Intended for healthcare professionals


Covid-19: “Shkreli Awards” go to pandemic’s top profiteers

BMJ 2021; 372 doi: (Published 05 January 2021) Cite this as: BMJ 2021;372:n16
  1. Owen Dyer
  1. Montreal, Canada

The Shkreli Awards for profiteering and dysfunction in healthcare, an annual tribute to the worst actors of the US health system, have unsurprisingly focused this year on misconduct during the covid-19 pandemic, with the place of dishonour taken by the Trump administration’s federal personal protective equipment (PPE) taskforce.

Led by Jared Kushner, the procurement taskforce launched “Project Airbridge” to find PPE abroad and bring it quickly to the US. But rather than distribute it to needy state governments, the taskforce gave these supplies to six private medical supply companies to sell to the highest bidder, creating a bidding war among states.

Half of the PPE was meant to go to designated pandemic “hot spots,” but no officials from the 10 hardest hit counties in the first covid-19 wave could confirm that they received any PPE from Project Airbridge, the Washington Post found.1

In distributing PPE, the administration “repeatedly put the profits of private sector enterprises above the health needs of the American people and the safety of healthcare workers,” said Merrill Goozner, former editor of Modern Healthcare and one of the award judges.

The Shkreli Awards, given by the Lown Institute, a US think tank, are named after “pharma bro” Martin Shkreli, perhaps the most disliked man in America. Shkreli’s notoriety dates from 2015, when his company Turing Pharmaceuticals bought Daraprim—a cheap generic drug that was the only treatment for some parasitic infections in babies and patients with HIV—and hiked the price by 5000%.

Shkreli is currently serving a seven year prison term for an unrelated securities fraud. The Daraprim price hike remains in effect.

Runners up in the 2020 awards include two physician staffing companies whose ownership comes, like Shkreli, from the world of private equity. TeamHealth and Envision cut pay and benefits for clinicians treating covid-19 patients, their award citation notes, while spending millions lobbying against legislation aimed at stopping “surprise billing” for out-of-network care.

Also named in the awards were peddlers of fake covid-19 cures, such as televangelist Jim Bakker and MyPillow chief executive Mike Lindell, who touted potentially toxic colloidal silver and oleandrin. A doctor, Jennings Ryan Staley of the Skinny Beach Med Spa in California, was criminally indicted for selling $4000 (£2944; €3256) “covid-19 treatment packs” consisting of hydroxychloroquine, antibiotics, alprazolam (Xanax), and sildenafil (Viagra).

A Connecticut internist, Steven Murphy, used public covid-19 testing sites to conduct unnecessary tests for at least 20 respiratory pathogens, billing up to $2000 per person and charging insurers $480 to give patients test results by phone.

Other award winners include hospitals accused of punishing doctors early in the pandemic for wearing PPE in front of patients, such as University Medical Center in El Paso,2 and four California hospital systems that, despite having spare beds, denied requests from overflowing nearby hospitals to take uninsured patients or those on Medicaid.3

Vaccine makers AstraZeneca, GlaxoSmithKline, Pfizer, and Johnson and Johnson receive a Shkreli for their open hostility to the covid-19 technology access pool, a voluntary scheme led by the World Health Organization to share trial data and other information.4

Their rival Moderna is named in two awards, including a Shkreli for setting the highest vaccine price of any maker even though taxpayer funding covered all its development costs.

An award also goes to the chief executive of Brigham and Women’s Hospital in Boston, Betsy Nabel, who resigned in July from Moderna’s board after she came under intense scrutiny for an article she wrote, published in several newspapers, defending high drug prices. In it, Nabel described herself as a cardiologist, Harvard professor, and hospital president but did not disclose her paid drug industry directorship.5

“What was even worse,” said award judge Patricia Gabow, “was that Moderna ‘selected’ Brigham and Women’s Hospital for the vaccine trial and Dr Nabel sold Moderna stock, after it quadrupled in price with the vaccine development.”