Who and what is Big Pharma?

Big Pharma review

What is Big Pharma

Big Pharma is a term used to describe global pharmaceutical companies many with their central offices in the USA. These companies wield growing influence over the practice of modern medicine worldwide.

Big Pharma has come under increasing criticism lately from many quarters. Concerns regarding price gouging, monopolistic behavior, and exerting undue influence on the medical establishment and the prescription of drugs have been raised.

This post will examine which companies constitute Big Pharma, what makes them so powerful, and will look into the concerns raised as well as some of there documented convictions and fines. Lastly we will look at some alternatives to Big Pharma to bring back the practice of medicine to a human scale for the benefit of the patient.

Who is Big Pharma

Big Pharma refers to pharmaceutical companies that have grown so large and command so much of the market share worldwide that have literally grown into international behemoths.  Their financial power has enabled political power particularly in the US. Many questions have been raised about Big Pharma’s contributions to the election of representatives is deforming the creation of drug legislation in their favour and not towards the common good.

Below is a list of a few companies considered part of th  Big Pharma family

GSK logoGlaxoSmithKline, a British based company with headquartered in Brentford, England, got established at the turn of the century with the merger of other drug companies (Glaxo Wellcome and SmithKline Beecham). Usually refered to as GSK, this company continues to grow in size and influence. This pharamceutical giant is the result of coglomoration of 30 companies over the years. It’s latest acquisition of biopharmaceutical company TESARO on 3 December 2018 for a sum of 5.1 billion US dollars (£4 billion). With reported earning of £21 billion in 2013, this pharmaceutical giant only continues to grow. GSK has been charged and convicted a number of times for pushing drugs for depression that were ineffective and bribing doctors to promote their products with lush vacations and perks.

pfizer logoPfizer is a New York based American pharmaceutical giant. It is a another company that continues to grow through mergers and acquisitions. Like GSK, it continues to swallow up smaller pharmaceutical companies as it size and influence ever expands. On 19 December 2018 it announced a merger of its health care division with GSK.  Ranked 57 in the Fortune 500 list of American companies based on earnings, Pfizer is the company behind the promotion of Viagra (sildenafil) the first and most popular erectile dysfunction drug on the market. Another successful product was antidepressant Zuloft. Like GSK, Pfizer has bee racked by a series of indictments for illegal activeness and influence peddling.  Pfizer is known as an a very aggressive marketer ind influence peddler.

Another American-based global  pharmaceutical company, Eli Lilly and Company are headquartered in Indianapolis, Indiana. Like most Big Pharma giants, Eli Lilly has grown through acquisitions of smaller firms, 23 in total so far since 1962. The latest acquisition of Loxo Oncology for $8 billion was announced in January 2019.  It is probably most well known for the production and marketing of Prozac, an anti-depression drug widely prescribed.  It is also the the company behind Cialis (tadalafil), an ED medication like Viagra but longer lasting. Like many other Big Pharma companies, Eli Lilly has been involved in controversy and litigation regarding its marketing practices and and noncompetitive actions.

novartis logoBased in Basil, Switzerland, Novartis International AG stands as one of the biggest players on the global pharmaceutical stage. Formed in 1996 by a merger of Sandoz and Ciba-Geiby,  Novartis is a pharmaceutical colossus.  Novartis has been listed as the 2nd largest pharmaceutical company in the world. It’s Sandoz wing is the largest manufacture of generic pills in the world. It’s scope and influence worldwide is breathtaking with a revenue stream of over $50 billion annually with a workforce of over 120,000.  Novartis has been in a long battle with India challenging its patent laws. At this point in time, India has held strong against this attack. Novartis itself has been subject to various charges on ongoing cases regarding to bad marketing, bribery, and producing unfaithful research results.

johnson & johson logoBased in New Jersey, Johnson and Johnson is regarded as the top dog of pharmaceutical giants. With a annual turnover of over $70 billion, Johnson and Johnson is a leading marketer of medical products like Band Aids as well as pharmaceutical products.  The company was originally the creation of 3 Jonson brothers and first incorporated in 1887.  After a process of acquisitions and mergers of some 70 other companies, Johnson and Jonson remains unrevealed in scope and market influence. Employing a workforce of over 150,000, it embodies the very definition of Big Pharma. No stranger to controversy, Johnson and Jonson has been embroiled in numerous lawsuits ranging from accusations of foreign bribery, trademark infringement and defective  products.

Conflict of Interest and Influence Peddling

Perhaps the biggest problem with Big Pharma is its contributions to political parties and extensive lobbying efforts and expense to ensure that legislation is framed to its advantage. Just in the years of 2013 and 2014, Big Pharma contributed a record $15 billion to political campaigns. This level of spending and influence is corrosive to the democratic process. Legislation framed to suit the agenda of large pharmaceutical interests is not always in the interests of the population at large.

The influence of Big Pharma is not just confined to the political process. A number of cases have come to light where companies court and practically bribe doctors with lavish gifts and paid vacations in return for promoting and prescribing their products.

On top of the above problems, comes massive advertising scale in terms of expense, reach and influence.  Both magazine and television commercials worldwide promote pharmaceutical products to the public. This in turn create a feedback loop to the GP’s that works well for the success of these products in financial terms yet raises questions over the overall health benefits to the public. On a number of occasions, various Big Pharma companies have been charged with the promotion of specific drugs to inappropriate audiences.

Price gouging

On many occasions pharmaceutical giants have been caught out jacking the price of essential drugs to obscene levels. This is in part enabled by restrictive patent laws that enables these firms to wield a virtual monopoly over specific drugs. Big Pharma claims these excessive prices are justified by the research and development put into developing these drugs and the risks involved. What is rarely mentioned is the fact that much of the research is done in universities at the taxpayers expense and free-of-charge to the pharmaceutical companies that take advantage of this research.  In many cases the companies simply by the rights to a drug without doing any research and then jack up prices to unjustified heights reaping enormous profits in the wake.

The battle between brand-name drugs and generic ones

Another area where Big Pharma dominates not in the best interests of the public but in the best interests of its shareholders is the ongoing tussle between brand-name drugs they promote and more cost effective generic variants of the same drug.

As clearly stated by the FDA, generic drugs work in the same way to the brand-name versions because they are comprised of the same active ingredients of the same amount.  To receive FDA approval, generic drugs must meet these high standards.

On a number of occasions Big Pharma companies have bee charged with unfairly blocking the production of lower-cost generic variations of their brand-name drugs.

The difference between brand-name and generic drugs is largely the cost, not the quality. Overpriced rand-name medications garner pharmaceutical companies exorbitant profits so they will maneuver to protect this market against generic challengers. This of course comes at a cost to the general public who cannot often afford to pay the brand-name prices often up to 20 times the cost of generic versions of the same drug.

Additionally, the bribing of doctors to prescribe brand-name drugs over generic versions readily available is unethical. These bribes have known to have included the supply of special suites at sporting venues, exotic foreign vacations, free food and drink,  and expensive dinners at high quality restaurants.