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NEW YORK — Martin Shkreli remains as unrepentant as ever.

In a brief, but illuminating appearance at a health industry gathering on Thursday, the controversial chief executive of Turing Pharmaceuticals rejected fresh criticism that he went back on his promise to lower the price of the life-saving medicine Daraprim.

“Our shareholders expect us to make as much as money as possible,” said a defiant Shkreli, who wore a hooded sweatshirt and sneakers in an auditorium that was otherwise filled with buttoned-down executives, physicians, and investors. “That’s the ugly, dirty truth.”

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Shkreli was responding to questions about his recent decision to leave intact the $750-a-tablet list price for Daraprim. Turing bought the drug last summer and quickly jacked up the price from $13.55, a 5,000 percent increase that became a flashpoint in the debate over prescription drug costs.

The drug is used to treat a rare parasitic infection known as toxoplasmosis, which can be fatal, especially for people with AIDS or who have weakened immune systems. But there are no generic alternatives, partly because Turing makes it difficult for such companies to obtain needed ingredients for testing.

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Public outrage accelerated when Shkreli used social media to deride his critics, but soon relented and promised to later lower the price. Late last month, Turing slashed the cost of Daraprim by 50 percent, but only for hospitals, which means insurers and some patients will still pay full freight.

In a 20-minute session at the Forbes Health Summit, Shkreli did not appear at all defensive when pressed to explain his decision. Rather, the 32-year-old former hedge fund manager was confrontational and seemed to relish the chance to air his views on capitalism and responsibilities to shareholders.

“I don’t like it when I have to fire employees or when shareholders are angry at me,” he said. “So I have to maximize revenue. The idea that pharmaceuticals are exempt from capitalism is insane.”

And in case he hadn’t made his point, Shkreli said that if he had to do anything differently over the past few months, he would have set the price of Daraprim even higher. “My investors expect me to maximize profits … Try to be a CEO yourselves and see how it goes.”

Actually, Shkreli was talking to a room packed with numerous corporate chiefs and other executives from some of the largest pharmaceutical companies and cutting-edge health data firms.

During the final moments of the session, Shkreli got into a brief exchange with Dr. Steve Miller, the chief medical officer of Express Scripts, the nation’s largest pharmacy benefits manager. Earlier this week, the company agreed to cover a $1 compounded version of Daraprim.

Speaking from the audience, Miller challenged Shkreli over his pricing. But Shkreli not only defended his decision but also managed to get Miller to acknowledge that Express Scripts does offer reimbursement at the $750 price for some patients.

“That’s awesome, man,” said a highly satisfied Shkreli. “Thanks for your business.”