The discussion about Big Pharma is a multifaceted one that will tackle a lot of different components. The goal here is to explain these components in order to bring light to an incredibly important issue that more young people need to be aware about.

What is ‘Big Pharma’?

Chart demonstrating the top 10 pharmaceutical companies in 2016.

Big Pharma is primarily in reference to the pharmaceutical industry
that creates, manufactures, and markets drugs used for medication. The secondary part is the more sinister side of the industry and focuses on the cold-hearted corporations that monopolize and make it difficult for people in need to receive drugs that may even be necessary to live. Pharma has shown time and time again to have poorly regulated the system which has resulted in extreme travesty and wreaked havoc on public health. The United States pharmaceutical market’s share in 2016 was worth around 446 billion dollars, according to Statista.com. This in itself isn’t really a problem because medicine is obviously important, but a lot of the practices that are funded with this money are questionable. Some of the top pharmaceutical companies in the U.S. consist of Johnson and Johnson, Merck & Co., and Pfizer. While these names may be familiar, many people don’t pay attention to the behind the scenes of their operations.

How do they operate?

The biggest portion of pharmaceutical companies’ worth does not go to research and the development of drugs, but goes towards advertisement. Even though this may come as a surprise, the revenue from said advertising is completely worth the companies’ while. According to this website, every dollar spent on advertising on a drug subsequently rolls in four dollars in retail sales. This margin is exceptional, therefore the cash spent on a billboard ad rather than a long-term research objective seems more financially beneficial… for the producers. The consumers on the other end of this receive the short end of the stick. Big Pharma shows the public an overwhelming amount of advertisements for expensive name-brand drugs, to which the patient then asks to try out when seeing the doctor. This patient marketing doesn’t seem to be an issue on its own, but what takes place from the physician’s end of things makes all the difference.

Image of a drug rep trying to sell physicians on a new drug.

The first half of Big Pharma’s marketing is geared towards the general public. But, the second half is geared towards doctors. One way they do this is by using drug reps. These people are sales representatives who to try to convince physicians to prescribe their company’s drug. They do this by being incredibly good at marketing, having a way with words, and maintaining a charming smile. Ultimately anything that will woo a doctor into promoting their product for them is the line of action. On top of all the talk, reps even provide physicians with bonuses such as paid trips, dinners, events, and merchandise, all for persuasive purposes. In a book written by ex-drug rep Gwen Olsen titled The Confessions of an Rx Drug Pusher, the truth behind the industry is revealed. She states that “[fellow drug reps] were being trained to misinform people” and that “[she] was being encouraged to minimize side effects when [she] talked to doctors”. Such things are not what a patient on the recipient end of these medications wants to hear, but it is the unfortunate truth. Thankfully, academic medical centers started eliminating the presence of drug reps, but persistence continues as doctors are now instead being invited to events by pharmaceutical companies rather than sending a speaker to them. The marketing ploy that Big Pharma uses is not completely negative, as it introduces physicians to new medications that can actually be innovative and helpful in treating illnesses, but the exploitation of the public’s ignorance is quite hapless. A step in the right direction was taken in 2010 when the Physician Payments Sunshine Act was passed in order to increase transparency between health care providers and the manufacturers of pharmaceuticals. This basically means that all transactions, whether they be paid dinners or funding for research between a pharma company and a licensed physician must be available for public access. To learn more about the guidelines of this law, please visit this website here. Additionally, to access this transactional information, visit the Open Payments Data website to see how much your very own doctors are being influenced by Big Pharma… the numbers may be staggering.

Any examples of Big Pharma’s actions?

An example of a Nexium ad that you have probably seen on television or in a magazine.

One main example where pharmaceutical companies have gypped the general public involve the medication Nexium. Around 2001, the popular heartburn pill, Prilosec, was facing the loss of their patent. This patent, just like any other that was given to a pharmaceutical company who brings a new drug to market, expires after around twenty years. This is so that the company who first produced it has a chance to make profit. After the patent runs out, other generic brands can sell the same drug (and almost always for a much lower price). The company behind Prilosec called AstraZeneca, didn’t want to lose their profit from the drug, so they quickly came out with Nexium: “the new purple pill”. They advertised this as being a new and improved drug. But, according to this PBS website, the drug is practically identical to the original Prilosec, while still being sold as a much higher price. This move allowed the industry to gain a ridiculous profit, while the consumers simply received a hit to their pockets. You can now find generic versions of Nexium called Esomeprazole on the markets, but for a while the brand name was rolling in lots of money. To learn more about this quite irritating event, read a director of Chemical and Pharmaceutical Science, Josh Bloom’s article on it here. While the situation sounds awful, these patent-extending ploys and price raising scam have occurred a lot more times than once.

How to fix it?

Generic vs. brand name drug prices during 2012. These trends still continue today.

There are lots of suggestions with regulating the drug market that can take place to fix the Big Pharma issue. But, the easiest solution is to educate the public about what goes on in the medicine and healthcare field, so that society can be autonomously in charge of their health as much as they can be. Being aware of the tips and tricks that go on behind closed doors, and then finding ways to work around them in order to stay healthy is super important.

A word of advice would be to pay attention to the generic drugs being sold out there. Just like how you can find a cereal that tastes exactly like Lucky Charms, but maybe looks a tad different and is half the price, it’s the same with a lot of drugs on the market. Finding out those sorts of things can save bank accounts and potentially even a life. Be the change rather than waiting for it, because if society starts rewriting the rules, eventually adjustments will have to be made.