In defence of big pharma

Matthew Penner

April 8, 2019

The British public is notoriously suspicious when it comes to making profits from healthcare, and pharmaceutical companies are no exception. However, this cynicism is largely unjustified and can be detrimental to the healthcare we receive.

A culture has now emerged that takes pride in the extreme view that the corporate gods, otherwise known as “big pharma”, are malicious and solely profit-oriented.

This perception has been fuelled by the recent unpublished data scandal, during which it was suggested that scientists and pharmaceutical companies were far more likely to publish positive trial results than negative ones.

This does, of course, have the potential to adversely affect public health, as doctors would prescribe drugs based on incomplete trial information. However, public outrage is largely misdirected. As the most recent House of Commons committee on science and technology put it:

“Whilst pharmaceutical companies have good rates of reporting within a reasonable timeframe, the picture is much more mixed for universities. It is particularly disappointing that trusted bodies such as Public Health England and a range of NHS Foundation Trusts are also failing to report results from clinical trials.”

This leads to the inevitable conclusion that non-reporting in the UK is more a result of the time constraints of academic work, rather than any attempt to artificially enhance the image of a drug for financial gain.

While non-reporting is a key problem that is being addressed in the entire industry, it is unfair and simply incorrect to claim that pharmaceutical companies are the primary offenders.

Another theory that many subscribe to purports that pharmaceutical companies are reluctant to fund cures for chronic conditions when a drug to simply manage symptoms can instead be sold in the long run for a larger profit. However, this argument does not stand up to even basic logical scrutiny.

For this to be true, pharmaceutical companies would all have to be in collaboration with each other, such that one does not find a miracle cure and undercut the competition. To make this claim would be libellous – no supporting evidence exists.

Proponents of this claim also fail to recognise that the trial and error method employed by drug development companies does not allow for overly selective research. A minor tweak to a molecule’s structure will drastically and unpredictably change its biochemical function, making it impossible to accurately predict if a molecule will help a patient cope with their condition or cure it.

How likely is it that a scientist who has just discovered a miracle cure will willingly hush it up and never speak of it again?

Another complaint levelled against pharmaceutical companies draws attention to their high spending on advertising relative to their research and development (R&D) budgets.

A recent study by Canadian researchers found that pharmaceutical companies spend anywhere from 50 to 150 per cent of their R&D budget on marketing their drugs to the public and doctors.

Critics argue that this money is squandered, or worse, that it’s used to convince physicians that drugs are safer and more effective than they truly are. It’s clear that at least some funds must be allocated towards marketing a drug – this allows doctors to be informed on how they should administer and prescribe it and makes patients aware of the options available to them.

The question remains: is the magnitude of spending on marketing justified? Put simply, if advertising wasn’t a necessity for sales, pharmaceutical companies would choose to spend far less. Such is the beauty of the free market – companies themselves are invested in limiting wastage.

When compared with government research programs, pharmaceutical companies are far more streamlined and less laden with wasteful bureaucracy, which allows for tighter R&D budgets and higher profits. It is unsurprising, therefore, that a proportion of the budget is invested in marketing the products of the R&D process.

The relationship between the NHS and pharmaceutical companies is a complicated one. As the majority consumer of medicine in the UK, it holds an abnormally large amount of power in the consumer-producer relationship.

This results in the well-known practice of price bartering. The current agreement sees drug spending growth capped at two per cent for the next five years, and in return, the National Institute for Health and Care Excellence expedites drug launches in the UK.

These deals are mutually beneficial – innovation is rewarded, and the UK protects its reputation as a global leader in the biochemical industry. Far from holding our country hostage, pharmaceutical companies are excellent trading partners, with whom the UK has a symbiotic relationship.

Given all of the above, why does big pharma have such negative connotations? Pharmaceutical companies have the unfortunate tendency to be large and faceless, with the unpopular task of putting a monetary value on health. Couple that with sensationalist coverage of pharmaceutical mishaps and it’s easy to see why these companies face such revulsion from the public.

Private pharmaceutical companies do, however, perform excellently – 90 per cent of modern medicines were developed by them. It’s crucial for us to recognise that state-run provision of medicine would be far more opaque, unaccountable, and ineffective than the private system.

Socialists and conspiracy theorists are united in promoting a misleading image of pharmaceuticals as a rich and elitist power that acts against public health. It is important to contest this image whenever it arises because, fundamentally, a pharmaceutical company is simply a collection of people who feel as much civic responsibility as anyone else.

Widespread stigma against them runs the risk of turning bright young people away from this vitally important industry and risks the enshrinement of these misguided beliefs into law.

The Association of the British Pharmaceutical Industry put it best when they wrote that the public image of big pharma is “stuck in a bygone era where pharmaceutical companies wine and dine doctors in exchange for signing on the dotted line”. Times have changed, and so must our attitudes.


Written by Matthew Penner

Matthew Penner specialises in natural sciences.


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