Money and Medicine: How Pharmaceutical Companies Are Profiting From a “Sick” Narrative

Written by Carter Trent; Edited by Nicki Steinberger, Ph.D.

SUMMARY: It’s easy to portray the pharmaceutical industry as the hero (during the pandemic) or the villain (profits over health). The reality is more complex, and whichever camp you fall into, know that it’s not black and white for everyone. This article examines a handful of factors, both systemic and psychological, in American society today, that shape an environment where Big Pharma thrives, while the population’s health continues to decline.

If you’re among the 70% of Americans taking prescription drugs daily, you may feel thankful pharmaceutical companies developed your medications. However, if you possess a dim view of Big Pharma, due to factors such as charging you the highest drug prices in the world, as well as the industry’s lobbying efforts to sway politics in their favor, your concern is well-taken.

This dichotomy hints at the deep, systemic challenges inherent in American healthcare, specifically, society’s dependence on medications for mental and physical “health.” The U.S. population today takes more medications than any other time in recent history, and pharmaceutical companies are profiting from this phenomena.

For example, a 2020 study published in the Journal of the American Medical Association (JAMA) found the profits of 35 large drug companies, including Pfizer, were almost double that of comparable, non-pharmaceutical businesses, such as Amazon and Microsoft. Pharma companies justify high profits by calling out the costs associated with the research and development (R&D) of new medicines, the regulatory hurdles to get approval from the U.S. Food and Drug Administration (FDA), and the manufacturing expenditures for new drugs.

As a result, the industry ensures its handsome profits by routinely raising drug prices. According to research published in JAMA, the median price for a year’s supply of new drugs rose from $2,115 in 2008 to over $180,000 in 2021. Higher drug prices result in insurance companies covering fewer drugs, raising premiums, or imposing higher out-of-pocket costs to you.

Greed Is Not Healthy for People and Other Living Things

This rapid rise in medication costs is due in part to a lack of drug pricing oversight by the U.S. government. The United States spends the most per capita on prescription drugs compared to other high-income countries, defined by the World Bank as nations with gross national income per capita over $13,205,66 such as France, Germany, and the United Kingdom. These countries employ government control over drug prices, while the U.S. does not.

The U.S. government attempted several times to establish price controls without success. For instance, in 2019, the U.S. Congress considered a bill that would allow the federal government to negotiate drug prices for Medicare. The Pharmaceutical Research and Manufacturers of America (PhRMA), a trade group representing drug companies, fought back.

Stephen Ubl, the CEO of PhRMA, described the bill: 

"... an innovation killer, a job killer, and ultimately, a hope killer for American patients who are waiting for better treatments and cures." 

He went on to say if the bill were passed, it would cause a "nuclear winter" to the pharmaceutical industry.

The most recent example of this type of big-corp backlash occurred in June 2023. Pharmaceutical manufacturer, Merck, filed a lawsuit against the U.S. government to battle new rules allowing Medicare to set drug prices. According to the lawsuit, these rules would set drug prices below market rates, creating a financial burden for pharma businesses.

Certainly, as private enterprises, pharmaceutical companies must pursue financial health, or risk going out of business. But pharma corporations aren’t reliant on high drug prices alone for profits.

Drug companies receive billions of dollars from the U.S. government for research into new treatments. A study by the Institute for New Economic Thinking showed that every new drug that was approved for use by the FDA between 2010 and 2019 was funded with billions in taxpayer dollars.

Such government subsidies call into question the pharmaceutical industry’s assertion that it needs outsized profits. In fact, Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine, points out in her book, “The Truth About the Drug Companies”:

"Instead of investing more in innovative drugs and moderating prices, drug companies are pouring money into marketing, legal maneuvers to extend patent rights, and government lobbying to prevent any form of price regulation."

Duped Into Believing More Drugs = Better Health

These systemic issues, such as government lobbying, are further reinforced by society’s increasing reliance on drugs for health. According to a 2023 CivicScience poll, the percentage of U.S. residents taking prescription drugs on a daily basis increased from 56% in 2019 to 70% today.

This increased dependence on medications has led to the fastest growing drug problem in the U.S.—the misuse of prescription drugs. Prescription opioids, in particular, have created what the U.S. Centers for Disease Control and Prevention (CDC) called the “opioid overdose epidemic.” Deaths from overdosing on prescription opioids, such as fentanyl, rose from 3,442 in 1999 to nearly 17,000 in 2021.

Adding to the prescription drug problem is that nearly a quarter of Americans take four or more medications daily. This use of multiple medications, called polypharmacy, increases the risk of side effects, drugs interacting in unintended, harmful ways, and death. In 2008, at age 28, respected actor Heath Ledger died from taking six prescribed medications, including painkillers and anti-anxiety meds. Polypharmacy is linked to over 1 million emergency room visits per year.

From the New York medical examiner’s office:

‘“Mr. Heath Ledger died as the result of acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine," medical examiner's spokeswoman Ellen Borakove said in a statement.

According to the medical examiner's office, Ledger took "prescribed therapeutic doses ... or less" of each medication he ingested. However, the medications were not meant to be taken together. The cumulative effect was that the actor's brain stem function that controls breathing was impaired and Ledger "fell asleep and never woke up."’

A key factor driving this growing marriage to medications is the idea that chemical medicine—pharmaceuticals, are "magic bullets." The magic bullet concept was coined by the founder of chemotherapy, Nobel Prize-winning physician Dr. Paul Ehrlich. His premise was that inside the lab, chemical substances could be created to detect the source of the toxin, and be used as an antitoxin to reverse the disease.

From The Nobel Prize:

“His aim was, as he put it, to find chemical substances which have special affinities for pathogenic organisms, to which they would go, as antitoxins go to the toxins to which they are specifically related, and would be, as Ehrlich expressed it, «magic bullets» which would go straight to the organisms at which they were aimed.”

Due to medical successes such as insulin and antibiotics, the idea of drugs as quick-fixes against disease gained popularity in the 20th century. Combined with a long history of humans fearing disease, from the Black Death in the 1300s to the AIDS epidemic in the 1980s, the magic bullet idea evolved into a public perception that medications provided salvation.

Jaw-Dropping Drug Commercials on Television  

The position of Big Pharma coming to your rescue to restore physical and mental health has been reinforced by advertising. Pharmaceutical companies are allowed to market directly to you, the consumer only in New Zealand and the United States. This enables drug manufacturers to alert you to new medications, promising to solve health issues while downplaying the risks.

Advertising has led to what some critics call "disease mongering." Medical journalist Lynn Payer described this situation: 

"Trying to convince essentially well people that they are sick, or slightly sick people that they are very ill... Disease mongering is the most insidious of the various forms that medical advertising, so-called medical education, and information and medical diagnosis can take."

Drug companies have used this tactic successfully for decades. In the 1950s, a sedative called Miltown became the rage. It was marketed as a way to deal with life’s anxieties, such as a trip to a crowded grocery store.

The drug’s popularity led to successors such as Prozac and Xanax. Each became a fad, prescribed to people who did not meet the clinical criteria for which the FDA originally approved the drugs, such as anxiety disorders.

The magic bullet concept, bolstered by pharma industry advertising, and coupled with a collective fear of disease, created a paradigm that medical journalist Dr. Ray Moynihan remarked upon: 

"This is the marketing of fear. This is not a healthy way to run a society. It's putting disease at the centre of human life."

Lifting the veil: Despite American faith in medicine, the history of prescription drugs shows a trail of medications lauded as cure-alls that ultimately fell short. In fact, the majority of prescription drugs on the market today target specific disease symptoms, but do little to manage the disease itself.

For instance, Dr. Ehrlich described a medicine for syphilis he helped to discover in 1909, called Salvarsan, as a quick fix, but it was far from it. Patients suffered a range of serious side effects, including liver damage.

Another example is the blockbuster drug Vioxx, marketed as a pain reliever for arthritis. It generated sales of $2.5 billion in 2003, before it was pulled off the market in 2004. The drug was recalled after thousands of people suffered heart attacks and died as a result of taking the medication.

The same can now be said of the COVID-19 vaccine. In speedy fashion, it was viewed as a silver bullet to end the pandemic. After all, a majority of Americans believe COVID-19 vaccines saved millions of lives. Yet a study released in May 2023 revealed that as COVID-19 vaccination rates climbed, so did unexplained deaths. Autopsies concluded many of the deaths were from vaccination-induced myocarditis, a dangerous inflammation of the heart, and a known “side effect” of the COVID-19 vaccine.

Despite these examples, you may still cling to the idea of pharmaceuticals as “wonder drugs,” and ironically, this hope alone is enough to boost your health. Called the placebo effect, research studies show the mere belief that a pill will help your condition, can actually alter your body function, i.e., reacting physically to the placebo as though it were real medication. 

A pain study in Science Translational Medicine, “Altered Placebo and Drug Labeling Changes the Outcome of Episodic Migraine Attacks,” showed that a placebo patients believed was the real-deal drug, boosted pain management effectiveness by 50%.

The pharmaceutical industry benefits financially from you believing prescription drugs are panaceas. This serves to incentivize pharma companies to leverage new drugs’ clinical trials to their advantage. Clinical trials are used to test the safety and efficacy of new medicine, but the majority of these trials are funded by drug manufacturers. Consequently, those running the clinical studies are motivated to produce results that make new drugs appear to be speedy gateways to wellness.

For example, Vioxx clinical trials showed an increased risk of cardiovascular damage from the drug, but the information was obfuscated when the drug manufacturer, Merck, applied to the FDA for approval to sell Vioxx. When the danger of taking the drug came to light, thousands of Vioxx-related lawsuits were filed, and this case is far from an exception.

A litany of lawsuits against pharmaceutical companies have taken place repeatedly. For instance, Paxil, an antidepressant, caused birth defects and increased risk of suicide. The drug’s manufacturer, GlaxoSmithKline, has paid out billions of dollars to settle Paxil-related lawsuits after their employees came forward to admit unfavorable clinical trial results were concealed.

The current opioid crisis is another example. Thousands of lawsuits were filed against various drug manufacturers, including Johnson & Johnson, because opioid manufacturers downplayed the risk of opioid addiction while promoting the benefits. As a result, billions of dollars in settlements were awarded.

Look Out!—It’s in the Food

One key factor contributing to the rise in reliance on prescription medications isn’t from drug advertising or a belief in a drug’s efficacy, but rather, stems from the way you eat. If you’re the “average American,” this may be true for you. In the Western Diet, a.k.a. the Standard American Diet (SAD), the typical American’s food consumption consists of high amounts of rancid seed oils, iodized salt, and refined sugars from industrially-processed foods.

One particular class of processed cuisine, called ultra-processed food, also incorporates artificial flavors and chemical preservatives. Examples of ultra-processed foods may include chips, cookies, frozen dinners, energy drinks, and luncheon meat.

These ultra-processed foods are linked to obesity and heart disease. If you are obese, expect to be prescribed more than double the number of medications compared to a person of “normal” weight. What a racket! If you ever questioned pharmaceutical companies’ motivations to keep you fat … Obesity and poor nutrition are also associated with an increased risk of cancer. 

American consumption of food-like products is rampant. According to research by New York University’s School of Global Public Health, intake of ultra-processed foods has grown to reach nearly 60% of calories consumed. Consequently, an estimated two-thirds of Americans are overweight or obese. The cost to treat diet-related conditions, from diabetes to obesity, is estimated at around $2 trillion.

Studies have also shown a SAD diet can affect the brain, causing depression and anxiety disorders. Of course, pharma companies have stepped in to provide drugs as the solution. 

Fine-Tuning Your Health Care Direction 

The systemic challenges that pharmaceutical companies profit from, such as poor diet and disease mongering, perpetuate an over-dependence on pharmaceuticals. Yet while this is true, you do have the ability to create change for yourself. The FDA states: 

"Although medicines can make you feel better and help you get well, it's important to know that all medicines, both prescription and over-the-counter, have risks as well as benefits."

Rather than blindly putting your faith in a drug, learn the trade-off so you can make an informed choice for yourself. For instance, 69% of prescription medications have between 10 to 100 different side effects, so it’s vital to understand a drug’s impact on your body, mind, and psyche.

Review your prescriptions regularly, including over-the-counter medications and herbal supplements, with your healthcare provider/holistic practitioner to determine if a change is needed. Research shows that a review of medications takes place less frequently than ideal. Aim to do this at least once a year, as well as any time a change in your health occurs, such as a new symptom from a medication.

And while following the path your doctor laid out might seem like the “right thing to do" (after all, you’ve been conditioned to trust the man or woman in the white coat no matter what), if your own sensibility or wisdom of your body is screaming for something different … pay attention, and be willing to change course.

Envision teaming with a recommended holistic practitioner, as a co-participant (with YOU) in your “getting and staying healthy” routine. Look at a shift toward a "gentle medicine" model. This concept was suggested by philosopher Jacob Stegenga, who described it this way:

"A proposal that physicians should intervene less, perhaps much less, than is presently the case, and we should try to improve health with changes to our lives and to our societies."

Gentle medicine proposes doctors pare back the use of aggressive treatments, such as a dependence on prescription meds as a first solution. It also calls for an end to the use of military language in medicine, such as "combating a disease," or an infection as "invasive," and patients as "survivors." Such verbiage promotes forceful medical interventions.

Resources such as the U.S. Department of Agriculture’s MyPlate, and the Weston A. Price Foundation offer information to help you transition from a SAD diet to a healthy one. As the Greek physician Hippocrates in 440 BCE is attributed with saying, "Let food be thy medicine and let thy medicine be food."

You’re not a number; you’re not a robot; you’re not someone who needs to fall in line with the crowd. Allow yourself to be treated as the whole of who you are, with your particular, unique, extraordinary needs.

Whether you decide to hold onto a tiny pebble, or big boulder of Western medicine, or ditch the protocols altogether, consider moving toward an integrative approach, by weaving in therapeutic, holistic health modalities that have the potential to reverse unwanted conditions, and leave you thriving. 

A non-exhaustive list may include homeopathy, acupuncture and Chinese herbs, Ayurveda, naturopathy, Western herbalism, chiropractic care, aromatherapy, massage, yoga, nutrition, and energy medicine.

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Originally published by A Voice For Choice Advocacy on August 03, 2023.

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