The 2017 Shkreli Awards – Readers’ Choice

For the new year, we released “The Shkreli Awards,” a list of the top ten worst actors in health care named for the infamous “pharma bro” Martin Shkreli. The list highlights some of the most egregious examples of profiteering and lack of empathy in health care in 2017.

We asked readers to let us know what they would have put on the list, and got tons of great suggestions. We’ve featured some of these readers’ choices here as Shkreli Award “Dishonorable Mentions”:

  1. Several medical device companies deserve an honorable mention for marketing unsafe or ineffective devices. One reader pointed out a recent study that examined internal documents from Johnson & Johnson/DePuy around their Pinnacle hip implants. Researchers found that J&J/DePuy manipulated data in their post-approval seeding trial to make the device seem safe and effective, although it had never been tested on humans before being sold. The implants were found to cause serious complications from the metal grinding against itself, leaving traces of toxic ions into the bloodstream. The company faces a billion-dollar lawsuit, but the underlying issue of insufficient evidence in medical device approval is still unresolved.
  2. Another reader called out expensive drugs that were approved based on their effectiveness on certain “secondary endpoints” but this year shown not to actually affect mortality. For example, Amgen’s highly-anticipated cholesterol-reducing drug Repatha cut risk of heart attack in half, but didn’t reduce mortality at all. The list price? $14,523 per year. 
  3. Patient advocate and Right Care Alliance Steering Committee member Casey Quinlan commented on Twitter about the “epic” starting price of new drug Luxturna – $850,000. Luxturna treats a rare retinal condition that can lead to blindness. The announcement came a little too late for the Shkreli awards, but sets an inauspicious trend for 2018.
  4.  We touched a bit on problems with the behavioral health system in the Shkreli Awards (ie. Arbour hospital‘s unsafe conditions and neglect) but readers were quick to point out that this is just the tip of the iceberg. From the growing benzodiazepine crisis to the recognition that college students aren’t getting the services they need, 2017 was a significant year for revealing systemic issues with mental health care access and effectiveness.
  5. And this disturbing headline from NPR, which we wanted to include in the 2017 awards, but didn’t quite make the cut: “We regret to inform you that a British surgeon was branding his initials on livers.” While branding patients is certainly not a widespread surgical practice (we hope!), one has to question what kind of health system we’ve created where this could happen twice

Thanks to the readers for their thoughtful comments and suggestions!