Former pharmaceutical executive Martin Shkreli points as he exits the courthouse after the jury issued a verdict in his case at the U.S. District Court for the Eastern District of New York, Aug. 4, 2017 in the Brooklyn borough of New York City.

Martin Shkreli, known as the “Pharma Bro,” will remain subject to a lifetime ban from working in the pharmaceuticals industry and as well as an order to pay $64.6 million in disgorged profits after a federal appeals court upheld a ruling against Shkreli on Tuesday.

A three-judge panel of the U.S. Court of Appeals for the Second Circuit handed down a unanimous ruling that upheld the district court’s decision that Shkreli must keep out of the pharmaceutical business because of his anti-competitive behavior in distributing a potentially lifesaving drug.

New York State Attorney General Letitia James (D), the Federal Trade Commission, and seven individual states sued Shkreli and his companies in 2020 for antitrust violations. They maintained that Shkreli and his business partner illegally created a monopoly for Daraprim — a brand-name drug used to treat toxoplasmosis. For the immunocompromised — particularly those with HIV/AIDS or cancer, and organ transplant recipients — toxoplasmosis can be fatal. James said that Shkreli continued to carry out his scheme even when he was in federal prison serving a 7-year sentence for securities fraud. Shkreli’s company raised the price of Daraprim by 4,000% overnight.