The Big Pharma Conspiracy

Beware! Pop culture tells us that the big pharmaceutical companies know all about the simple, natural cures for everything — cancer included — but are jealously covering them up. Should you be unfortunate enough to contract some terminal illness, the best the doctors are going to give you is some synthetic, patented drug that can be sold to you at a high profit. It won't work as well as that natural treatment would, but that's OK, because it means they get to sell it to you over and over again, until you finally die. Guess what? You've just been victimized by the Big Pharma Conspiracy, one of the most popularly believed conspiracy theories.

How could it be that I've been doing Skeptoid for almost 11 years and never covered the Big Pharma Conspiracy? Oh well. It be.

The basic Big Pharma Conspiracy says that pharmaceutical companies suppress natural cures on the principle that they are not patentable and thus not profitable to sell; so they instead distribute only patented, expensive, and less effective drugs. This allows them to keep profits up, and since the drugs are less effective, it keeps the patients sick enough to require more and more of the expensive products. Most familiar is the claim that a perfect cure for all cancers exists, but Big Pharma suppresses it because if everyone was cancer-free it would kill their profitable cancer business. A corollary takes it a step further, asserting that the drug companies actually create some of the diseases that make their products necessary.

Who exactly is Big Pharma? Author Robert Blaskiewicz describes them as:

...An abstract entity comprised of corporations, regulators, NGOs, politicians, and often physicians, all with a finger in the trillion-dollar prescription pharmaceutical pie.

This definition is important, because it allows the conspiracy theorist to vastly simplify what is, in reality, a complicated industry filled with conflicting roles and interests. Lumping them all together into a single entity turns them into a proverbial "they" at whom it is easy to point an accusing finger.

A quick and easy way to hear the Big Pharma Conspiracy elucidated in detail by someone in your neighborhood today is to talk with any alternative medicine practitioner whose diploma is unaccredited, like a naturopath or a chiropractor. Ask why they didn't become a medical doctor, and nine times out of ten, they'll recite the Big Pharma Conspiracy narrative point for point, all the way down the line. "Doctors see patients as diseases, not as humans"; "doctors only treat symptoms, not causes"; "doctors' only motivation is to make money and earn kickbacks from pharmaceutical companies by prescribing as many drugs as possible, and to keep those patients on those drugs forever".

All one needs to do is a web search for the term "Big Pharma" and look at the headlines that appear:

Big Pharma is America's New Mafia

How Big Pharma Created America's Opioid Epidemic

The Evils of Big Pharma Exposed

The Drugs May Be the Problem — Inconvenient Truths about Big Pharma

One piece of evidence suggesting the Big Pharma Conspiracy might not be as successful as its believers claim is that real conspiracies are discovered and eradicated in the industry all the time. One of the most famous cases concerned heparin, a blood thinner that's used extensively in surgery and dialysis. Most of it comes from suppliers in China where it is derived from pig intestines. It can cost $900 a pound. In 2007, some Chinese suppliers began cutting the expensive product with a different drug that cost only 1% as much and can appear to produce a similar effect, but with different and unpredictable side effects. Suddenly people began dying on the operating table and suffering severe allergic reactions, and it was traced to this contaminated heparin. The FDA ordered it all recalled, which resulted in a catastrophic shortage. Lacking any enforcement ability inside China, the FDA put stringent new testing standards in place for the companies that sold heparin, shifting the burden from the Chinese suppliers to the American distributers. Big Pharma stood to profit billions from selling the cheaper but dangerous contaminated version, but Big Pharma brought the hammer down hard and put a stop to it.

Another piece of evidence that Big Pharma doesn't suppress natural cures is that natural products are widely available; you can buy them in any supermarket. Pick any natural compound you can think of, and you'll find that someone sells it. Regulators don't put a stop to this, except in cases where the product is toxic. The most they can do is require sellers to include the disclaimer alongside their labeling for what they claim the product does:

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Even if they're not allowed to make a false claim on the labeling like "It cures all cancers", that doesn't hurt a thing. The Internet does all of that marketing for them. All you have to do is an Internet search for "cures cancer" and you'll find an endless list of products being offered for sale. The bottom line here is that Big Pharma may not offer a natural product that cures all cancers, but they also don't do anything to suppress anyone outside their industry from doing it. Saying that Big Pharma suppresses natural cures is exactly like saying Ford suppresses Chevrolet.

Laetrile is an example of a product that was widely sold as a cure for cancer until it was banned by the FDA — "suppressed", some would prefer to say. The reason for the ban was that extensive clinical trials throughout the 1970s and 1980s proved that it had no effect on cancer whatsoever, except to give cyanide poisoning that was sometimes fatal. But true believers are still able to find it; it can be bought online and in clinics, mainly in Mexico. Today it's usually sold as "amygdalin" or "Vitamin B-17", even though it's not a vitamin and there's no such thing as Vitamin B-17. Such cases as this, where the product is overtly toxic, are really the only cases one can find of a product being "suppressed" by Big Pharma.

Finally, we can point to one more piece of evidence that any alleged Big Pharma Conspiracy does not seem to have any effect, and this is that the market for these allegedly-suppressed cures is just as big as Big Pharma's market. Americans spend almost exactly the same amount of money on FDA-approved pharmaceutical drugs as they do on unapproved drugs, basically supplements, vitamins, and all other herbal or natural remedies. In 2017 they'll spend just under $40 billion on unapproved drugs — a number which grows strongly each year. The market for FDA-approved drugs is 11 times as big — just under $450 billion; but since insurance pays for the majority of that, what Americans pay out of pocket is about the same.

Digging deeper into the conspiracy claims, we find that one of its fundamental assumptions is untrue. This assumption is that Big Pharma does not sell natural compounds, or compounds that they cannot patent. Both of these are trivially disproven. Nearly all research in the pharmaceutical industry starts in the lab with a petri dish, an incubator, and some compound found in nature. This is why all pharmaceutical companies have research stations all around the world, staffed with molecular biologists; they are collecting compounds to study, to test against disease agents, and see which ones have potential for development into a product.

But rarely can a natural compound be sold as-is, because in order to meet regulatory scrutiny, it has to be purified and the dose must be controlled. The best way to do this is to find a way to synthesize the molecule in some controlled process. Do this, and the pills that come off the assembly line will all be homogenous in purity and in the exact dosage each contains. (Oddly, anti-pharma activists tend to see this as a negative, preferring instead to put their faith in a version which has not undergone any meaningful manufacturing control.) So the claim that Big Pharma doesn't sell natural products is false.

It's equally false that they don't sell anything they can't patent. Obviously they prefer patented products that allow them to monopolize the market for a time, but this is not unique to the pharmaceutical industry. It's the standard business practice in every industry, even in the natural supplements industry, where a quick read of many pill bottles reveals that the formulation is patented.

And, of course, patents don't last forever. A huge segment of the pharmaceutical industry is devoted to the manufacture and sale of generics, or even just products like aspirin. The patent for aspirin expired during World War I, yet it remains a hugely profitable product, and is sold by virtually every Big Pharma company.

It's one thing to believe conspiracy theories like all the world's leaders are reptilian aliens in electronic disguises, or the Air Force does experiments on captured aliens at Area 51, because those don't impact the lives of intelligent adults in the real world. But the Big Pharma Conspiracy does. It suggests, enables, and encourages distrust of the medical profession. Obviously, that's bad for the public health. It drives people toward those alternative medicine practitioners whose professions may be free of conspiracy theories, but are unfortunately also free of effectiveness.

The Big Pharma Conspiracy also takes attention away from the real problems that exist within the pharmaceutical industry. When we invent an imaginary boogeyman as a placeholder because we're not familiar with what the real problems might be, we go forward with bad information and we lobby and we talk to our friends and we spread bad information. And then more people have a wrong understanding of the issues in the pharmaceutical industry. One of those is a problem with transparency of clinical trials. Another is the inherent conflict of interest with drug manufacturers having to fund and oversee their own trials. But when more voters remain ignorant of these, and instead demand action on imaginary cancer cures being suppressed, everyone loses.

Most people die in a hospital, undergoing treatment for whatever their terminal condition is. Thus there will always be a temptation for those mistrustful of science to blame the medical treatment for the death, rather than the disease that was being treated. This is enough of a public relations conundrum for the medical industry, without additional layers of even more irrational paranoia and conspiracy mongering being stacked on top. Use pharmaceutical drugs, or don't, that's up to you because it's doesn't affect anyone but you. But anti-pharma conspiracy mongering does affect other people; so please take the trouble to better inform yourself before going forth to spread it.

By Brian Dunning
Follow @BrianDunning