This MacArthur 'genius' grantee says she isn't a drug price rebel but she kind of is

The day Priti Krishtel found out she won the MacArthur "genius grant" didn't start out as a particularly happy day.

"I had a friend going through surgery that day. So I was standing at my kitchen counter just kind of nervously pacing," she said.

But then Priti received a mysterious email asking for a reference, so she hopped on the phone thinking, "It'll distract me." Then came the moment of revelation.

"The [MacArthur foundation] said, 'We're calling you under false pretenses. We're actually calling to give you the fellowship.' And I literally sat down and was in shock for a while."

For over 20 years, Priti has been working as a health justice lawyer and is the co-founder and co-executive director of the non-profit I-MAK. She aims to prevent pharmaceutical companies from exploiting loopholes in the U.S. patent laws that allow them to keep exclusive rights to medicines for extended period of time. Through these exclusive rights, pharma companies can sell their drugs at high prices without the threat of competition. This means that people and countries in need of medication are often unable to afford it.

Priti previously co-authored a story for NPR about how patents on the COVID-19 vaccine prevented some of the most vulnerable populations in the world from getting access to the shots.

We spoke to Priti about what it feels like to be a so-called "genius" MacArthur fellow, what inspired her to work as a health justice lawyer and her plans for the future — and the $800,000 MacArthur prize. This interview has been edited for length and clarity.

Congratulations on winning the MacArthur Fellowship, Priti! How do you feel?

I think it finally started to sink in today. Family are calling, friends are calling. It's really started to hit me that it's happened.

The unofficial designation for this fellowship is the "genius grant." Do you feel like a genius?

The term makes me laugh, because I've had a couple of friends who have gotten it before and I used that term without hesitation when I talked about their award. Now that I've become a fellow, I would not bring myself to use the term genius.

How did you get started working on pharmaceutical patent law and how does your work help people?

My work started at the peak of the HIV epidemic in the early 2000s [when HIV deaths were at their highest]. When I was first starting out as a young legal aid lawyer, I moved to India to work for an Indian NGO representing low-income patients. I saw families who placed their children in orphanages before their parents died because HIV medications weren't reaching India at that time. Through advocacy and policy work and a lot of activism, we finally got cheaper HIV medications all over the world. I saw young people — children with HIV — go on to live happy, healthy, productive lives.

Much of your work now focuses on how pharmaceutical companies abuse the patent system to keep prices high. What's going on and how does that work?

Originally, as far back as the writing of the Constitution, you were supposed to get a time-limited monopoly of 20 years if you invented something. In the last 40 years, the biggest corporations figured out that if they kept filing patents [with small changes to the drug such as dose requirements], they could stack them up [extending the patent protection], to the point where it blocks out all competition.

For example, take the top selling drug in the country, HUMIRA [an arthritis treatment]. After the first patent expired, the company [AbbVie] filed and got so many more patents that they made two-thirds of all their revenue after the first patent expired. But what you see in another part of the world, like Europe, is that the price came down because other companies came in as competition.

So the ways in which drug companies are using the patent system, and the fact that patients don't have a voice in the patent system, is leading to longer monopolies, higher prices or drugs not being available at all.

What has the COVID-19 pandemic taught us about the way companies are profiting off of life-saving medicine?

COVID taught us that when the biggest drug companies have monopolies on their products, they will always sell to the highest bidder [i.e., countries who are willing to pay the most for vaccine doses]. They will always price the medication or the vaccines out of reach. And who's left behind? It's always the global south and the African continent in particular.

For example, Moderna was almost 100% publicly funded [Moderna received over $10 billion in funding from the U.S. government]. But unfortunately, the U.S. government gave away the rights to the vaccine [by awarding patents to Moderna]. So now Moderna stands to make $100 billion dollars by the end of this decade, and $40 billion alone by the end of this year. And it was taxpayer funding that helped bring that invention to market.

What inspires and motivates you to keep working on a problem that has affected so many people?

I think we are all people who have faced illness or who have lost loved ones. I've certainly lost more people than I can count at this point. I've been a caregiver for a dear friend who is a cancer patient. We're all so intimately in touch with wanting to keep our loved ones safe and healthy and alive. And we also know the anguish that we feel as health care costs spiral out of control.

I think in terms of how I arrived at this work, though, my dad is probably my biggest influence. He worked in the pharmaceutical industry and really instilled in me and my sister a love for science and for finding cures. My sister and I went in different directions with that. My sister became a doctor and a researcher, and I realized people like my dad are trying to save lives and bring these cures to market. But there's a huge gap where people aren't actually getting these medicines.

The act of standing up against these corporations is in some ways an act of rebellion. Have you always been a rebellious person? Is that part of the reason why you're doing the work that you do?

My mother would say yes. But I don't really view my job as standing up to the pharmaceutical industry. My dad is from the industry. In that sense, I am more interested in shining a light on a system that I think is not working for people.

When you aren't hard at work trying to close the loopholes in the U.S. medical patent system, how do you relax and recharge?

I am a mom. So most of my free time goes to hanging out with my 4-year-old, which is the joy of my life, and my husband. I also have a group of friends who I call my book club, but I don't actually read the book most of the time. They are my big idea group. We talk about everything and so they have just really been my joy outside of work in recent years.

So the award also comes with a hefty $800,000 dollar stipend, for you to spend on whatever you wish. What are you planning to do with that money?

I don't know yet. I feel like it's gonna take a little time for that to sink in.

There has to be at least a vacation that you want to take or something.

Definitely! My mom has always said to me, "You know, someday I want you to take me to Europe." She has been saying that for 20 years, so it's definitely on the top of my mind right now.

Fixing the systemic issues in the medical patent system is a long and arduous process, but what can you say to people who are now struggling to pay for their medicine and don't know what to do?

There is relief coming. This administration just achieved this huge success with the Inflation Reduction Act. For the first time, Medicare has the ability to negotiate drug prices. So step by step a growing number of people have pushed Congress to take action. The more people speak up, the more they don't allow this system to move further and further in favor of private interests.

Are there any last words that you would like to leave to our readers?

I just don't think that people's ability to heal should depend on their ability to pay. And I think we all have the ability to be a part of the solution.