If there’s a sinister evil organisation out there that everyone from across the political landscape can agree to hate, it’s Big Pharma.
Big Pharma is the loaded term used to refer to the big pharmaceutical corporations who, among other things, make money out of us feeling bad.
Unlike arms dealers or social media giants or tobacco companies, we actually need these corporations to make our medicines.
But they make their money from people getting ill and that seems just sick.
As we’ll see there are real reasons to think that the big pharmaceutical corporations are run by Nazgul from Mordor. Thing is, there are plenty of elves working there, too.
So Big Pharma is evil?
Unsurprisingly the picture isn’t as black and white as that.
Some conspiracy theories circulate along the lines that Big Pharma actually has a cure for cancer sealed away in a drawer somewhere while they make millions from chemotherapy.
But of course this would need tens of thousands of doctors, scientists, researchers and executives to all keep quite about it. And there just aren’t that many Nazgul to fill the top jobs.
It also ignores the point that, in a competitive market, a corporation would make far more money selling a cure for cancer…
Similar theories are raised by anti-vaxx campaigners who believe that if only we were to live well, eat well and trust in our sacred immune systems then we wouldn’t need any of these toxic vaccines Big Pharma is so keen to inject into our children.
But vaccine recommendations are supported by the overwhelming majority of scientists who study disease their entire lives.
Yes, the corporations make money out of it. But just about everything that makes our lives better is driven by profit. The devices you’re using, the clothes you’re wearing, the furniture you’re sitting on – these are all the products of businesses making money.
The thing is it just feels different when someone makes money out of our sickness and health.
And maybe that instinct shouldn’t be altogether ignored. Especially when faced with the big pharmaceutical corporations whose murky origins set the moral tone for their business practices. After all, companies that once happily sold heroin to kids might not always be trusted to do the right thing.
Wait, what? Heroin for children?
As late as 1912, the German pharmaceutical company, Bayer, was marketing heroin for children to treat coughs. Yes, that’s over a century ago and those were different times. There was little regulation, for one thing, and history shows us that the only limit big business respects is the rule of law.
And not even that a good deal of the time.
The reputation of pharmaceutical corporations was restored somewhat with the advent of antibiotics which, at the time, were like miracle drugs. Suddenly it was possible to vanquish infections and diseases that had plagued humans since the beginning of civilisation.
But it didn’t take long before the drug companies realised that the nascent advertising industry could make money for them, too. They began to pour millions into marketing their products with fake informational campaigns and canvassing of doctors to recommend their drugs.
In a perfect world doctors would keep up with the latest drug research and draw on their training to make the best choice for patients. In practice, they’re assailed by drug reps who bribe them with umbrellas, notepads, lunch dates and free samples to give away to their patients.
The drug reps have a playbook of strategies to influence the doctor’s prescriptions, playing dumb with the arrogant doctors, offering friendship to the chatty ones, all the time knowing that doctors are humans and so respond to basic reciprocity. In the US, they can even see if the doc has been playing along because the drug companies buy up the prescription records from pharmacies.
Some eloquent doctors are even paid tens of thousands of dollars by the drug companies to make speeches promoting their products at conferences.
The drug companies rarely outright lie about the products they sell. Instead they carefully cherry-pick their studies and data, selling narratives designed to appeal to doctors’ beliefs and philosophies. In the case of opiate addition, for instance, the story was carefully sold that addiction was a moral failing of the patient rather than a feature of the drug itself.
This kind of misleading data and aggressive targeting of doctors by corporations like Purdue Pharma led to the infamous opioid crisis which has claimed the lives of hundreds of thousands in the last 20 years.
If you’re wondering how big business could undermine such an essential branch of science, the answer is quite simple: it’s insanely profitable to do so.
How much money does Big Pharma make?
The drugs market was worth around 1.3 trillion dollars in 2019. ($1,300,000,000,000 – always helpful to actually see all the zeros!)
The reason that drug companies make so much money is simply because they charge so much for the drugs they make. Defending a decision to price a prostate cancer drug at over $100,000 a year, Johnson and Johnson came out with the usual line of:
“We have an obligation to ensure that the sale of our medicines provides us with the resources necessary to invest in future research and development.”
A corporation exists to make a profit. It costs a lot of money – a few billion dollars – to research and develop new life-saving drugs. They need to charge a lot to cover that.
There are a number of reasons to be skeptical about that.
Firstly, pharmaceutical corporations typically invest twice as much for marketing the drug than the actual research.
Secondly, the actual research is mostly done by universities supported by government grants. Paid for by our taxes. The corporations then buy up the research at bargain prices, does the final safety trials and then sells the drugs to us again through our health system.
So we end up paying twice for the same medicine.
Thirdly, they cook the books.
Pharmaceutical corporations don’t release their data but independent assessments put the costs of bringing a drug to market at about 25% of what’s typically claimed.
The ruthless capitalism of the big pharmaceutical companies was highlighted in the late 1990’s when South Africa declared it couldn’t afford to buy the anti-retroviral drugs for AIDS. Instead they would buy cheaper copies of the same medicine.
The response of some 40 pharmaceutical corporations was to sue the South African government.
Similar struggles were enacted in places like Brazil and India, and in each case Big Pharma used all of the powers at its disposal to prevent people getting affordable live-saving medicine.
Their argument was that they were protecting their patents. If anyone could just make cheaper copies where would their incentive be to develop new medicines for other conditions?
But in a world where patents are given priority over patients, something has gone badly wrong.
Okay, I’m convinced. Big Pharma is the Devil incarnate!
Well, no.
After all, it is better to have someone in the world making medicines that save lives, treat pain, help people deal with terrible conditions.
Try getting ill. Go to hospital with some mysterious infection. Develop a treatable form of cancer. Suddenly you’ll be very grateful that there is such a thing as a health industry.
I saw it last year. The best friend of my partner had spent 10 years in bed since she was 16 with a debilitating muscle disease. She was unable to hold up her own head. Then they discovered a new medicine and suddenly she was able to walk, swim, dance and have fun again.
It was like magic.
I was also stung by a reply to a comment I left on a science forum. It went like this:
“I wish to address your Big Pharma comment. The majority of scientists who work in a pharmaceutical company are not evil people. They do not have ulterior motives. They are transparent and do the job they do because of two reasons:
-Salaries tend to be better in industry.
– They fundamentally give a shit about solving a problem like curing cancer or Alzheimers. They are highly skilled individuals who could easily work in a bank or financial services making a lot more money.”
It must be a drag to spend your working hours developing a medicine for some terrible illness and then to be told you’ve sold your soul by a hippie who believes garlic can cure anything.
The business practices of pharmaceutical corporations are indefensible, however. They have repeatedly behaved in a way that is morally bankrupt. They have acted like mafia empires, bullying entire countries and threatening to cut off their supplies of medicine.
But worst of all their antics have undermined trust in science.
If there’s one charge I hear again and again when I talk to people who disbelieve in science, it’s that the scientists themselves have all been bought by commercial interests.
This is clearly not true. There are over 10 million working scientists in the world today and it’s just not credible to suppose they’re all on a secret pay roll.
But health is a field of science that matters to each of us in a very personal way. It’s unlikely that our happiness will ever depend on a bunch of physicists or biologists. But we are at some point in our lives likely to depend on the medical system for our own health or that of our loved ones.
And so when trust in medicine is damaged because of this kind of rapacious capitalism we all stand to lose.
Further reading:
https://www.washingtonpost.com/outlook/i-was-a-drug-rep-i-know-how-pharma-companies-pushed-opioids/2019/11/25/82b1da88-beb9-11e9-9b73-fd3c65ef8f9c_story.html – insights into how drug representatives influence doctors by a former drug rep who became a doctor
https://www.theatlantic.com/health/archive/2019/03/drug-prices-high-cost-research-and-development/585253/ – how the big pharmaceutical companies mislead about the costs of drug development
https://newrepublic.com/article/149438/big-pharma-captured-one-percent – on the ethics and business practice of drug corporations