The Big Pharma monster–and how we tame it

Illustrated by Lucy Chen

If you’ve been even mildly paying attention to the news over the past several years, you will undoubtedly have heard one phrase chanted over and over by policymakers, activists and lobbyists alike: “Big Pharma”. As Americans’ approval of the pharmaceutical industry sinks lower than their approval of even the federal government itself, we should be (on an emotional level, if nothing else) moved to assess how Big Pharma has been allowed to reap wave after wave of profits at the expense of the middle class, whose medications are slowly creeping out of reach. 

As we get closer to the 2020 Presidential election, there is no doubt that we will hear impassioned condemnations of the pharmaceutical industry by anti-“corporate greed” candidates like Bernie Sanders and Elizabeth Warren, who have been outspoken about the need for drug prices to be cut in half in order to be affordable for everyday Americans. This talk of a Big Pharma revolution raises several important questions that Americans should be thinking about as we prepare to navigate a world of increasingly inaccessible healthcare. First, we should ask ourselves how we came to be in the position we are today: what regulations (or lack thereof) have allowed pharmaceutical companies to claim over half a trillion dollars in revenue without any accountability for the plight of their consumers, who have to choose between affording their medication or affording rent? What tangible effects have rising drug costs had on Americans’ health? And how as a nation can we possibly go about implementing policy that loosens Big Pharma’s chokehold on middle-class America?

To answer the question of how the pharmaceutical industry has gotten away with this, we should turn to the patent system. Big Pharma has been protecting their pocketbooks by abusing the patent system, citing “incremental innovation” as the reason for needing to renew their patents before they expire and other biotechnology companies are given the chance to create cheaper, generic versions of their most popular (and profitable) drugs. Most often, these “innovations” consist of negligible changes to the drug itself, but pharmaceutical companies have used the concept to create a loophole through which they can siphon millions of dollars in profits.

Rising drug costs combined with the opacity of insurance companies directly leads to Americans forgoing their prescription medications, leading to worsening health outcomes. The example perhaps cited most often is insulin: Lantus (a brand-name for insulin) experienced a 54% price increase in a single fiscal year. Furthermore, a recent AARP report showed that the average cost of common specialty drug therapies in 2013 was $53,384, more than the American median household income. Clearly and alarmingly, Americans cannot afford the medications they need to control their often chronic, debilitating illnesses. Unsurprisingly, this leads to worse health outcomes, poorer qualities of life and shorter life expectancies for poor and middle-class Americans.

Big Pharma is clearly a powerful economic and political force that has influenced health care policy for the benefit of its own profit margins. So how do we enact meaningful policy change that can transform the political landscape to one that is more habitable to the average American? 

An obvious place to start is to close the loopholes in the patent system that pharmaceutical companies have exploited for far too long (specifically, the FDA should remove the “incremental innovations” clause). Combined with a tightening of the Inter Partes Review (IPR) board (which oversees and affirms the validity of patents), patent reform will re-introduce competition to the drug market, causing a natural price drop due to the insurgence of generic options for common drugs. But we cannot stop at patents. The federal government should consider options for setting a ceiling on the price of medications based directly on how much Americans can reasonably afford, and should be prepared to dish out expensive consequences for profit-hungry corporations who fail to adhere to those standards.  

As we look to the future, we need to keep at the forefront of our minds the urgency of prescription inaccessibility as we assess candidates’ plans for confronting and controlling Big Pharma. By voting into office the warrior most equipped to battle with the monster of the pharmaceutical industry, we will have done our part to ensure that it is slain.

Edited by: Daniel Berkovich

Illustrated by: Lucy Chen

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