Despite its government spending more than any other on health care both per capita and as a percentage of GDP, spending over $4.5 trillion in 2022, the United States has the lowest life expectancy at birth and the highest mortality rates for avoidable or treatable conditions of any high-income country. The heart of the issue lies in Big Pharma.
The term “Big Pharma” is used to describe the global pharmaceutical market. The name was coined as a reflection of the role drugs play in our daily lives, ranging from their societal value to their role in the global economy. Today, Big Pharma companies not only manufacture drugs, but also control drug development and pricing, with over 600 drug price hikes in January 2024 alone. This business model leads to a staggering statistic: One in four Americans report difficulty in affording the medications required for their health and well-being.
The issue of inaccessible medication is especially prevalent when it comes to insulin. Around 8.4 million Americans with diabetes require insulin to survive, yet a quarter of them are not able to afford it. When insulin is unaffordable, the consequences can be life-threatening.
The rise of Big Pharma occurred alongside the emergence of the opioid epidemic. In 1900, Bayer, the same company that first launched aspirin, created a much stronger painkiller, naming it after the German word for heroic: heroin. The company advertised it as a miracle drug that could be used to treat everything from colds to stomach cancer and even claimed it was safe for children.
Bayer was not the only company maximizing profits. Pushing medical, legal and ethical boundaries, drug companies of the 1900s prioritized profit over the public, leaving behind a legacy that has since spiraled into a drug epidemic and resulted in pharmaceuticals becoming one of the most powerful industries in the United States.
Although the Pure Food and Drug Act of 1906, which laid the foundation for the Food and Drug Administration (FDA), attempted to regulate drugs, Big Pharma was simultaneously “coevolving with the new regulatory landscape.” Rather than aiming to protect consumers’ health and safety, some of the new institutional actions instead put power right back into companies’ hands.
The FDA’s 1997 guidelines allowed Purdue Pharma to directly market the opiate OxyContin to consumers, hand out “coupons” to physicians and fund programs that promoted the drug. These strategies resulted in the overprescription of opiates, which led Americans to believe when one goes to the doctor, they can expect to walk out with a drug prescription. This belief drove forth a notion that health is transactional.
Medical marketing expanded beyond the scope of painkillers in the 1950s, the golden age of Big Pharma. Modern-day pharmaceutical giant Pfizer launched the broad-spectrum antibiotic Terramycin in 1951 with a $7.5 million marketing investment, an exorbitant sum of money at the time. Pfizer’s aggressive marketing techniques opened the door for Big Pharma to push ethics out the window for increased profit and set an example for transgressive marketing that continues to this day.
Egregious abuse of the patent system has also contributed to the nation’s drug pricing crisis. Big Pharma has found a way to exploit patent law for profit, extending existing patents to create a monopoly over certain drug products. Patent law was designed to promote innovation by granting creators of innovative technology a limited period of monopoly. However, Big Pharma has distorted this process, making minor changes in drug products’ packaging and flavoring to extend their patents and continue their monopolies.
A key example of this is Eylea, a drug Regeneron created to treat macular degeneration, which results in loss of central vision. Since the drug’s approval in 2011, Regeneron has been granted over 90 patents on Eylea, after making minute changes like packaging alteration while gradually increasing the price of the drug. The cost of a single dose of Eylea is now $2,625. With the number of patents and corresponding extensions to the monopoly period, no other alternative or generic treatments are available for people with macular degeneration.
To combat Big Pharma, the U.S. government must take critical steps in the areas of drug marketing and patent system reform. The United States Patent and Trademark Office must be highly critical in granting patents to pharmaceutical companies, ensuring a balance between private and public interest. Furthermore, increasing funding to the National Institutes of Health, the largest source of groundbreaking therapeutics, and channeling new products to smaller pharmaceutical companies are key in the fight against Big Pharma monopolies.
The pharmaceutical industry has transformed from a sector of scientific innovation to a profit-addicted monolith. It’s time we end the new golden age of Big Pharma.
