‘It’s not funny, Mr. Shkreli. People are dying.’
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WASHINGTON — Martin Shkreli, the former drug executive who became the poster boy for extreme drug price increases, held his tongue as members of Congress blasted him at a hearing Thursday — but he managed to enrage the lawmakers even more as he smirked his way through the hearing.

“It’s not funny, Mr. Shkreli. People are dying, and they’re getting sicker and sicker,” Representative Elijah Cummings (D-Md.) told Shkreli as he grinned during the congressman’s opening statement.

Shkreli’s lawyer later called him a “hero” — and insisted he would be judged that way by history.

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The appearance by Shkreli, who garnered nationwide attention after raising the price of a decades-old drug known as Daraprim by more than 5,000 percent, was the highlight of a congressional hearing that managed to explore the complicated reality of drug pricing in the United States.

The session also dealt with the latest efforts to reduce the backlog of unapproved generic drugs — which Republicans hope to reduce as a way to provide patients with cheaper options.

As expected, though, Shkreli stole the show.

Shkreli — who stepped down late last year as chief executive officer of Turing Pharmaceuticals — stuck to his script, invoking the Fifth Amendment when the questioning turned to him.

“On the advice of counsel, I invoke my Fifth Amendment privilege against self-incrimination and respectfully decline to answer your question,” Shkreli said, over and over.

Representative Jason Chaffetz of Utah, the chairman of the House Oversight and Government Reform Committe, tried to ask Shkreli what he would say to “that single, pregnant woman with AIDS … who might need Daraprim to survive.”

Again, Shkreli took the Fifth.

Chaffetz eventually dismissed Shkreli after he and other lawmakers tried unsuccessfully to get him to respond to questions. The one question he did answer: He acknowledged that a committee member had pronounced his name correctly.

Chaffetz later said he won’t try to hold Shkreli in contempt of Congress for refusing to answer questions. “Probably not. I didn’t think it rose to that level. It was discourteous,” but not enough to warrant a contempt charge, he told reporters after the hearing.

Immediately after he left the hearing room, Shkreli and his new lawyer, New York defense attorney Benjamin Brafman, spoke to reporters outside the hearing room — and Shkreli stood silently as Brafman came to his defense.

Shkreli had to take the Fifth because of an unrelated securities fraud charge he’s facing, Brafman said — not because of contempt for the committee. And his smirks, Brafman said, were a result of “nervous energy by an individual who would very much like to explain what happened, but has agreed to listen to his lawyer.”

Minutes later, however, Shkreli couldn’t resist one last shot at the committee, firing off a tweet.

Shkreli was indicted in December on securities fraud charges — allegedly using stock from Retrophin, a drug company he founded, to pay off debts in a financially troubled hedge fund. He resigned as Turing’s chief executive officer after his arrest.

Brafman added that it was “extraordinarily unfair that Turing has been singled out.”

“When all of the facts about Daraprim and Turing are ultimately disclosed, I think everyone will recognize that Mr. Shkreli is not a villain. He’s not the bad boy. I think at the end of this story, he is a hero,” Brafman said.

Throughout the hearing, Shkreli could barely hide his disgust with the proceedings, smirking at the lawmakers’ questions and scowling as he rose to be sworn in.

Cummings, the top Democrat on the panel, was especially tough on Shkreli. The problem of rising prescription drug prices, Cummings said, “directly affects my constituents and the constituents of every member of this Congress.”

“They can’t buy Wu-Tang Clan albums for $2 million,” Cummings said in another shot at Shkreli. “Hardworking American families should not be forced to pay increases of 10 percent, 100 percent, or 1,000 percent just to subsidize the lifestyles of hedge fund managers and corporate executives.”

Just before Shkreli was dismissed, Cummings “pleaded” with Shkreli to use any remaining influence to convince Turing to lower its drug prices.

“Rightly or wrongly, you have been viewed as a so-called bad boy of pharma. … You can use that to essentially come clean and right your wrong, and become one of the most effective patient advocates in this country,” Cummings said.

“I don’t ask, Mr. Shkreli — I beg that you reflect on it. There are so many people who could use your help. May God bless you.”

Republicans tried to turn the subject to the backlog of generic drug applications waiting to be approved by the Food and Drug Administration. Chaffetz said the approval process was “too slow” and complained that the agency was “drowning in a backlog of applications.”

Dr. Janet Woodcock, the director of the agency’s Center for Drug Evaluation and Research, said the agency is starting to clear up a backlog that built up years ago, when she said it was flooded with generic drug applications and didn’t get enough funding from Congress to handle it. She said that starting in October, any new generic drug applications will be put on a timetable to be approved in 10 months.

“It takes us some time to dig out of this hole, and it will take a bit more time before we’re fully caught up,” Woodcock said. “It is the older [applications] that we need to clean up, and we are working very hard and very successfully to do that.”

Most of the questions, however, were about the drug price hikes. And it fell to Nancy Retzlaff, Turing’s chief commercial officer, to play good cop to Shkreli’s bad cop.

She insisted that “to our knowledge, no patient needs to pay $750 per pill for Daraprim” — the new price Turing set after buying the drug, which used to be priced at $13.50 per pill. That’s because the company has set up a financial assistance program for uninsured patients, she said, and because most patients get it through government health care programs that leave many paying “one penny per pill.”

Retzlaff said she was “comfortable with that increase” because of the financial assistance programs and because Turing invests “60 percent of our net revenues” in research and development of new drugs.

Chaffetz, however, confronted her with video of a television interview in which Shkreli claimed that “we take all of our cash, all of our profits and spend it on research for these patients.”

“He may have meant profits,” Retzlaff offered.

And Retzlaff’s explanation of the different prices only drew more scolding from committee members, who were incredulous at how radically drug prices can change depending on where patients get the medications.

“So most people have no idea what the price is after you go through the gymnastics you just described,” said Representative Peter Welch, a Democrat from Vermont.

“That’s right. That’s how the industry works,” Retzlaff replied.

Republicans were outraged, too. Chaffetz raised the example of a pregnant woman with AIDS who might need the drug but be unable to afford it: “What’s she supposed to do? Is she supposed to tweet Martin ask to get it for a penny?”

Representative Blake Farenthold of Texas said the price increases ultimately get passed on to taxpayers — who pay for the government health programs that cover low-income patients — and even privately insured people, who could have to pay more for their coverage.

“You make it sound like no one’s getting hurt, but everyone in this room is getting hurt by those prices,” Farenthold said.

Retzlaff even had to answer for Shkeli’s “imbeciles” tweet. “Were you aware of that?” a visibly angry Cummings asked after Shkreli had left.

“I was not aware of that,” Retzlaff said, with a touch of dismay.

This story has been updated with Chaffetz comments and testimony from Nancy Retzlaff and the FDA’s Janet Woodcock.

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