn't see products that had been innovated by Gilead, 269 00:16:07,216 --> 00:16:10,595 they just were very strategic in the companies they purchased, 270 00:16:10,595 --> 00:16:12,430 then they would often take those products 271 00:16:12,430 --> 00:16:17,476 and in some cases combine drugs to make them an effective better therapy. 272 00:16:17,476 --> 00:16:21,189 But from--as far as innovation from start to finish, 273 00:16:21,189 --> 00:16:23,399 I quite frankly don't think that occurred, 274 00:16:23,399 --> 00:16:27,486 perhaps maybe even only once in the 30-year history of Gilead Sciences. 275 00:16:27,486 --> 00:16:31,741 So then the question is not how do you develop the next miracle drug 276 00:16:31,741 --> 00:16:34,243 but how do you get hold of it? 277 00:16:34,243 --> 00:16:36,537 And that you can do through acquisitions. 278 00:16:36,537 --> 00:16:40,458 So you acquire the company that is the developing the drug, 279 00:16:40,458 --> 00:16:43,836 and then try to exploit it as much as possible. 280 00:16:45,421 --> 00:16:50,176 In 2011, Gilead Sciences positioned itself to acquire a company 281 00:16:50,176 --> 00:16:51,510 that was leading the field 282 00:16:51,510 --> 00:16:56,557 in the fight against the most deadly infectious disease in the United States: 283 00:16:56,557 --> 00:16:58,976 hepatitis C. 284 00:16:58,976 --> 00:17:02,772 This merger between business and miracle drug 285 00:17:02,772 --> 00:17:05,900 triggered the most contentious industry move to date. 286 00:17:05,900 --> 00:17:10,696 One of the biggest controversies that erupted in the pricing of new drugs 287 00:17:10,696 --> 00:17:12,823 occurred about two to three years ago. 288 00:17:12,823 --> 00:17:15,117 Was around these drugs to treat hepatitis C. 289 00:17:15,117 --> 00:17:18,371 And I wouldn't say Gilead is an outlier, 290 00:17:18,371 --> 00:17:22,291 it's just that they were able to get hold of a drug 291 00:17:22,291 --> 00:17:23,709 that is a miracle drug. 292 00:17:26,003 --> 00:17:27,964 There is a new cure on the rise. 293 00:17:27,964 --> 00:17:31,592 There is a new drug on the market that will help cure hepatitis C. 294 00:17:31,592 --> 00:17:33,678 The drug has been called a miracle drug. 295 00:17:33,678 --> 00:17:36,347 It actually cures hepatitis C. 296 00:17:36,347 --> 00:17:37,598 Sofosbuvir. 297 00:17:37,598 --> 00:17:41,102 Sofosbuvir was designed by a chemist called Mike Sofia 298 00:17:41,102 --> 00:17:42,812 at a company called Pharmasset. 299 00:17:42,812 --> 00:17:45,940 Wait a minute, so this is a definite cure for hepatitis C? 300 00:17:45,940 --> 00:17:47,233 This is a cure for hepatitis C. 301 00:17:47,233 --> 00:17:48,693 -No kidding! -Yeah. 302 00:17:48,693 --> 00:17:50,319 -No kidding! -I mean, that's amazing, right? 303 00:17:50,319 --> 00:17:52,822 We did the original human studies of that drug. 304 00:17:52,822 --> 00:17:56,117 I presented the data at the Berlin Liver meeting. 305 00:17:56,117 --> 00:17:59,996 And I remember the meeting because the audience was in stunned silence. 306 00:17:59,996 --> 00:18:03,916 This was perhaps the only time I've ever sat in a medical conference 307 00:18:03,916 --> 00:18:06,752 where everybody went, "Ah..." 308 00:18:06,752 --> 00:18:07,837 They couldn't believe it. 309 00:18:07,837 --> 00:18:11,632 For the first time, tablets had cured hepatitis C. 310 00:18:11,632 --> 00:18:14,468 We're not talking about a drug with marginal benefits; 311 00:18:14,468 --> 00:18:18,139 we're talking about a drug that's a game changer for people's lives. 312 00:18:18,139 --> 00:18:21,934 Gilead Sciences, making a big move into the world of hepatitis C treatment 313 00:18:21,934 --> 00:18:24,020 with its acquisition of Pharmasset, 314 00:18:24,020 --> 00:18:27,815 a deal in fact expected to close by the end of the day tomorrow. 315 00:18:27,815 --> 00:18:33,738 Gilead Sciences is buying drug developer Pharmasset for $11 billion. 316 00:18:33,738 --> 00:18:36,032 Gilead's chairman and CEO, John Martin, joins us. 317 00:18:36,032 --> 00:18:38,701 What gives you the confidence that this is a company 318 00:18:38,701 --> 00:18:41,495 that was worth $11 billion of Gilead's money? 319 00:18:41,495 --> 00:18:44,248 The company that we're talking about, Pharmasset, 320 00:18:44,248 --> 00:18:45,666 made tremendous progress, 321 00:18:45,666 --> 00:18:47,585 especially over the last year, 322 00:18:47,585 --> 00:18:49,628 and it's already in Phase 3 studies, 323 00:18:49,628 --> 00:18:51,839 studies that lead to approval, 324 00:18:51,839 --> 00:18:55,217 so we expect 7977 to be the first to market. 325 00:18:55,217 --> 00:18:57,636 Now this is 2011. 326 00:18:57,636 --> 00:18:59,930 By 2014, 327 00:18:59,930 --> 00:19:02,725 we had combined drugs and done the clinical trials 328 00:19:02,725 --> 00:19:04,268 and presented the data 329 00:19:04,268 --> 00:19:07,188 that resulted in a treatment for hepatitis C 330 00:19:07,188 --> 00:19:12,693 that could cure 95% of patients with one tablet once a day 331 00:19:12,693 --> 00:19:15,780 that was simple, safe, and effective. 332 00:19:15,780 --> 00:19:18,991 All of a sudden it changes to, "We have a med that works in three months, 333 00:19:18,991 --> 00:19:22,453 the side effects are minimal to none, it's there, 334 00:19:22,453 --> 00:19:25,164 and let's get everybody tested, let's get everybody cured." 335 00:19:25,164 --> 00:19:27,208 There'd be no transmission of hepatitis C 336 00:19:27,208 --> 00:19:30,586 if everybody started on it immediately. 337 00:19:30,586 --> 00:19:32,713 I mean, this is a virus that could be cleared. 338 00:19:32,713 --> 00:19:34,840 We could clear it from the planet. 339 00:19:34,840 --> 00:19:38,511 But we can't because it's too expensive. 340 00:19:38,511 --> 00:19:42,014 The thousand-dollar-a-day pill. 341 00:19:42,014 --> 00:19:44,725 That's a lot of money for a single tablet. 342 00:19:44,725 --> 00:19:48,813 In fact, that makes one tablet of sofosbuvir, as it's called, 343 00:19:48,813 --> 00:19:52,566 the most expensive substance on Earth. 344 00:19:54,485 --> 00:19:58,489 So Gilead brings a cure to market. 345 00:19:58,489 --> 00:20:00,074 That didn't make the headlines. 346 00:20:00,074 --> 00:20:02,952 What made the headlines was their price. 347 00:20:02,952 --> 00:20:06,372 And so what you saw a few days later 348 00:20:06,372 --> 00:20:09,458 when it first launched, it was somebody holding up a pill, 349 00:20:09,458 --> 00:20:12,211 and it said, "The new face of the pharmaceutical industry, 350 00:20:12,211 --> 00:20:13,421 the thousand-dollar pill." 351 00:20:13,421 --> 00:20:15,172 It's important to understand, you know, 352 00:20:15,172 --> 00:20:18,843 something about hepatitis C and the disease. 353 00:20:18,843 --> 00:20:22,012 A thousand dollars a pill sounds outrageous, 354 00:20:22,012 --> 00:20:24,098 but, you know, the cost and the investment involved, 355 00:20:24,098 --> 00:20:26,350 we're talking billions of dollars were spent 356 00:20:26,350 --> 00:20:30,688 to, you know, to purchase this treatment or this drug. 357 00:20:30,688 --> 00:20:33,441 A lot of that development happened at Emory University 358 00:20:33,441 --> 00:20:36,777 by a faculty member who received a lot of NIH grants. 359 00:20:36,777 --> 00:20:41,532 There was also some work that happened in the Veterans Administration Hospital. 360 00:20:41,532 --> 00:20:45,077 The faculty member set up a company called Pharmasset, 361 00:20:45,077 --> 00:20:49,331 which was going to monetize that discovery, 362 00:20:49,331 --> 00:20:52,668 and then Gilead Pharmaceuticals decided to buy the company 363 00:20:52,668 --> 00:20:54,670 that this faculty member had started. 364 00:20:54,670 --> 00:20:58,757 They paid $11.2 billion for this product, 365 00:20:58,757 --> 00:21:03,804 at the time, a price that Wall Street viewed as excessive. 366 00:21:03,804 --> 00:21:06,098 Down the road, it was proven by Gilead 367 00:21:06,098 --> 00:21:10,269 that they recouped that $11.2 billion in less than a year 368 00:21:10,269 --> 00:21:12,229 from the rollout of that product. 369 00:21:12,229 --> 00:21:16,400 There's an interesting ethical and political and societal question 370 00:21:16,400 --> 00:21:21,363 of who should reap the benefits of initially that sale 371 00:21:21,363 --> 00:21:25,659 if the drug really was in large part developed with public funds, 372 00:21:25,659 --> 00:21:29,580 and the answer is it certainly doesn't end up in the pocket of the taxpayer. 373 00:21:29,580 --> 00:21:32,208 They get to pay twice-- once for the discovery 374 00:21:32,208 --> 00:21:34,502 and once to buy the drug if they need it. 375 00:21:36,212 --> 00:21:41,509 They lofty prices forced unprecedented levels of pharmaceutical rationing. 376 00:21:41,509 --> 00:21:44,094 As demand for the life-saving drug swelled, 377 00:21:44,094 --> 00:21:47,097 access continued to diminish. 378 00:21:47,097 --> 00:21:49,725 Health insurers and government payers said 379 00:21:49,725 --> 00:21:54,104 basically we're only gonna treat you if you already have liver damage. 380 00:21:54,104 --> 00:21:57,608 So, no, we're not gonna give you this cure 381 00:21:57,608 --> 00:21:59,026 until you're already sick. 382 00:22:08,869 --> 00:22:13,290 I had, um, ammonia on my brain, you know, 383 00:22:13,290 --> 00:22:17,837 from having the virus in my system. 384 00:22:19,797 --> 00:22:23,217 Some of the side effects are, like, brain fog, 385 00:22:23,217 --> 00:22:27,012 is, like, not being able to think clearly, 386 00:22:27,012 --> 00:22:29,598 poor memory. 387 00:22:29,598 --> 00:22:33,852 I knew that there was a new treatment that was gonna be available, 388 00:22:33,852 --> 00:22:37,815 and I was hoping that I'd be able to avail myself of that. 389 00:22:37,815 --> 00:22:40,401 But it seemed like it was never gonna happen 390 00:22:40,401 --> 00:22:47,366 because of all of the restrictions that, um, that I had to go through to qualify. 391 00:22:47,366 --> 00:22:49,743 And then even after I qualified, 392 00:22:49,743 --> 00:22:53,455 I wasn't able to afford or get the medication. 393 00:22:53,455 --> 00:22:56,709 And the medication was obscenely expensive. 394 00:22:56,709 --> 00:22:59,420 Now anybody looking at a single pill will say, 395 00:22:59,420 --> 00:23:02,423 "That couldn't possibly cost a thousand dollars," and they'd be right. 396 00:23:02,423 --> 00:23:04,425 No way that pill costs a thousand dollars. 397 00:23:04,425 --> 00:23:07,970 The cost of that drug is less than a dollar a day, 398 00:23:07,970 --> 00:23:10,889 and that includes the plastic bottle it comes in. 399 00:23:10,889 --> 00:23:14,977 And the price to the consumer is a thousand dollars a day. 400 00:23:14,977 --> 00:23:18,606 So I don't know, is that a reasonable profit margin? 401 00:23:18,606 --> 00:23:22,484 That very question ripped through the industry and patient groups alike. 402 00:23:23,736 --> 00:23:26,989 And the answer wasn't unanimous. 403 00:23:26,989 --> 00:23:30,326 Now, I think the drug was priced very fairly. 404 00:23:30,326 --> 00:23:33,871 The drug was priced cheaper than what existed, 405 00:23:33,871 --> 00:23:36,707 uh, safer than what existed, 406 00:23:36,707 --> 00:23:40,252 uh, and more effective than what existed. 407 00:23:40,252 --> 00:23:45,132 I think that's a pretty powerful argument to say why that price should be where it was. 408 00:23:45,132 --> 00:23:48,802 I was just so scared for my daughter because, you know, 409 00:23:48,802 --> 00:23:51,472 if something were to happen to me and I died... 410 00:23:56,143 --> 00:24:00,022 ...she wouldn't have me to be there for her. 411 00:24:00,022 --> 00:24:03,567 And I wanted--I wanted her to be happy 412 00:24:03,567 --> 00:24:07,154 and to meet a man to love her 413 00:24:07,154 --> 00:24:10,366 and support her. 414 00:24:10,366 --> 00:24:13,452 Go to her wedding. 415 00:24:13,452 --> 00:24:17,331 See my grandchildren. 416 00:24:17,331 --> 00:24:19,708 Things that I thought about a lot. 417 00:24:19,708 --> 00:24:23,170 Gilead Sciences hit a home run yesterday with its earnings 418 00:24:23,170 --> 00:24:25,381 when it reported after the market closed. 419 00:24:25,381 --> 00:24:27,549 Gilead delivered revenue of $5 billion. 420 00:24:27,549 --> 00:24:30,678 That was almost double what it earned last year at this time 421 00:24:30,678 --> 00:24:32,721 because of its drug Sovaldi. 422 00:24:32,721 --> 00:24:36,016 While hundreds of thousands of patients lingered on waiting lists 423 00:24:36,016 --> 00:24:38,811 hoping for their chance at the miracle drug, 424 00:24:38,811 --> 00:24:40,938 Gilead's stock prices soared. 425 00:24:40,938 --> 00:24:42,314 If anything, it's now very clear. 426 00:24:42,314 --> 00:24:44,942 Gilead dramatically underpaid for Pharmasset. 427 00:24:44,942 --> 00:24:46,902 They were just visionaries. 428 00:24:46,902 --> 00:24:48,946 Boy, it makes me like them even more. 429 00:24:48,946 --> 00:24:53,742 When you talk about these new hepatitis C drugs, 430 00:24:53,742 --> 00:24:55,953 the system's working the way it's supposed to. 431 00:24:55,953 --> 00:25:02,376 Gilead comes up with a new drug that literally cures hep C in 12 weeks. 432 00:25:02,376 --> 00:25:04,712 It's expensive when it first comes out, 433 00:25:04,712 --> 00:25:06,130 but you're done, you're cured. 434 00:25:06,130 --> 00:25:10,467 It turned out that a number of the people who I was in the group with 435 00:25:10,467 --> 00:25:15,681 did die before they were able to qualify or get the money together. 436 00:25:17,141 --> 00:25:20,602 That made me angry and also feeling guilty. 437 00:25:20,602 --> 00:25:24,273 You know, why was it that it was me and not one of those other people 438 00:25:24,273 --> 00:25:26,817 who I had befriended in the group? 439 00:25:26,817 --> 00:25:30,696 Maybe, you know, why did they have to die 440 00:25:30,696 --> 00:25:33,991 and leave their families. 441 00:25:33,991 --> 00:25:35,784 As someone in the industry, 442 00:25:35,784 --> 00:25:40,247 do you believe that people are only driven by massive profit? 443 00:25:40,247 --> 00:25:43,542 I mean, is that the only reason why they get up in the morning? 444 00:25:43,542 --> 00:25:46,837 There's a very cynical view of what motivates people, 445 00:25:46,837 --> 00:25:49,840 both in science and in medicine in particular. 446 00:25:49,840 --> 00:25:53,177 And it must be very sad to be a person who believes that, 447 00:25:53,177 --> 00:25:57,389 that the only reason people get up out of bed and go to work in the morning 448 00:25:57,389 --> 00:26:02,311 is because they really want to make as much money as possible no matter what. 449 00:26:02,311 --> 00:26:03,937 I have had the good fortune, 450 00:26:03,937 --> 00:26:07,483 as have most people who work in hospitals and universities, 451 00:26:07,483 --> 00:26:09,902 to be surrounded by people who get out of bed in the morning 452 00:26:09,902 --> 00:26:11,695 because they want to help other people. 453 00:26:11,695 --> 00:26:14,323 And the idea that people would not do that anymore 454 00:26:14,323 --> 00:26:16,617 if they didn't become bazillionaires 455 00:26:16,617 --> 00:26:20,704 is a very cynical and probably incorrect view of human nature. 456 00:26:20,704 --> 00:26:25,083 Using Gilead's own documents, 457 00:26:25,083 --> 00:26:30,923 the evidence shows that the company pursued a calculated scheme 458 00:26:30,923 --> 00:26:35,511 for pricing and marketing its hepatitis C drug 459 00:26:35,511 --> 00:26:37,763 based on one goal: 460 00:26:37,763 --> 00:26:40,349 maximizing revenue, 461 00:26:40,349 --> 00:26:44,394 regardless of the human consequences. 462 00:26:46,021 --> 00:26:52,402 When you look at the way in which top executives in the United States are being paid, 463 00:26:52,402 --> 00:26:58,534 the vast majority of their pay is geared toward stock price performance. 464 00:26:58,534 --> 00:27:02,830 Now, in this particular case, there's another dimension of executive pay 465 00:27:02,830 --> 00:27:04,081 which we've done research on, 466 00:27:04,081 --> 00:27:08,335 and the research we've done is kind of, as far as I'm concerned, 467 00:27:08,335 --> 00:27:11,421 is a breakthrough because other people have not noticed this, 468 00:27:11,421 --> 00:27:14,800 that almost every number you read in The Wall Street Journal, 469 00:27:14,800 --> 00:27:16,385 The New York Times, and the press, 470 00:27:16,385 --> 00:27:19,096 it's not what the CEOs actually get paid, 471 00:27:19,096 --> 00:27:22,349 it's an estimate of what they might make in the future 472 00:27:22,349 --> 00:27:24,685 from their stock options and stock awards. 473 00:27:24,685 --> 00:27:27,187 But it's the buybacks that are the problem, 474 00:27:27,187 --> 00:27:29,648 and they're huge. 475 00:27:29,648 --> 00:27:33,485 Stock buybacks are when a company buys back its own share 476 00:27:33,485 --> 00:27:35,279 from the stock market. 477 00:27:35,279 --> 00:27:39,992 In 2014, after the huge profits of Sovaldi kicked in, 478 00:27:39,992 --> 00:27:44,413 Gilead spent $11 billion on these buybacks, 479 00:27:44,413 --> 00:27:47,708 and in doing so, they sent the company's stock price through the roof. 480 00:27:48,959 --> 00:27:51,211 With such an intense spike in share values, 481 00:27:51,211 --> 00:27:54,047 this opened up a window for company executives 482 00:27:54,047 --> 00:27:56,925 to cash in on their stock options. 483 00:27:56,925 --> 00:27:59,219 So in the case of John C. Martin, 484 00:27:59,219 --> 00:28:02,014 it was reported, if you use the estimated fair value, 485 00:28:02,014 --> 00:28:06,727 that he made $19 million in each year. 486 00:28:06,727 --> 00:28:09,354 Now that sounds like a lot of money, and it is. 487 00:28:09,354 --> 00:28:12,566 But that's not what he actually took home. 488 00:28:12,566 --> 00:28:18,405 A close look at Gilead's publicly filed proxy statements from 2014 and 2015 489 00:28:18,405 --> 00:28:23,076 reveal not only John C. Martin's estimated value of stock options 490 00:28:23,076 --> 00:28:27,456 but more importantly, the actual realized gains. 491 00:28:27,456 --> 00:28:32,085 In 2014, he took home almost $193 million, 492 00:28:32,085 --> 00:28:36,506 and in 2015, $232 million. 493 00:28:36,506 --> 00:28:41,637 That was the whole point of being the CEO of the company for this guy. 494 00:28:41,637 --> 00:28:45,140 And the executive pay didn't stop at John Martin. 495 00:28:45,140 --> 00:28:50,062 The top five executives combined took home over $400 million 496 00:28:50,062 --> 00:28:53,440 within one year of the drug's release. 497 00:28:53,440 --> 00:28:55,275 To put that in perspective, 498 00:28:55,275 --> 00:28:59,404 if you apply the one-year salaries of these five individuals 499 00:28:59,404 --> 00:29:03,867 towards selling Sovaldi at the company's cost of a dollar a day, 500 00:29:03,867 --> 00:29:07,162 you could completely eradicate hepatitis C 501 00:29:07,162 --> 00:29:13,752 from France, Spain, Argentina, the United Kingdom, Canada, 502 00:29:13,752 --> 00:29:18,674 Australia, and the United States of America. 503 00:29:23,762 --> 00:29:25,597 According to Jonas Salk, 504 00:29:25,597 --> 00:29:31,061 the reward for work well done is the opportunity to do more. 505 00:29:31,061 --> 00:29:34,731 But our current culture seems to believe that the reward for work well done 506 00:29:34,731 --> 00:29:38,151 is the opportunity to take more. 507 00:29:38,151 --> 00:29:40,779 Is this business as usual? 508 00:29:40,779 --> 00:29:44,074 The price we pay for living in a free market? 509 00:29:44,074 --> 00:29:46,910 Has it always been like this, 510 00:29:46,910 --> 00:29:48,412 or have we lost our way? 511 00:30:08,306 --> 00:30:11,226 Also known as infantile paralysis 512 00:30:11,226 --> 00:30:14,229 because of its propensity to affect children, 513 00:30:14,229 --> 00:30:16,648 polio was pandemic. 514 00:30:16,648 --> 00:30:21,862 Outbreaks ravaged Europe, North America, Australia, and New Zealand 515 00:30:21,862 --> 00:30:24,364 during the first half of the 20th century. 516 00:30:24,364 --> 00:30:27,284 Polio was a terrifying disease. 517 00:30:27,284 --> 00:30:31,872 Parents were afraid to send out their children to play, 518 00:30:31,872 --> 00:30:33,290 especially during the summer months 519 00:30:33,290 --> 00:30:37,753 where, uh, the U.S. went through a series of epidemics 520 00:30:37,753 --> 00:30:42,507 of the polio virus would spread and affect many children. 521 00:30:42,507 --> 00:30:45,719 In extreme cases, it could lead to the death of children 522 00:30:45,719 --> 00:30:49,848 and also to paralysis, very serious respiratory defects. 523 00:30:49,848 --> 00:30:53,643 Children could end up in what became famous as iron lungs. 524 00:30:53,643 --> 00:30:56,563 These were mechanical devices that helped breathe children. 525 00:30:56,563 --> 00:30:58,774 Without these devices, children would die. 526 00:30:58,774 --> 00:31:02,152 So it was really terrifying and affected entire society. 527 00:31:02,152 --> 00:31:05,655 There are a lot of parents whose children are healthy and happy now 528 00:31:05,655 --> 00:31:06,990 who live in fear. 529 00:31:06,990 --> 00:31:08,408 I know I do. 530 00:31:08,408 --> 00:31:11,078 The fear, my friends, is polio. 531 00:31:11,078 --> 00:31:14,414 Mechanical respiratory aids temporarily do the work 532 00:31:14,414 --> 00:31:16,958 of the muscles required to breathe 533 00:31:16,958 --> 00:31:19,419 until those muscles can recover 534 00:31:19,419 --> 00:31:24,007 or until substitute muscles can be trained to replace them. 535 00:31:24,007 --> 00:31:27,260 The uninfected lived in fear. 536 00:31:27,260 --> 00:31:30,889 The infected struggled to breathe. 537 00:31:30,889 --> 00:31:36,561 And both could only wait as medical professionals waged war against the disease. 538 00:31:36,561 --> 00:31:38,396 1955. 539 00:31:38,396 --> 00:31:42,609 A day which may well mark the most significant event in all of medical history. 540 00:31:42,609 --> 00:31:45,195 The world will very soon know whether the battle against the disease 541 00:31:45,195 --> 00:31:49,950 that has twisted hundreds of thousands of young bodies has been won. 542 00:31:49,950 --> 00:31:51,743 At just 40 years old, 543 00:31:51,743 --> 00:31:55,080 Dr. Jonas Salk, a New York born virologist, 544 00:31:55,080 --> 00:32:00,252 gathered with the rest of the world to hear the results from his latest research. 545 00:32:00,252 --> 00:32:04,297 If the results from the observed study areas are employed, 546 00:32:04,297 --> 00:32:08,176 the vaccine could be considered 80% to 90% effective 547 00:32:08,176 --> 00:32:11,096 against paralytic poliomyelitis. 548 00:32:11,096 --> 00:32:13,640 It was the end of polio. 549 00:32:13,640 --> 00:32:16,852 And so when Jonas developed this drug 550 00:32:16,852 --> 00:32:20,188 and had a profound impact on society, 551 00:32:20,188 --> 00:32:23,316 it essentially eradicated the disease, 552 00:32:23,316 --> 00:32:28,363 and one of the major achievements of biomedical research of the last century. 553 00:32:28,363 --> 00:32:33,285 Perhaps even more poignant and impactful than the work that led to the vaccine 554 00:32:33,285 --> 00:32:36,580 was the decision Salk make afterwards. 555 00:32:36,580 --> 00:32:39,249 Who owns the patent on this vaccine? 556 00:32:39,249 --> 00:32:41,293 Well, the people, I would say. 557 00:32:41,293 --> 00:32:42,878 There is no patent. 558 00:32:42,878 --> 00:32:45,964 Could you patent the sun? 559 00:32:45,964 --> 00:32:49,593 The accessibility of the vaccine had a profound effect 560 00:32:49,593 --> 00:32:50,844 on the entire planet. 561 00:32:52,012 --> 00:32:54,472 If Salk had patented the vaccine, 562 00:32:54,472 --> 00:32:58,476 he would have profited upwards of $7 billion. 563 00:32:58,476 --> 00:33:03,231 What this answer reflect is his desire and passion 564 00:33:03,231 --> 00:33:09,112 to do work that benefits mankind without profit and personal benefit for himself. 565 00:33:09,112 --> 00:33:14,451 Salk's pioneering legacy lit the way for modern medical innovation, 566 00:33:14,451 --> 00:33:19,497 and it ushered in a new energy for scientific and medical discovery. 567 00:33:19,497 --> 00:33:25,462 The drug industry has always been dependent on scientific breakthroughs 568 00:33:25,462 --> 00:33:28,715 to really come up with innovative medicines. 569 00:33:28,715 --> 00:33:34,179 And the whole first part of that process is really driven by basic science, 570 00:33:34,179 --> 00:33:39,226 the vast majority almost universally funded by the federal government. 571 00:33:39,226 --> 00:33:43,605 The NIH plays a huge role in the development of basic science. 572 00:33:43,605 --> 00:33:48,401 The United States has the largest federally funded science program in the world, 573 00:33:48,401 --> 00:33:53,406 with nearly $32.3 billion being invested annually. 574 00:33:53,406 --> 00:33:58,912 NIH funds are essential in the earliest parts of research, 575 00:33:58,912 --> 00:34:03,458 which brings the basic knowledge of how the human body works. 576 00:34:03,458 --> 00:34:05,252 And that research is done generally 577 00:34:05,252 --> 00:34:08,129 with support from the NIH and academic scientists. 578 00:34:09,631 --> 00:34:14,761 The trek from basic science into the development of a pharmaceutical drug 579 00:34:14,761 --> 00:34:18,682 is called translational research. 580 00:34:18,682 --> 00:34:20,600 Having the capital and infrastructure 581 00:34:20,600 --> 00:34:24,229 that many government and educational facilities lack, 582 00:34:24,229 --> 00:34:29,067 pharmaceutical companies often step in in the late stages of development 583 00:34:29,067 --> 00:34:31,528 and prep the drug for the market. 584 00:34:31,528 --> 00:34:34,906 Lastly, the drugs must get approval from the FDA. 585 00:34:34,906 --> 00:34:36,324 Food and Drug Administration 586 00:34:36,324 --> 00:34:39,077 Once the FDA gives its stamp of approval, 587 00:34:39,077 --> 00:34:41,496 the transformation is complete 588 00:34:41,496 --> 00:34:44,874 from science into a product. 589 00:34:44,874 --> 00:34:47,961 And if there's one thing America knows how to do, 590 00:34:47,961 --> 00:34:50,922 it's sales. 591 00:34:50,922 --> 00:34:52,590 I am ready. 592 00:34:52,590 --> 00:34:54,342 Because today, there's Harvoni. 593 00:34:54,342 --> 00:34:55,593 -Good afternoon. -Hi. 594 00:34:55,593 --> 00:34:57,304 I'd like to get a prescription filled. 595 00:34:57,304 --> 00:34:59,973 It's for brand name Abilify. 596 00:34:59,973 --> 00:35:01,641 Sleep. 597 00:35:01,641 --> 00:35:04,894 -Congratulations, you're down with Crestor. -Yes! 598 00:35:04,894 --> 00:35:06,813 Prilosec OTC. 599 00:35:06,813 --> 00:35:08,231 I got my first prescription free. 600 00:35:08,231 --> 00:35:09,816 Ask your doctor about Farxiga. 601 00:35:09,816 --> 00:35:10,984 -Tecfidera. -Viagra. 602 00:35:10,984 --> 00:35:13,528 -Eliquis. -Otezla. 603 00:35:13,528 --> 00:35:16,197 I feel better now--better now--better now. 604 00:35:24,456 --> 00:35:29,002 Direct-to-consumer marketing is a public health disaster. 605 00:35:29,002 --> 00:35:32,422 Consumers who know almost nothing 606 00:35:32,422 --> 00:35:35,342 about the scientific basis of their disease, 607 00:35:35,342 --> 00:35:36,718 for the most part, 608 00:35:36,718 --> 00:35:40,722 can only be convinced to put pressure on their doctor 609 00:35:40,722 --> 00:35:44,476 to prescribe something that they have no idea what the impact of that's going to be. 610 00:35:44,476 --> 00:35:46,686 And I'm sure you'll talk to lots of doctors who say, 611 00:35:46,686 --> 00:35:48,647 "I have patients come in and ask all the time 612 00:35:48,647 --> 00:35:52,901 if they should be taking a drug for a disease they don't have." 613 00:35:52,901 --> 00:35:56,696 I mean, you listen to that list of all the bad things that can happen to you. 614 00:35:56,696 --> 00:35:58,656 The companies have tested this 615 00:35:58,656 --> 00:36:01,993 and they found out that saying all these scary things, 616 00:36:01,993 --> 00:36:04,079 people just think you're being more truthful. 617 00:36:04,079 --> 00:36:07,457 It makes it seem like it's more-- you know, they have a higher degree of confidence. 618 00:36:07,457 --> 00:36:10,752 But, you know, the television advertising's quite manipulative. 619 00:36:12,504 --> 00:36:15,882 As a Brit, I do find it disconcerting when I'm in the States 620 00:36:15,882 --> 00:36:18,635 to see all the direct-to-consumer advertising. 621 00:36:18,635 --> 00:36:20,470 I find that a little strange. 622 00:36:20,470 --> 00:36:23,390 Every time I get surprised that, you know, you switch the TV on 623 00:36:23,390 --> 00:36:27,185 and there's people playing golf and hugging their grandchildren 624 00:36:27,185 --> 00:36:28,561 and it's beautiful. 625 00:36:28,561 --> 00:36:31,606 So on British TV, you won't see adverts for medicines 626 00:36:31,606 --> 00:36:35,110 which are only available by prescription through doctors. 627 00:36:35,110 --> 00:36:39,280 Pharmaceutical companies cannot market or advertise publicly 628 00:36:39,280 --> 00:36:41,408 branded drugs to the public. 629 00:36:44,702 --> 00:36:47,831 On May 19th, 1983, 630 00:36:47,831 --> 00:36:50,917 the American public set eyes on a television commercial 631 00:36:50,917 --> 00:36:55,672 that would spark a debate that rages on still today. 632 00:36:55,672 --> 00:36:59,259 If you're one of the many people who take the prescription drug Motrin, 633 00:36:59,259 --> 00:37:02,178 you should ask your physician or pharmacist about Rufen. 634 00:37:02,178 --> 00:37:05,223 They will tell you that both Motrin 400 milligram tablets 635 00:37:05,223 --> 00:37:07,392 and Rufen 400 milligram tablets 636 00:37:07,392 --> 00:37:10,311 are different brand names for the same drug: 637 00:37:10,311 --> 00:37:11,688 ibuprofen. 638 00:37:11,688 --> 00:37:14,232 There is only one important difference. 639 00:37:14,232 --> 00:37:17,235 Rufen can cost you considerably less. 640 00:37:17,235 --> 00:37:18,611 Boots Pharmaceutical aired 641 00:37:18,611 --> 00:37:21,906 the first broadcast television commercial in the United States 642 00:37:21,906 --> 00:37:23,658 for a prescription drug, 643 00:37:23,658 --> 00:37:26,911 and in doing so, sent the FDA reeling. 644 00:37:26,911 --> 00:37:30,707 Within 48 hours, the federal government pulled the plug. 645 00:37:30,707 --> 00:37:35,211 Pharmaceutical advertising regulations hadn't been addressed in over a decade, 646 00:37:35,211 --> 00:37:37,297 and at the time, no one had anticipated 647 00:37:37,297 --> 00:37:41,468 a pharmaceutical direct-to-consumer advertisement. 648 00:37:41,468 --> 00:37:44,512 Ironically, even the industry was torn. 649 00:37:44,512 --> 00:37:48,975 In a 1984 letter to the then-representative John Dingell of Michigan, 650 00:37:48,975 --> 00:37:53,062 vice president of Eli Lilly said direct-to-consumer advertisements 651 00:37:53,062 --> 00:37:56,566 would be "both unwise and inappropriate." 652 00:37:56,566 --> 00:38:01,029 The Upjohn Company said it "would be detrimental to the pharmaceutical industry." 653 00:38:01,029 --> 00:38:05,575 And Schering-Plough claimed that "in most cases, it cannot safely be accomplished." 654 00:38:06,576 --> 00:38:10,538 The FDA responded with a set of rigid rules and requirements. 655 00:38:10,538 --> 00:38:12,373 Ads weren't outright banned, 656 00:38:12,373 --> 00:38:15,293 but they had to list all applicable ingredients, 657 00:38:15,293 --> 00:38:18,713 safety information, warnings, precautions, 658 00:38:18,713 --> 00:38:20,924 adverse reactions, and the like. 659 00:38:20,924 --> 00:38:24,719 This rendered TV ads nearly impossible to pull off. 660 00:38:24,719 --> 00:38:29,182 This confined pharma companies primarily to print ads for nearly a decade 661 00:38:29,182 --> 00:38:31,935 until 1996, when Schering-Plough, 662 00:38:31,935 --> 00:38:36,439 the same company that condemned direct-to-consumer ads eight years earlier, 663 00:38:36,439 --> 00:38:39,275 ran a divisive ad for Claritin. 664 00:38:39,275 --> 00:38:40,568 The plan was simple: 665 00:38:40,568 --> 00:38:43,821 Make no mention that Claritin is a pharmaceutical drug. 666 00:38:46,074 --> 00:38:48,701 -Claritin. -It's time, it's time. 667 00:38:48,701 --> 00:38:50,787 Don't wait another minute for Claritin. 668 00:38:50,787 --> 00:38:52,664 Claritin. I'll ask my doctor. 669 00:38:52,664 --> 00:38:53,998 It's time to see your doctor. 670 00:38:53,998 --> 00:38:55,750 Mr. Wilkin, the doctor will see you now. 671 00:38:55,750 --> 00:38:58,378 At last, a clear day is here. 672 00:38:58,378 --> 00:39:02,507 I want to know more about Claritin. 673 00:39:02,507 --> 00:39:05,218 Yes, ask your doctor for a trial of Claritin. 674 00:39:07,345 --> 00:39:09,430 In a clever marketing move, 675 00:39:09,430 --> 00:39:11,891 Schering-Plough used what was later coined 676 00:39:11,891 --> 00:39:14,894 the "ask your doctor" loophole. 677 00:39:14,894 --> 00:39:17,855 They essentially shrugged off the required fine print, 678 00:39:17,855 --> 00:39:20,024 the bold print, and everything in between. 679 00:39:20,024 --> 00:39:22,068 In its place, one clear message: 680 00:39:22,068 --> 00:39:24,404 "Ask your doctor for details." 681 00:39:24,404 --> 00:39:27,699 The whole purpose of that supports an overall marketing strategy 682 00:39:27,699 --> 00:39:30,743 which is to leave no stone unturned. 683 00:39:30,743 --> 00:39:33,955 Make patients ask about drugs. 684 00:39:33,955 --> 00:39:36,833 The Claritin campaign once again rocked the boat, 685 00:39:36,833 --> 00:39:39,252 forcing the FDA to reassess, 686 00:39:39,252 --> 00:39:42,630 and in 1997, during Bill Clinton's second term, 687 00:39:42,630 --> 00:39:45,508 direct-to-consumer ads were deregulated, 688 00:39:45,508 --> 00:39:48,052 giving way to the kind of pharmaceutical ads 689 00:39:48,052 --> 00:39:50,096 that now dominate the airwaves. 690 00:39:50,096 --> 00:39:55,059 President Clinton agreed to have drugs advertised 691 00:39:55,059 --> 00:39:59,314 on television, newspapers, which had been prohibited previously. 692 00:39:59,314 --> 00:40:03,318 So that just exploded the direct-to-consumer advertising. 693 00:40:03,318 --> 00:40:05,695 So now, companies are spending more money on marketing 694 00:40:05,695 --> 00:40:07,739 than they're spending on research and development. 695 00:40:07,739 --> 00:40:10,366 We don't know what companies are spending 696 00:40:10,366 --> 00:40:11,618 on research and development, 697 00:40:11,618 --> 00:40:14,287 but we have seen studies that show that 698 00:40:14,287 --> 00:40:18,041 many companies are spending 19 times as much money 699 00:40:18,041 --> 00:40:20,335 on the marketing and advertising part 700 00:40:20,335 --> 00:40:22,837 than they are on the research and development part. 701 00:40:22,837 --> 00:40:26,424 Now, they like to argue that they need these high prices 702 00:40:26,424 --> 00:40:29,010 to cover RandD, 703 00:40:29,010 --> 00:40:31,137 but why do they need such high prices 704 00:40:31,137 --> 00:40:34,098 to cover all this marketing and promotion? 705 00:40:39,437 --> 00:40:40,813 Now, don't forget, 706 00:40:40,813 --> 00:40:44,484 the consumer side that we see, direct-to-consumer advertising, 707 00:40:44,484 --> 00:40:48,321 has a whole other side which is direct-to-physician marketing 708 00:40:48,321 --> 00:40:50,073 that consumers never see. 709 00:40:50,073 --> 00:40:52,450 Pharmaceutical companies spend a lot of money 710 00:40:52,450 --> 00:40:54,243 marketing their products to doctors. 711 00:40:54,243 --> 00:40:55,745 I think one estimate suggested 712 00:40:55,745 --> 00:40:58,289 it was in the range of $60 billion a year. 713 00:40:58,289 --> 00:41:02,877 Now, drugs, doctors, and the relationship with the pharmaceutical industry. 714 00:41:02,877 --> 00:41:05,296 Those connections have long been the subject 715 00:41:05,296 --> 00:41:07,298 of ethical and business concerns, 716 00:41:07,298 --> 00:41:10,009 particularly when it comes to the financial ties 717 00:41:10,009 --> 00:41:12,428 between doctors and the drug companies. 718 00:41:12,428 --> 00:41:14,305 But this is through the medical journals, 719 00:41:14,305 --> 00:41:17,433 this is through drug reps coming to their offices, 720 00:41:17,433 --> 00:41:19,352 this is through conferences 721 00:41:19,352 --> 00:41:21,938 when they go to their professional society meetings. 722 00:41:21,938 --> 00:41:24,440 The industry has just run astray. 723 00:41:24,440 --> 00:41:26,317 I mean, it's gone wild. 724 00:41:26,317 --> 00:41:29,237 They are throwing money at doctors left and right, 725 00:41:29,237 --> 00:41:31,864 they're paying doctors to conduct studies, 726 00:41:31,864 --> 00:41:33,658 even to ghostwrite certain articles. 727 00:41:33,658 --> 00:41:34,992 What that means is 728 00:41:34,992 --> 00:41:37,954 the pharmaceutical company actually writes the article 729 00:41:37,954 --> 00:41:40,206 and then slaps a doctor's name on it. 730 00:41:40,206 --> 00:41:41,958 -For a medical journal? -That's right. 731 00:41:41,958 --> 00:41:45,044 When I did some initial research on this a few years ago, 732 00:41:45,044 --> 00:41:46,921 there were many, many physicians 733 00:41:46,921 --> 00:41:49,340 receiving seven-figure supplements 734 00:41:49,340 --> 00:41:53,720 while they still conducted or managed a practice in their home. 735 00:41:53,720 --> 00:41:57,140 So this is a disaster from a public health point of view. 736 00:41:57,140 --> 00:42:00,935 It's a pressure point that just simply doesn't need to be there. 737 00:42:00,935 --> 00:42:03,062 It serves no function whatsoever 738 00:42:03,062 --> 00:42:05,356 other than to cloud clinical judgment, 739 00:42:05,356 --> 00:42:06,816 and that's not good healthcare. 740 00:42:06,816 --> 00:42:08,568 And in fact, if you look 741 00:42:08,568 --> 00:42:11,821 at recent settlements from the federal government, 742 00:42:11,821 --> 00:42:15,116 pretty much every major drug company in the United States 743 00:42:15,116 --> 00:42:17,994 has had a finding in recent years 744 00:42:17,994 --> 00:42:21,956 dealing with breaking the law regarding the marketing of drugs. 745 00:42:23,124 --> 00:42:25,877 Who wants to be a millionaire? 746 00:42:27,920 --> 00:42:29,255 You do the math. 747 00:42:29,255 --> 00:42:31,507 There are people in this room 748 00:42:31,507 --> 00:42:35,261 who are going to make an ungodly sum of money 749 00:42:35,261 --> 00:42:36,637 selling Advair. 750 00:42:39,766 --> 00:42:42,435 The last two decades have ushered in an era 751 00:42:42,435 --> 00:42:45,313 of unprecedented healthcare fraud. 752 00:42:45,313 --> 00:42:48,191 GSK will plead guilty to criminal charges. 753 00:42:48,191 --> 00:42:50,151 Janssen Pharmaceuticals will plead guilty. 754 00:42:50,151 --> 00:42:53,154 Eli Lilly pleading guilty to criminal conduct 755 00:42:53,154 --> 00:42:55,656 after skating under the radar for years. 756 00:42:55,656 --> 00:42:57,366 Off-label promotion, 757 00:42:57,366 --> 00:42:59,869 failure to disclose safety information, 758 00:42:59,869 --> 00:43:01,454 physician kickbacks. 759 00:43:01,454 --> 00:43:04,040 Nearly every major pharmaceutical company 760 00:43:04,040 --> 00:43:06,959 has been caught over and over again. 761 00:43:06,959 --> 00:43:08,669 For nearly a decade, 762 00:43:08,669 --> 00:43:13,091 Allergan illegally promoted Botox for uses that were not approved 763 00:43:13,091 --> 00:43:16,177 as safe and effective by the FDA. 764 00:43:16,177 --> 00:43:17,929 That's the way it should be: 765 00:43:17,929 --> 00:43:20,431 When GSK makes money, you make money. 766 00:43:20,431 --> 00:43:22,600 The more you sell, the more you make. 767 00:43:22,600 --> 00:43:25,937 GSK engaged in an illegal marketing campaign 768 00:43:25,937 --> 00:43:27,939 where drugs were promoted for disorders 769 00:43:27,939 --> 00:43:30,149 where there was no medical evidence they would help. 770 00:43:30,149 --> 00:43:33,027 Put simply, the alleged conduct is shameful. 771 00:43:33,027 --> 00:43:35,905 Um, we do occasionally make mistakes. 772 00:43:35,905 --> 00:43:38,825 By pushing Seroquel for unapproved purposes, 773 00:43:38,825 --> 00:43:41,869 AstraZeneca made patients into guinea pigs 774 00:43:41,869 --> 00:43:43,871 in an unsupervised drug test. 775 00:43:43,871 --> 00:43:46,374 The Virginia Attorney General announcing 776 00:43:46,374 --> 00:43:48,459 a $100 million settlement 777 00:43:48,459 --> 00:43:50,294 involving off-label marketing. 778 00:43:50,294 --> 00:43:54,298 The settlement includes criminal fines totaling $485 million. 779 00:43:54,298 --> 00:43:57,426 Pfizer has agreed to pay $2.3 billion, 780 00:43:57,426 --> 00:43:59,929 which makes it the largest criminal fine in history. 781 00:43:59,929 --> 00:44:03,933 GlaxoSmithKline is paying a $3 billion fine. 782 00:44:03,933 --> 00:44:07,144 Fraudulently marketing nine drugs off-label, 783 00:44:07,144 --> 00:44:09,355 including Advair, Lemictal, Imitrex. 784 00:44:09,355 --> 00:44:12,441 The company's also accused of paying kickbacks to doctors 785 00:44:12,441 --> 00:44:13,651 to prescribe the drug. 786 00:44:13,651 --> 00:44:15,945 So let me tell you some of the perks that they received. 787 00:44:15,945 --> 00:44:17,154 They would give doctors 788 00:44:17,154 --> 00:44:19,156 basketball tickets, yacht trips. 789 00:44:19,156 --> 00:44:21,158 Hawaiian vacations, tickets to Madonna. 790 00:44:21,158 --> 00:44:24,328 They're paying doctors millions of dollars to go on speaking tours. 791 00:44:24,328 --> 00:44:27,123 NASCAR races, Knicks games, Celtics games, 792 00:44:27,123 --> 00:44:30,042 tennis lessons, Crosby, Stills and Nash tickets, 793 00:44:30,042 --> 00:44:31,586 pheasant hunting! 794 00:44:31,586 --> 00:44:34,463 Okay, all the ways they would bribe the doctors 795 00:44:34,463 --> 00:44:36,048 to do this to their own patients. 796 00:44:37,967 --> 00:44:40,720 From the years 2009 to 2016, 797 00:44:40,720 --> 00:44:44,599 the Justice Department recovered $19.3 billion 798 00:44:44,599 --> 00:44:48,811 in settlements in judgments related to healthcare fraud. 799 00:44:59,655 --> 00:45:02,116 In fact, just last year, the Justice Department reached 800 00:45:02,116 --> 00:45:06,203 an all-time high in the number of healthcare fraud defendants charged 801 00:45:06,203 --> 00:45:11,751 with more than 800 indictments and more than 580 convictions. 802 00:45:11,751 --> 00:45:13,628 Whatever they're fined, 803 00:45:13,628 --> 00:45:16,047 they're just gonna charge it back to us. 804 00:45:16,047 --> 00:45:18,132 It just becomes a cost of doing business. 805 00:45:18,132 --> 00:45:22,303 God bless America, free enterprise is a wonderful concept. 806 00:45:34,190 --> 00:45:37,360 Most people have no idea 807 00:45:37,360 --> 00:45:40,279 how much any drugs they take cost 808 00:45:40,279 --> 00:45:42,657 unless it's over the counter, basically-- 809 00:45:42,657 --> 00:45:44,241 because they have insurance, 810 00:45:44,241 --> 00:45:46,702 they have a copay, but it's not very big-- 811 00:45:46,702 --> 00:45:52,249 until the drug they're taking is $20,000, 812 00:45:52,249 --> 00:45:56,379 and then they look at the bill and they're like, "What?" 813 00:45:58,339 --> 00:46:02,468 It's very strange to see money becoming so important for me 814 00:46:02,468 --> 00:46:05,429 because money has never been very important to me, 815 00:46:05,429 --> 00:46:10,017 but right now it's $20,000 for one drug, 816 00:46:10,017 --> 00:46:11,560 for one treatment, 817 00:46:11,560 --> 00:46:15,231 and I know that I have to take it every three weeks 818 00:46:15,231 --> 00:46:16,732 for the rest of my life. 819 00:46:16,732 --> 00:46:18,567 How is that possible? 820 00:46:18,567 --> 00:46:21,904 But if we can't pay for it, I wouldn't last very long. 821 00:46:23,739 --> 00:46:26,242 The premium of everybody goes up too. 822 00:46:26,242 --> 00:46:30,204 I mean, it's something that people don't see because it's not on their bill, 823 00:46:30,204 --> 00:46:33,332 but they're all complaining about the insurance premium going up. 824 00:46:33,332 --> 00:46:34,792 Why is it going up? 825 00:46:34,792 --> 00:46:37,670 It's because, yeah, it's because of people like me, 826 00:46:37,670 --> 00:46:40,548 because my drug is too expensive. 827 00:46:40,548 --> 00:46:43,968 And then you get into anxiety, how do I pay for it, 828 00:46:43,968 --> 00:46:45,678 or am I worth it? 829 00:46:45,678 --> 00:46:47,763 Should I resign myself? 830 00:46:49,223 --> 00:46:52,601 I saw my mother die, so I know, I know what happens. 831 00:46:52,601 --> 00:46:55,396 It's the ultimate side effect. 832 00:46:58,065 --> 00:47:00,693 Mr. President, it is unacceptable 833 00:47:00,693 --> 00:47:03,821 that the monthly cost of cancer drugs 834 00:47:03,821 --> 00:47:07,366 has more than doubled over the last ten years. 835 00:47:07,366 --> 00:47:09,452 In the United States of America, 836 00:47:09,452 --> 00:47:12,663 you should not be forced into bankruptcy 837 00:47:12,663 --> 00:47:16,250 because you are diagnosed with cancer. 838 00:47:16,250 --> 00:47:20,504 When I first recurred to stage 4 metastatic breast cancer, 839 00:47:20,504 --> 00:47:22,131 within a couple of months, 840 00:47:22,131 --> 00:47:27,261 my insurance company started pushing me to apply for disability, 841 00:47:27,261 --> 00:47:31,265 so then in two years I'd have to go on Medicare, 842 00:47:31,265 --> 00:47:35,811 and they hired some third-party consulting firm 843 00:47:35,811 --> 00:47:38,522 that would call me at night and send me paperwork 844 00:47:38,522 --> 00:47:41,567 and push me to do this. 845 00:47:41,567 --> 00:47:47,156 So, I did it because they threatened to cancel my insurance. 846 00:47:47,156 --> 00:47:50,117 And then in December, the Friday before Christmas, 847 00:47:50,117 --> 00:47:53,245 I was hooked up to an IV getting treatment, 848 00:47:53,245 --> 00:47:57,958 and my broker calls from my health insurance 849 00:47:57,958 --> 00:48:02,630 and tells me that the insurance company found a small little caveat 850 00:48:02,630 --> 00:48:05,341 and cancelled my policy. 851 00:48:05,341 --> 00:48:09,929 Thank goodness I was able to apply for the ACA, 852 00:48:09,929 --> 00:48:13,057 but because of our insurance premiums 853 00:48:13,057 --> 00:48:17,394 and my copays for my drugs, 854 00:48:17,394 --> 00:48:19,105 now we have our house on the market 855 00:48:19,105 --> 00:48:23,567 because we really can't afford to live where we live anymore 856 00:48:23,567 --> 00:48:29,532 because my healthcare costs are just too high and devastating for us. 857 00:48:36,080 --> 00:48:41,210 The only thing worse than finding out there's no cure for your disease 858 00:48:41,210 --> 00:48:44,713 is finding out there's a cure but you can't afford it. 859 00:48:44,713 --> 00:48:48,509 They come back from having run your credit and say, 860 00:48:48,509 --> 00:48:52,388 "You don't have enough money to have this disease." 861 00:48:52,388 --> 00:48:56,225 A lot of these drug companies will give you their drug, 862 00:48:56,225 --> 00:49:01,021 but you have to be within a certain income restriction for those plans. 863 00:49:01,021 --> 00:49:04,692 So, for example, I don't work, 864 00:49:04,692 --> 00:49:07,903 I can't work, I'm sick, I've been sick. 865 00:49:07,903 --> 00:49:10,364 My husband works, my husband works very hard 866 00:49:10,364 --> 00:49:13,742 to keep us in our home which we've had to remortgage 867 00:49:13,742 --> 00:49:16,328 because of my disease. 868 00:49:16,328 --> 00:49:21,375 And your spouse's income now knocks you out of those programs, 869 00:49:21,375 --> 00:49:25,171 so you have to get divorced 870 00:49:25,171 --> 00:49:28,465 so that your income is the zero that it is, 871 00:49:28,465 --> 00:49:33,012 and that's usually referred to as involuntary divorce. 872 00:49:33,012 --> 00:49:37,016 So now you're getting your copays kind of taken care of through these programs, 873 00:49:37,016 --> 00:49:39,852 but now you die. 874 00:49:39,852 --> 00:49:44,565 Your spouse has to be left your assets 875 00:49:44,565 --> 00:49:47,443 and now has to pay tax on those assets, 876 00:49:47,443 --> 00:49:51,238 so it's like you end up paying one way or another. 877 00:49:51,238 --> 00:49:55,743 Either way, the diagnosis comes with the price tag of losing everything, 878 00:49:55,743 --> 00:49:59,038 not just for you but whoever survives you. 879 00:50:08,422 --> 00:50:11,675 Well, before we discuss 880 00:50:11,675 --> 00:50:16,805 whether a particular company is charging too much or making too much, 881 00:50:16,805 --> 00:50:20,267 let's remember that they're just playing the game that they're handed. 882 00:50:20,267 --> 00:50:24,521 So, if a company charges a lot of money, 883 00:50:24,521 --> 00:50:28,692 they're basically just doing what the system is inviting them to do anyway. 884 00:50:28,692 --> 00:50:31,237 It's basically capitalism. 885 00:50:31,237 --> 00:50:34,073 So, are there other areas of the economy 886 00:50:34,073 --> 00:50:36,617 where we tell people, "You can't make that much"? 887 00:50:36,617 --> 00:50:40,663 We have invited them to innovate these new therapies 888 00:50:40,663 --> 00:50:42,331 and then gouge the system, 889 00:50:42,331 --> 00:50:46,001 but it is the system that they were handed to work with. 890 00:50:46,001 --> 00:50:47,753 The system needs to change. 891 00:50:51,382 --> 00:50:54,510 The United States grants patents for inventions, 892 00:50:54,510 --> 00:50:56,637 which are essentially lawful monopolies 893 00:50:56,637 --> 00:50:59,098 that last up to 20 years. 894 00:50:59,098 --> 00:51:02,101 This is absolutely in step with the American spirit 895 00:51:02,101 --> 00:51:05,062 to encourage and embolden innovation, 896 00:51:05,062 --> 00:51:07,022 but these patents become complicated 897 00:51:07,022 --> 00:51:10,192 when their management causes suffering or death. 898 00:51:10,192 --> 00:51:12,403 Drug patents are a financing mechanism. 899 00:51:12,403 --> 00:51:15,364 It's a way we finance research and development. 900 00:51:15,364 --> 00:51:16,532 It's not working. 901 00:51:16,532 --> 00:51:20,452 There's no question that brand name manufacturers 902 00:51:20,452 --> 00:51:23,914 engage in what are called evergreening techniques 903 00:51:23,914 --> 00:51:25,916 or life cycle management 904 00:51:25,916 --> 00:51:30,212 where they'll take a drug that is very profitable 905 00:51:30,212 --> 00:51:33,132 and they'll do everything they can 906 00:51:33,132 --> 00:51:36,010 to extend their patent. 907 00:51:36,010 --> 00:51:38,637 So if you make a small tweak to a molecule 908 00:51:38,637 --> 00:51:42,266 or if you come up with a slightly different development process, 909 00:51:42,266 --> 00:51:44,518 then you can earn a new patent. 910 00:51:44,518 --> 00:51:48,689 And that way, when a drug's patent is getting ready to expire, 911 00:51:48,689 --> 00:51:51,233 the company seeks patents not on the drug, 912 00:51:51,233 --> 00:51:53,027 but on all these externalities, 913 00:51:53,027 --> 00:51:56,238 and then gets another bunch of years of patent protection. 914 00:51:56,238 --> 00:51:59,533 How is it okay that a drug company can take, 915 00:51:59,533 --> 00:52:02,745 instead of the right-handed version of the molecule, 916 00:52:02,745 --> 00:52:04,788 take the left-handed version of the molecule, 917 00:52:04,788 --> 00:52:07,541 which is basically a mirror image of the same molecule, 918 00:52:07,541 --> 00:52:10,586 get it patented as a brand new discovery, 919 00:52:10,586 --> 00:52:12,629 and then market it as a new drug? 920 00:52:12,629 --> 00:52:15,841 And we saw when Prilosec became Nexium, 921 00:52:15,841 --> 00:52:18,719 the old purple pill became the new purple pill. 922 00:52:18,719 --> 00:52:21,889 Essentially no clinical advantage, 923 00:52:21,889 --> 00:52:24,641 virtually no molecular difference of any consequence. 924 00:52:24,641 --> 00:52:29,855 That type of evergreening strategy I think is inappropriate and wasteful. 925 00:52:29,855 --> 00:52:33,192 And what governments have to realize is that companies 926 00:52:33,192 --> 00:52:35,861 have become so powerful through these monopolies 927 00:52:35,861 --> 00:52:37,654 that they can't even regulate them anymore. 928 00:52:37,654 --> 00:52:41,784 Can the governments regulate legal monopolies on drugs 929 00:52:41,784 --> 00:52:44,787 in a way that benefits the public? 930 00:52:44,787 --> 00:52:47,206 No. The evidence is no. 931 00:52:49,500 --> 00:52:53,003 Insulin prices on the rise, and it could have a big impact 932 00:52:53,003 --> 00:52:57,049 on the growing number of people with diabetes. 933 00:52:57,049 --> 00:53:01,512 A new report finds the price of insulin has tripled in ten years' time, 934 00:53:01,512 --> 00:53:04,890 a painful price for many of the 29 million people 935 00:53:04,890 --> 00:53:06,975 in the United States with diabetes. 936 00:53:06,975 --> 00:53:10,896 Those high prices combined with rising insurance deductibles 937 00:53:10,896 --> 00:53:15,818 mean many people who rely on insulin are left facing impossible choices. 938 00:53:27,329 --> 00:53:31,250 I always remember insulin being 939 00:53:31,250 --> 00:53:36,004 a very easy-to-obtain, cheap drug. 940 00:53:36,004 --> 00:53:43,095 I remember my mom would pay $15 every three months. 941 00:53:43,095 --> 00:53:46,098 Whereas, you know, fast forward to today, 942 00:53:46,098 --> 00:53:52,020 the most recent price I heard was $342.99 for a vial. 943 00:53:53,063 --> 00:53:54,773 That's unheard of. 944 00:53:54,773 --> 00:53:57,526 You know, I'll never have a choice not to buy insulin. 945 00:53:57,526 --> 00:54:00,195 I'll always have to pay what they charge. 946 00:54:00,195 --> 00:54:02,489 I have to have insulin 947 00:54:02,489 --> 00:54:05,576 every second of every day to stay alive. 948 00:54:07,369 --> 00:54:10,873 I've calculated up the price of my life. 949 00:54:10,873 --> 00:54:16,503 It will cost over $7.5 million, 950 00:54:16,503 --> 00:54:18,672 just in insulin, just for me, 951 00:54:18,672 --> 00:54:21,967 to keep me alive till I'm 70 years old. 952 00:54:21,967 --> 00:54:25,012 Insulin is a life-or-death medication. 953 00:54:25,012 --> 00:54:27,264 Between 2002 and 2013, 954 00:54:27,264 --> 00:54:29,558 the price of insulin more than tripled 955 00:54:29,558 --> 00:54:32,352 to more than $700 per patient. 956 00:54:32,352 --> 00:54:35,397 Federal lawsuit accuses the three insulin manufacturers 957 00:54:35,397 --> 00:54:37,357 of conspiring to raise their prices. 958 00:54:37,357 --> 00:54:38,942 Just coincidentally, 959 00:54:38,942 --> 00:54:41,904 it happens that the three major suppliers of insulin 960 00:54:41,904 --> 00:54:43,947 seem to be raising their prices 961 00:54:43,947 --> 00:54:46,992 at the same exact time at the same level. 962 00:54:46,992 --> 00:54:51,079 So I think you have to be very naive not to believe that there is collusion. 963 00:54:53,123 --> 00:54:56,001 Put a critical eye on the pricing history 964 00:54:56,001 --> 00:54:58,629 of two primary insulin drugs 965 00:54:58,629 --> 00:55:01,006 and you'll notice a pattern. 966 00:55:01,006 --> 00:55:05,135 Since 2001, the cost of both drugs 967 00:55:05,135 --> 00:55:08,388 has risen simultaneously, 968 00:55:08,388 --> 00:55:12,809 making their price history nearly indistinguishable. 969 00:55:12,809 --> 00:55:14,811 At least when it comes to insulin, 970 00:55:14,811 --> 00:55:18,649 where the original discoverers, Banting and Best, 971 00:55:18,649 --> 00:55:21,527 gave away the insulin patent for $3 972 00:55:21,527 --> 00:55:24,154 so that this wouldn't happen. 973 00:55:24,154 --> 00:55:28,450 In 1923, Frederick Banting, Charles Best, and James Collip, 974 00:55:28,450 --> 00:55:32,579 the team that first discovered and refined what is now known as insulin, 975 00:55:32,579 --> 00:55:34,790 made a move for the common good: 976 00:55:34,790 --> 00:55:38,544 They sold the patent for insulin to the University of Toronto 977 00:55:38,544 --> 00:55:40,879 for just $1 each. 978 00:55:40,879 --> 00:55:44,508 Much like Jonas Salk, their intent was to let the world benefit 979 00:55:44,508 --> 00:55:46,635 from their discovery, stating, 980 00:55:46,635 --> 00:55:50,222 "When the details of the method of preparation are published, 981 00:55:50,222 --> 00:55:53,308 anyone would be free to prepare the extract, 982 00:55:53,308 --> 00:55:56,895 but no one could secure a profitable monopoly." 983 00:55:56,895 --> 00:56:00,607 Shortly after, the University of Toronto teamed up with Eli Lilly 984 00:56:00,607 --> 00:56:04,361 to mass-produce insulin under a royalty-free agreement. 985 00:56:04,361 --> 00:56:07,739 The profits would then be put back into research and development 986 00:56:07,739 --> 00:56:10,075 at the university. 987 00:56:10,075 --> 00:56:13,203 It wasn't long, however, before drug companies 988 00:56:13,203 --> 00:56:16,665 had figured out a way to turn a good profit on insulin. 989 00:56:16,665 --> 00:56:20,502 By 1941, Eli Lilly and two other pharmaceutical companies 990 00:56:20,502 --> 00:56:24,756 were indicted for an alleged insulin price-fixing scheme. 991 00:56:24,756 --> 00:56:29,553 It was a charge that Lilly would settle in a no-contest agreement. 992 00:56:29,553 --> 00:56:32,306 Sadly, after the development of insulin, 993 00:56:32,306 --> 00:56:35,934 Eli Lilly would start to make small adjustments to the research 994 00:56:35,934 --> 00:56:38,854 in order to seek their own patents on the drug 995 00:56:38,854 --> 00:56:43,025 and completely undermine the intention of the inventors. 996 00:56:43,025 --> 00:56:46,320 Somehow, with really no innovations, 997 00:56:46,320 --> 00:56:49,656 the same drug, insulin, the prices keep escalating. 998 00:56:49,656 --> 00:56:51,533 That makes no sense at all, 999 00:56:51,533 --> 00:56:54,828 and yet this diabetes is an illness that we've seen 1000 00:56:54,828 --> 00:56:57,205 that Americans suffer from young and old. 1001 00:56:57,205 --> 00:57:00,584 So what I see is, people all over my state, 1002 00:57:00,584 --> 00:57:03,920 seniors that come up to me and say that they're saving 1003 00:57:03,920 --> 00:57:07,466 the injectors from their insulin 1004 00:57:07,466 --> 00:57:10,677 just so they have a few more drops in each tube. 1005 00:57:10,677 --> 00:57:12,554 That is happening right now. 1006 00:57:12,554 --> 00:57:14,640 This is the United States of America. 1007 00:57:14,640 --> 00:57:17,893 Our seniors shouldn't be having to do that. 1008 00:57:17,893 --> 00:57:19,561 What's even more shocking, 1009 00:57:19,561 --> 00:57:24,858 to this day, there are still no low-priced generics on the market. 1010 00:57:24,858 --> 00:57:27,986 Somehow, these three manufacturers have figured out a way 1011 00:57:27,986 --> 00:57:32,282 to extend their patent lives for nearly a century. 1012 00:57:32,282 --> 00:57:35,077 One of the things that is really distasteful 1013 00:57:35,077 --> 00:57:40,332 is that the big pharmaceutical companies currently pay off generics 1014 00:57:40,332 --> 00:57:42,834 to keep their products off the market. 1015 00:57:42,834 --> 00:57:46,546 It's called pay-for-delay, and it screws people all the time. 1016 00:57:46,546 --> 00:57:48,924 But I mean, how long can they keep doing that? 1017 00:57:48,924 --> 00:57:50,967 -Indefinitely? -It's just gonna keep escalating. 1018 00:57:50,967 --> 00:57:53,261 Look, if you're a company in any industry, 1019 00:57:53,261 --> 00:57:55,347 and a monopoly is just put on your lap, 1020 00:57:55,347 --> 00:57:58,392 you're gonna go for it, that's just the facts. 1021 00:57:58,392 --> 00:58:02,437 These evergreening techniques are becoming common practice. 1022 00:58:02,437 --> 00:58:06,316 If there's a loophole, the pharmaceutical industry will find it. 1023 00:58:06,316 --> 00:58:08,193 Check out shares of Allergan. 1024 00:58:08,193 --> 00:58:10,278 They've been rising higher this afternoon 1025 00:58:10,278 --> 00:58:12,072 on an announcement about patents 1026 00:58:12,072 --> 00:58:14,574 around one of their big eye drugs, Restasis. 1027 00:58:14,574 --> 00:58:16,535 Now, this is a bit of a complicated story, 1028 00:58:16,535 --> 00:58:19,079 but it's absolutely amazing when you really dig into it. 1029 00:58:19,079 --> 00:58:22,374 So what they've done, somewhat incredibly, 1030 00:58:22,374 --> 00:58:27,212 is they've transferred the patent to an Indian tribe in northern New York, 1031 00:58:27,212 --> 00:58:31,174 and then the tribe is licensing the patent back to Allergan, 1032 00:58:31,174 --> 00:58:34,344 and then the tribe is arguing that, as a sovereign nation, 1033 00:58:34,344 --> 00:58:39,224 as a sovereign entity, the patent office no longer has the right 1034 00:58:39,224 --> 00:58:41,268 to be involved in a patent dispute 1035 00:58:41,268 --> 00:58:45,230 because it can't override the sovereignty of the Indian tribe. 1036 00:58:45,230 --> 00:58:48,275 This strategy potentially allows Allergan 1037 00:58:48,275 --> 00:58:51,403 to dodge patent challenges from rival companies. 1038 00:58:51,403 --> 00:58:53,321 I just spoke with Allergan CEO Brent Saunders. 1039 00:58:53,321 --> 00:58:57,826 He says he thinks this is the first time this system has ever been used in this way. 1040 00:58:57,826 --> 00:59:00,954 I think there's a lot of misunderstanding on why we did it. 1041 00:59:00,954 --> 00:59:03,165 It wasn't desperation, it was tenacity. 1042 00:59:03,165 --> 00:59:05,751 You describe this as offensive behavior. 1043 00:59:05,751 --> 00:59:07,419 I think it's terribly offensive. 1044 00:59:07,419 --> 00:59:10,172 I think it violates the spirit of the law, 1045 00:59:10,172 --> 00:59:13,425 I think it really sticks it to American consumers, 1046 00:59:13,425 --> 00:59:17,095 and I think in particular, Allergan is a company that talks a good game 1047 00:59:17,095 --> 00:59:20,056 about wanting to be good to consumers 1048 00:59:20,056 --> 00:59:23,059 and they have a social contract, yadda-yadda-yadda, 1049 00:59:23,059 --> 00:59:25,270 and then they do things like this. 1050 00:59:29,483 --> 00:59:34,404 I solemnly pledge to dedicate my life in the service of humanity. 1051 00:59:34,404 --> 00:59:37,783 I will practice medicine with conscience and dignity. 1052 00:59:37,783 --> 00:59:42,704 The health and life of my patient will be my first consideration. 1053 00:59:44,414 --> 00:59:47,334 Doctors swear the Hippocratic Oath, 1054 00:59:47,334 --> 00:59:50,045 a pledge that they will uphold a certain morality 1055 00:59:50,045 --> 00:59:53,006 when it comes to their practice. 1056 00:59:53,006 --> 00:59:55,884 Is it reasonable to expect pharmaceutical companies 1057 00:59:55,884 --> 00:59:58,428 to be held to the same standards? 1058 00:59:58,428 --> 01:00:01,223 Do you think pharmaceutical companies 1059 01:00:01,223 --> 01:00:04,059 should operate under a different moral code 1060 01:00:04,059 --> 01:00:05,769 compared to other companies? 1061 01:00:05,769 --> 01:00:07,813 Well... 1062 01:00:07,813 --> 01:00:12,359 Should pharmaceutical companies be guided by a moral compass? 1063 01:00:13,985 --> 01:00:17,030 Should pharmaceutical companies have a moral compass? 1064 01:00:21,034 --> 01:00:23,495 That's a good question. 1065 01:00:23,495 --> 01:00:26,540 Pharmaceutical companies absolutely should have a moral compass. 1066 01:00:26,540 --> 01:00:31,253 Absolutely, pharmaceutical companies should act with moral integrity 1067 01:00:31,253 --> 01:00:32,796 when they are dealing with drugs 1068 01:00:32,796 --> 01:00:35,590 that make the difference between life and death for patients. 1069 01:00:35,590 --> 01:00:39,719 The notion of a moral code governing what they do 1070 01:00:39,719 --> 01:00:41,513 doesn't make much sense to me. 1071 01:00:41,513 --> 01:00:44,224 I think companies should have some morals. 1072 01:00:44,224 --> 01:00:48,311 I mean, there are some lines that they shouldn't cross. 1073 01:00:48,311 --> 01:00:52,023 I think all of healthcare is a right, okay. 1074 01:00:52,023 --> 01:00:55,652 There's a long discussion behind that. 1075 01:00:55,652 --> 01:00:57,320 They are not like medicine. 1076 01:00:57,320 --> 01:00:58,530 They are a company. 1077 01:00:58,530 --> 01:01:02,534 They are no different than big oil, 1078 01:01:02,534 --> 01:01:05,328 Coca-Cola, 1079 01:01:05,328 --> 01:01:07,622 maybe the tobacco industry. 1080 01:01:07,622 --> 01:01:10,959 The sad reality is that they are corporations, 1081 01:01:10,959 --> 01:01:13,503 and they are answerable to their shareholders, 1082 01:01:13,503 --> 01:01:16,506 and that doesn't make it right or good, 1083 01:01:16,506 --> 01:01:20,010 but it's a little naive to think that a company that makes drugs 1084 01:01:20,010 --> 01:01:22,929 is somehow gonna have a different set of morals 1085 01:01:22,929 --> 01:01:26,808 than a company that makes gasoline or computers or cars. 1086 01:01:26,808 --> 01:01:32,314 Corporations are nothing more than a conglomeration of individuals, 1087 01:01:32,314 --> 01:01:35,734 and those individuals have their own moral compasses, 1088 01:01:35,734 --> 01:01:38,486 and oftentimes we see that, for some reason, 1089 01:01:38,486 --> 01:01:40,405 people check those at the door 1090 01:01:40,405 --> 01:01:43,283 when they walk into their offices and they're making decisions 1091 01:01:43,283 --> 01:01:46,953 because they put something else ahead of what is right. 1092 01:01:48,580 --> 01:01:50,832 Imagine, for a moment, popping a pill before bed 1093 01:01:50,832 --> 01:01:53,126 that costs about $13.50. 1094 01:01:53,126 --> 01:01:55,295 Now imagine waking up the next morning 1095 01:01:55,295 --> 01:02:00,258 to find that the price of the exact same pill jumped to $750 overnight. 1096 01:02:00,258 --> 01:02:03,803 When Shkreli increased Daraprim's price 5000%, 1097 01:02:03,803 --> 01:02:06,473 he complained that he was being unfairly vilified. 1098 01:02:06,473 --> 01:02:09,059 There are literally a dozen companies just like ours 1099 01:02:09,059 --> 01:02:12,812 that raise prices dramatically, and higher, might I add, than our company, 1100 01:02:12,812 --> 01:02:15,899 and I don't see those companies getting the criticism that I got. 1101 01:02:15,899 --> 01:02:17,484 Why do they keep coming after you? 1102 01:02:17,484 --> 01:02:19,527 You know, I just can't fathom. 1103 01:02:19,527 --> 01:02:21,655 I guess it might have something to do with me being very handsome, 1104 01:02:21,655 --> 01:02:24,115 very wealthy, and very funny. 1105 01:02:24,115 --> 01:02:27,702 Last time you heard the name Martin Shkreli on this broadcast, 1106 01:02:27,702 --> 01:02:30,789 he drastically raised the price of a life-saving drug. 1107 01:02:30,789 --> 01:02:32,499 Tonight, the head of a drug company, 1108 01:02:32,499 --> 01:02:34,834 who's accused of gouging patients, 1109 01:02:34,834 --> 01:02:36,711 says he should be thanked. 1110 01:02:36,711 --> 01:02:38,505 There's no doubt I'm a capitalist, 1111 01:02:38,505 --> 01:02:41,174 I'm trying to create a big drug company, a profitable drug company. 1112 01:02:41,174 --> 01:02:42,801 I now walk down the streets of Manhattan, 1113 01:02:42,801 --> 01:02:45,887 people ask me for autographs, they want selfies, I have a lot of fans. 1114 01:02:47,847 --> 01:02:49,766 He is a brash self-promoter 1115 01:02:49,766 --> 01:02:52,894 who's called himself the world's most eligible bachelor. 1116 01:02:52,894 --> 01:02:55,689 This is a city where success is prized. 1117 01:02:55,689 --> 01:02:58,608 It is a city if you make it here, you can make it anywhere. 1118 01:02:58,608 --> 01:03:00,735 I wonder if you would do anything differently. 1119 01:03:00,735 --> 01:03:03,071 I probably would have raised the price higher 1120 01:03:03,071 --> 01:03:05,615 is probably what I would have done. 1121 01:03:05,615 --> 01:03:08,660 I'm a child of immigrants that are janitors from Brooklyn. 1122 01:03:08,660 --> 01:03:10,578 I've made myself into an enormous fortune. 1123 01:03:10,578 --> 01:03:12,831 In response to all of this attention, 1124 01:03:12,831 --> 01:03:15,667 and doctors and patient groups saying they can't access this drug, 1125 01:03:15,667 --> 01:03:17,377 are you gonna change the price? 1126 01:03:17,377 --> 01:03:18,586 No. 1127 01:03:21,006 --> 01:03:24,217 When Martin Shkreli, the infamous "Pharma Bro" 1128 01:03:24,217 --> 01:03:26,469 who took a one-dollar-a-day pill 1129 01:03:26,469 --> 01:03:29,639 and raised that pill to $750 1130 01:03:29,639 --> 01:03:31,558 for no rationale other than he could 1131 01:03:31,558 --> 01:03:35,020 because he was the only manufacturer, or provided the only source, 1132 01:03:35,020 --> 01:03:37,814 that's not illegal, but it is immoral. 1133 01:03:37,814 --> 01:03:42,235 People's lives are at stake because of the price increases you impose 1134 01:03:42,235 --> 01:03:45,488 and the access problems that have been created. 1135 01:03:45,488 --> 01:03:49,492 You've been viewed as a so-called bad boy of pharma. 1136 01:03:49,492 --> 01:03:51,036 Are you listening? 1137 01:03:51,036 --> 01:03:52,203 Yes. 1138 01:03:52,203 --> 01:03:55,749 The way I see it, you can go down in history 1139 01:03:55,749 --> 01:04:00,670 as the poster boy for greedy drug company executives, 1140 01:04:00,670 --> 01:04:03,048 or you can change the system. 1141 01:04:03,048 --> 01:04:06,593 In this industry, sadly, 1142 01:04:06,593 --> 01:04:10,096 they say something like this: 1143 01:04:10,096 --> 01:04:14,976 "Yeah, we'll go in and we will take the blows of the Congress 1144 01:04:14,976 --> 01:04:17,437 because they'll be upset for a little while, 1145 01:04:17,437 --> 01:04:20,106 but all we gotta do is basically rope-a-dope." 1146 01:04:20,106 --> 01:04:26,112 A 30% discount on a 500% price increase 1147 01:04:26,112 --> 01:04:27,614 hardly makes a dent. 1148 01:04:27,614 --> 01:04:29,741 Does that sound like a good deal to you? 1149 01:04:29,741 --> 01:04:32,619 What we try to do is address the issue 1150 01:04:32,619 --> 01:04:34,662 from a portfolio point of view. 1151 01:04:34,662 --> 01:04:36,039 Let's talk about RandD. 1152 01:04:36,039 --> 01:04:38,124 How much did Mylan spend 1153 01:04:38,124 --> 01:04:40,710 on research and development products in 2015? 1154 01:04:40,710 --> 01:04:42,712 Actually, we've spent, over the years, 1155 01:04:42,712 --> 01:04:46,132 trying to do several things that failed and trying to-- 1156 01:04:46,132 --> 01:04:50,136 That's not what I asked you, I said how much did you spend 1157 01:04:50,136 --> 01:04:55,100 on RandD in 2015? 1158 01:04:55,100 --> 01:04:56,810 I mean, I feel like you're just-- 1159 01:04:56,810 --> 01:04:59,145 you're not giving me answers, ma'am. 1160 01:04:59,145 --> 01:05:01,106 That's pharma's philosophy. 1161 01:05:01,106 --> 01:05:04,400 They know they're gonna take the blow, 1162 01:05:04,400 --> 01:05:08,947 so they'll come in and the chief executive will get hit a few times, 1163 01:05:08,947 --> 01:05:12,700 and then they'll leave and say... 1164 01:05:12,700 --> 01:05:14,327 Then we can go right back 1165 01:05:14,327 --> 01:05:16,704 and just continue to do what we've been doing. 1166 01:05:16,704 --> 01:05:19,415 I think when people look back in 10 or 20 or 30 years 1167 01:05:19,415 --> 01:05:23,336 and write the history of drug pricing in the early 21st century, 1168 01:05:23,336 --> 01:05:29,425 they're gonna be struck by two remarkable and often inexcusable trends. 1169 01:05:29,425 --> 01:05:32,262 Between the gaming of the patent system 1170 01:05:32,262 --> 01:05:34,848 or the exclusivity and licensing system 1171 01:05:34,848 --> 01:05:37,642 for the old drugs, which is unconscionable, 1172 01:05:37,642 --> 01:05:40,603 and the charging of hundreds of thousands of dollars a year 1173 01:05:40,603 --> 01:05:45,608 for a new drug that's still on patent, which is also very, very troubling, 1174 01:05:45,608 --> 01:05:46,901 people will look back and say, 1175 01:05:46,901 --> 01:05:49,863 "That is where the industry began slitting its own throat 1176 01:05:49,863 --> 01:05:52,073 and basically begging to be regulated 1177 01:05:52,073 --> 01:05:54,951 because people are just fed up with those kinds of prices." 1178 01:05:59,122 --> 01:06:01,332 Be it a single-payer system, 1179 01:06:01,332 --> 01:06:04,544 collective bargaining, or pricing committees, 1180 01:06:04,544 --> 01:06:08,339 there are many ways government can regulate drug prices. 1181 01:06:08,339 --> 01:06:13,094 The United States is the only industrialized country in the world 1182 01:06:13,094 --> 01:06:17,432 that operates on a system of whatever the traffic will bear. 1183 01:06:17,432 --> 01:06:19,684 Aside from everything else, 1184 01:06:19,684 --> 01:06:21,895 the government just doesn't negotiate for prices. 1185 01:06:21,895 --> 01:06:23,980 I mean, some people know that, for example, 1186 01:06:23,980 --> 01:06:26,274 that Medicare is forbidden to negotiate, 1187 01:06:26,274 --> 01:06:28,776 but I don't think the majority of people understand that. 1188 01:06:28,776 --> 01:06:30,653 I mean, that would be such an easy fix. 1189 01:06:30,653 --> 01:06:32,071 The reason we pay more 1190 01:06:32,071 --> 01:06:35,533 is because all the other countries negotiate with the drug companies 1191 01:06:35,533 --> 01:06:36,701 and we don't. 1192 01:06:36,701 --> 01:06:39,871 Canada, Britain, Germany, Switzerland. 1193 01:06:39,871 --> 01:06:42,999 Pick any developed country, they all negotiate. 1194 01:06:42,999 --> 01:06:47,128 Take the hepatitis C drug, sofosbuvir, for example. 1195 01:06:47,128 --> 01:06:52,675 In 2016, the same drug cost 37% less in the U.K., 1196 01:06:52,675 --> 01:06:59,349 66% less in Spain, and 99% less in Egypt and India. 1197 01:06:59,349 --> 01:07:02,560 It appears that there's an opinion in the U.S. 1198 01:07:02,560 --> 01:07:06,397 that medicines made overseas are inferior or even dangerous. 1199 01:07:06,397 --> 01:07:09,651 Well, all of the factories that are manufacturing these generics 1200 01:07:09,651 --> 01:07:14,072 are licensed by the FDA and the World Health Organization, 1201 01:07:14,072 --> 01:07:18,451 and in the case of hep C meds, they're licensed by Gilead anyway, 1202 01:07:18,451 --> 01:07:23,414 so they're absolutely identical in every way to the expensive product, 1203 01:07:23,414 --> 01:07:28,419 and the reality is that probably 50% of the prescription medicines in the U.S. 1204 01:07:28,419 --> 01:07:29,963 are made in India anyway. 1205 01:07:29,963 --> 01:07:34,509 Is it that somehow we're carrying a greater load because we're richer 1206 01:07:34,509 --> 01:07:37,220 or because we're financing RandD for the rest of the world? 1207 01:07:37,220 --> 01:07:38,930 No. We're carrying a greater load 1208 01:07:38,930 --> 01:07:43,351 because the drug companies built a system that precludes us 1209 01:07:43,351 --> 01:07:46,312 from negotiating over prices in this country. 1210 01:07:46,312 --> 01:07:48,940 Everybody else does, so we pay more. 1211 01:07:48,940 --> 01:07:52,652 As a rule, pharmaceutical industry always wins. 1212 01:07:52,652 --> 01:07:54,404 Last November in 2016, 1213 01:07:54,404 --> 01:07:58,574 we had an initiative on the ballot in California, Prop 61, 1214 01:07:58,574 --> 01:08:01,744 that said they could negotiate for prices. 1215 01:08:01,744 --> 01:08:06,416 Do you have any idea what the pharmaceutical industry is spending 1216 01:08:06,416 --> 01:08:09,252 against Proposition 61? 1217 01:08:09,252 --> 01:08:16,634 They are spending $126 million! 1218 01:08:16,634 --> 01:08:22,223 $126 million 1219 01:08:22,223 --> 01:08:26,978 to defeat a proposal that will lower drug costs 1220 01:08:26,978 --> 01:08:28,896 for the people of California. 1221 01:08:28,896 --> 01:08:31,816 It is incomprehensible! 1222 01:08:31,816 --> 01:08:35,361 The time is long overdue for the American people 1223 01:08:35,361 --> 01:08:38,114 to stand up to the greed of the pharmaceutical industry. 1224 01:08:38,114 --> 01:08:40,742 We should be doing it here in Washington, 1225 01:08:40,742 --> 01:08:42,493 but they own Washington, unfortunately. 1226 01:08:52,670 --> 01:08:56,215 Well, they have spent, since 1998, 1227 01:08:56,215 --> 01:08:59,135 over $3 billion in lobbying. 1228 01:08:59,135 --> 01:09:02,680 $3 billion in lobbying, 1229 01:09:02,680 --> 01:09:06,476 not to mention enormous amounts of money in campaign contributions. 1230 01:09:06,476 --> 01:09:08,853 Not only are they the top lobbying industry, 1231 01:09:08,853 --> 01:09:11,814 but they outspend every other American industry 1232 01:09:11,814 --> 01:09:14,567 by at least 44%. 1233 01:09:14,567 --> 01:09:17,695 This gives them unparalleled lobbying power. 1234 01:09:17,695 --> 01:09:22,075 Donald Trump got elected to drain the swamp in Washington. 1235 01:09:22,075 --> 01:09:24,410 If anybody ever did drain the swamp, 1236 01:09:24,410 --> 01:09:26,537 what they would find lying around the bottom 1237 01:09:26,537 --> 01:09:30,833 is four or five drug industry lobbyists for every representative in Washington. 1238 01:09:30,833 --> 01:09:33,795 The New York Times sort of intimated this morning in their op-ed 1239 01:09:33,795 --> 01:09:36,297 that Congress yells a lot but does nothing. 1240 01:09:36,297 --> 01:09:37,632 I couldn't agree more. 1241 01:09:37,632 --> 01:09:39,884 Because the lobbying, and you guys lobby too. 1242 01:09:39,884 --> 01:09:40,968 You lobby. 1243 01:09:40,968 --> 01:09:44,931 Is Congress too close to the biotech and pharma industry? 1244 01:09:44,931 --> 01:09:49,519 They've got lobbyists everywhere 1245 01:09:49,519 --> 01:09:51,938 pushing for what they want. 1246 01:09:51,938 --> 01:09:54,941 The unfortunate realities of politics in America 1247 01:09:54,941 --> 01:09:57,902 is that the larger your lobbying trade group is 1248 01:09:57,902 --> 01:10:00,196 and the more money you can wield, 1249 01:10:00,196 --> 01:10:02,573 and they often call it dark money, 1250 01:10:02,573 --> 01:10:05,827 the dark money goes to support electing politicians, 1251 01:10:05,827 --> 01:10:10,039 and that money absolutely influences decisions that are made. 1252 01:10:11,707 --> 01:10:16,462 The reach of pharma's financial contributions is staggering. 1253 01:10:16,462 --> 01:10:20,675 In 2016, out of the 100 members of the Senate, 1254 01:10:20,675 --> 01:10:25,054 93 senators accepted money from pharma. 1255 01:10:25,054 --> 01:10:27,432 A lobbyist has a lot of money at their disposal. 1256 01:10:27,432 --> 01:10:29,559 First of all, you can give contributions, 1257 01:10:29,559 --> 01:10:32,061 which is really the mother's milk of politics, 1258 01:10:32,061 --> 01:10:35,106 to virtually every congressman you need to impact, 1259 01:10:35,106 --> 01:10:36,858 and not just contributions, 1260 01:10:36,858 --> 01:10:39,318 you can raise significant sums of money for them 1261 01:10:39,318 --> 01:10:41,529 if you have a lot of resources. 1262 01:10:41,529 --> 01:10:45,199 You can, in essence, buy your way through your issue 1263 01:10:45,199 --> 01:10:46,784 if you do it carefully. 1264 01:10:46,784 --> 01:10:51,581 The Congress of the United States of America 1265 01:10:51,581 --> 01:10:57,211 should be put up for malpractice for not addressing this issue. 1266 01:10:57,211 --> 01:11:00,923 Mr. President, let us be frank, let us be honest. 1267 01:11:00,923 --> 01:11:06,304 The current political campaign finance system is corrupt 1268 01:11:06,304 --> 01:11:08,848 and amounts to legalized bribery. 1269 01:11:08,848 --> 01:11:12,268 The pharmaceutical industry has prevailed for almost a decade 1270 01:11:12,268 --> 01:11:15,980 here in Washington in just wiping this issue off the agenda. 1271 01:11:15,980 --> 01:11:18,483 There's no discussion, there are no votes, 1272 01:11:18,483 --> 01:11:22,111 we have not really done anything to even try to act 1273 01:11:22,111 --> 01:11:25,865 on pharmaceutical prices with a vote on the floor of the House 1274 01:11:25,865 --> 01:11:27,575 since 2007. 1275 01:11:29,327 --> 01:11:31,829 Last month, federal lawmakers from both parties 1276 01:11:31,829 --> 01:11:33,831 helped the industry block Senate legislation 1277 01:11:33,831 --> 01:11:37,543 to let Americans purchase lower-priced FDA-approved medicines from Canada. 1278 01:11:37,543 --> 01:11:40,880 Right, so, that is absurd, and by the way, again, 1279 01:11:40,880 --> 01:11:44,342 let's emphasize that it wasn't just Republicans, it was Democrats as well. 1280 01:11:44,342 --> 01:11:49,055 Pharma's gone back and forth as to whether or not they want to be partisan. 1281 01:11:49,055 --> 01:11:51,933 So in some eras, you see pharma weighing in very much 1282 01:11:51,933 --> 01:11:53,434 for the Republican Party. 1283 01:11:53,434 --> 01:11:58,356 In other years, it was more equal between the Democrats and the Republicans. 1284 01:11:58,356 --> 01:12:01,275 The reality is, if you're a congressman, 1285 01:12:01,275 --> 01:12:04,612 they let you know that if you do things that they like, 1286 01:12:04,612 --> 01:12:06,989 they will give you money; 1287 01:12:06,989 --> 01:12:09,492 if you do things they don't like, 1288 01:12:09,492 --> 01:12:11,244 they will give money to your opponent. 1289 01:12:11,244 --> 01:12:15,873 Just the threat of a campaign contribution to an opponent 1290 01:12:15,873 --> 01:12:18,960 is all that's necessary to be able to control a politician, 1291 01:12:18,960 --> 01:12:23,631 and it's why it's so difficult to get any meaningful legislation advanced 1292 01:12:23,631 --> 01:12:27,176 at either the state or federal level is because of all the money. 1293 01:12:27,176 --> 01:12:30,429 We have members here who just love free trade. 1294 01:12:30,429 --> 01:12:33,641 We can bring any product you want in from China, 1295 01:12:33,641 --> 01:12:37,603 you can get lettuce and tomato coming from farms in Mexico, 1296 01:12:37,603 --> 01:12:40,523 but for some strange reason, 1297 01:12:40,523 --> 01:12:45,528 we cannot bring in brand-name drugs from Canada. 1298 01:12:45,528 --> 01:12:48,990 Just can't do it, can't figure out how to do it. 1299 01:12:48,990 --> 01:12:51,701 And everybody here knows what the reason is. 1300 01:12:51,701 --> 01:12:54,870 So you have a very wrong system, 1301 01:12:54,870 --> 01:12:56,956 a very immoral, at some level, system 1302 01:12:56,956 --> 01:13:00,918 that really, in essence, comes down to bribery that is legal, 1303 01:13:00,918 --> 01:13:02,795 and that's what's gotta be changed, 1304 01:13:02,795 --> 01:13:06,007 but to change it, you've gotta get the very members of Congress 1305 01:13:06,007 --> 01:13:09,176 who benefit from these bribes to agree not to take them. 1306 01:13:15,141 --> 01:13:17,101 It's very, very hard 1307 01:13:17,101 --> 01:13:20,521 because of the reach and influence and the money 1308 01:13:20,521 --> 01:13:24,025 that the drug corporations have to do this work, 1309 01:13:24,025 --> 01:13:28,404 but there is enough anger and there is enough energy 1310 01:13:28,404 --> 01:13:30,281 that we are making progress. 1311 01:13:30,281 --> 01:13:32,491 The era of modern medical research 1312 01:13:32,491 --> 01:13:35,161 has brought us undeniable breakthroughs 1313 01:13:35,161 --> 01:13:38,914 that have curbed illness and extended lifespans, 1314 01:13:38,914 --> 01:13:40,374 but at what cost? 1315 01:13:40,374 --> 01:13:43,044 Everyone looks gorgeous! 1316 01:13:43,044 --> 01:13:47,089 I feel like it's my calling-- if you want to call it that-- 1317 01:13:47,089 --> 01:13:51,010 I feel like it's my job to effect change 1318 01:13:51,010 --> 01:13:53,554 because I think it's really unfair 1319 01:13:53,554 --> 01:13:56,098 to have to be your own advocate to this level. 1320 01:13:59,602 --> 01:14:02,271 The drug companies are almost holding 1321 01:14:02,271 --> 01:14:04,440 people that are sick or chronically ill 1322 01:14:04,440 --> 01:14:06,776 or have some sort of a disease or cancer or whatever, 1323 01:14:06,776 --> 01:14:08,319 they're holding us hostage. 1324 01:14:08,319 --> 01:14:11,530 Somewhere along the way, the pharmaceutical industry 1325 01:14:11,530 --> 01:14:15,076 turned its back on the very society that it serves, 1326 01:14:15,076 --> 01:14:19,413 pledging its loyalty to profit, corrupting our political system, 1327 01:14:19,413 --> 01:14:22,500 and testing the breaking point of our economy. 1328 01:14:22,500 --> 01:14:26,003 I'm not sure what a revolution for sick people would look like, 1329 01:14:26,003 --> 01:14:29,048 but I do know that we need one. 1330 01:14:29,048 --> 01:14:32,301 If the healthy and well could stand up with the sick, 1331 01:14:32,301 --> 01:14:33,844 we could get a lot done, 1332 01:14:33,844 --> 01:14:36,138 and we need to figure this one out together. 1333 01:14:36,138 --> 01:14:37,431 It can't go on. 1334 01:14:37,431 --> 01:14:41,227 It's not just that our healthcare is way more expensive 1335 01:14:41,227 --> 01:14:43,145 than any other country on earth, 1336 01:14:43,145 --> 01:14:46,732 it's that there is no good end to this path that we're on. 1337 01:14:46,732 --> 01:14:49,902 We have Stockholm syndrome, we're just sort of like, 1338 01:14:49,902 --> 01:14:53,406 people are accepting horrible consequences from the current system 1339 01:14:53,406 --> 01:14:55,491 because they think there's no alternative. 1340 01:14:55,491 --> 01:14:58,327 The important thing is there is an alternative. 1341 01:14:58,327 --> 01:15:02,873 The alternative is to do something different than what we're doing right now. 1342 01:15:02,873 --> 01:15:05,584 Something has to change. 1343 01:15:05,584 --> 01:15:08,671 Price regulation, patent reform, 1344 01:15:08,671 --> 01:15:10,756 industry transparency, 1345 01:15:10,756 --> 01:15:14,260 single-payer system, negotiation reform, 1346 01:15:14,260 --> 01:15:18,472 marketing regulations, anything has to change. 1347 01:15:18,472 --> 01:15:21,350 We are exposing to the world 1348 01:15:21,350 --> 01:15:26,105 just how greedy this pharmaceutical industry is. 1349 01:15:26,105 --> 01:15:28,315 Somebody has to say no. 1350 01:15:28,315 --> 01:15:32,528 Somebody has to react and say, "It's not acceptable. 1351 01:15:32,528 --> 01:15:35,823 We can do better. As a society, we can do better." 1352 01:15:35,823 --> 01:15:38,701 Everyone knows somebody who's sick, who's been sick. 1353 01:15:38,701 --> 01:15:42,913 They want that person to have better treatment options, 1354 01:15:42,913 --> 01:15:50,379 as I do, but it can't be a conversation about what's that person worth to you? 1355 01:15:50,379 --> 01:15:53,799 It can't be that kind of conversation. 1356 01:15:53,799 --> 01:15:55,718 They will fight it, 1357 01:15:55,718 --> 01:15:58,512 they will try to buy our Congress, 1358 01:15:58,512 --> 01:16:01,140 they will stifle legislation, 1359 01:16:01,140 --> 01:16:03,726 and they will spend billions of dollars 1360 01:16:03,726 --> 01:16:07,521 to hang onto the system that has given them their power. 1361 01:16:07,521 --> 01:16:11,734 Do not concentrate on, so much, who you're fighting against; 1362 01:16:11,734 --> 01:16:14,320 concentrate on what you're fighting for. 1363 01:16:14,320 --> 01:16:16,655 One person can make a difference. 1364 01:16:16,655 --> 01:16:19,283 I think people need to get on the phone, 1365 01:16:19,283 --> 01:16:21,035 call their congressman, and say, 1366 01:16:21,035 --> 01:16:25,456 "Look, I want something done about this drug pricing. 1367 01:16:25,456 --> 01:16:27,583 It's ridiculous." 1368 01:16:27,583 --> 01:16:29,668 They can be beaten. 1369 01:16:29,668 --> 01:16:34,965 They will be beaten if patients and consumers stand up and say, 1370 01:16:34,965 --> 01:16:37,426 "No more, we're not gonna do this anymore." 1371 01:16:37,426 --> 01:16:40,387 It's the only way we have a chance to push back 1372 01:16:40,387 --> 01:16:43,849 against all the money and influence that the drug companies have. 1373 01:16:45,768 --> 01:16:48,479 We have lost control of the industry 1374 01:16:48,479 --> 01:16:52,942 that holds our lives in the palm of their hand. 1375 01:16:52,942 --> 01:16:58,155 What, then, are we willing to do to get it back? 1376 01:16:58,155 --> 01:17:02,326 The answer can't be nothing. 117981

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