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Bhaskar '21: Reconciling the pharmaceutical industry in the age of COVID-19

As the COVID-19 vaccine rollout progresses nationally, all eyes are on the industries responsible for creating and churning out the vaccine in such record time. Given the success of Operation Warp Speed, can we possibly praise the companies that took a huge gambit to provide us the vaccine? Or is their positive public relations spike unwarranted in light of the ethical gray zone they perpetually occupy? 

Public opinion has largely trended toward the latter. Big Pharma ranks up there with Big Oil on the list of industries that we love to hate. After all, its public image has long been laced with “crooks” (Sen. Bernie Sanders’s words, not mine) who wine, dine and bribe health care practitioners in exchange for physicians to sign, prescribe and occasionally look the other way when drug trial results fall short of the gold standard. Even despite recent amendments to limit the extent to which pharmaceutical companies may influence health practitioners, the public image of Big Pharma remains fixated on stigmatizing the industry as one that liberally compromises and undermines the tenets of public health due to its profit-hungry tendencies. All in all, many of the attacks on pharma are unfair and fail to recognize the important social benefits these companies provide.

A healthy amount of skepticism about the pharmaceutical industry is warranted — necessary even. In the past 24 years, pharmaceutical corporations have paid almost 400 settlements in instances of health care fraud. Inaccurate and misleading promotions of prescription pain medications have had disastrous results by fueling America’s national opioid crisis. The use of manipulative direct-to-consumer marketing tactics continues to impair the unbiased expertise of care providers by steering them towards certain products. On an individual level, the high prices of prescription medications pose financial barriers to access to medications, sparking public ire toward the industry. However, solely looking at the failures of the industry provides an incomplete image, one that overlooks the tremendous level of civic responsibility pharmaceutical companies handle. We must re-examine our prejudices and recognize Big Pharma for what it is: a wildly imperfect but widely necessary solution to bolster and maintain the current efficacy of health care innovation within America. 

Private drug companies are heavily responsible for funding vaccine research and development. Pre-pandemic data from 2018 reveals that private biotech and pharmaceutical firms invested a whopping $102 billion in pharmaceutical research, almost triple what the National Institutes of Health spent in that same year. These investments manifest in robust networks of labs and resources for funded research opportunities, and support for hundreds of thousands of well-paying jobs, all of which catalyze innovation. In the midst of a global pandemic, such innovation is crucial. Shortening the time taken to develop a viable vaccine has been crucial to saving lives, time and money. Left purely up to federally-funded organizations, the process of creating, producing and delegating a vaccine would likely reflect the underfunded, disparate and overall disorganized nature of federal agencies. 

While some criticize the pharmaceutical industry as being too profit-hungry, the high payoffs associated with vaccine production are precisely what motivate innovation. The process of creating drugs, especially on a molecular level, is one mired in trial and error, and biopharmaceutical companies incur tremendous risks when translating research into practice. Moreover, industries bear immense pressure from the Food and Drug Administration to monitor and minimize side effects and ensure safety throughout the process of testing and administration.

While the individual ingredients of a vaccine may not seem worth the hefty price tag, the costs of bringing a drug or vaccine past trial phases and gaining approval to be placed on the market are incredibly expensive. Costs of vaccine production include the expenses of physically developing a vaccine, observing its efficacy through three to four cycles of clinical trials and performing damage control for the sunk costs of unsuccessful trials. For therapies that target rarer diseases, the price associated with innovation and supporting the minds at work often far exceeds the market demand for it, leading companies to mark up the prices. Though the profit margins are not ideal for the public, they spur industry stakeholders to pursue research and innovation into such treatments. 

Furthermore, the industry itself relies on the minds of highly educated scientists and researchers who enter the field following rigorous higher education curricula and training. With so many financial and logistical barriers in place, one can see how the price hikes of drugs are partially necessary to fund and maintain vaccine and pharmaceutical development — during both viable trials and failures.

While Big Pharma’s capitalistic nature has many flaws, it is also the cornerstone of health care innovation in the U.S. Capitalism and the competition it provides manufacture a desire for industries to develop novel vaccines, drugs, therapies and other solutions to health care’s most pressing needs. This seemingly contradictory blend of altruistic social impact and profit-maximization is, in fact, key to understanding and posing feasible reform of the modern pharmaceutical industry. 

As an industry that impacts human life and well-being above all other economic impacts, recognizing the necessary shortcomings of the pharmaceutical industry is not mutually exclusive from pushing for greater transparency and accountability. Our concern should not lie in the fact that the industry seeks to profit, but rather that it must be checked in specific cases in which they maximize profits under unethical circumstances or transgress upon their responsibilities to public health. In such cases, accountability is necessary, and punitive measures, including financial “caps” on the pricing that the industries can set on drugs such as insulin, may be invoked. Supporting culpability does not require denigrating the entire industry.   

It is understandable, considering the pharmaceutical industry’s track record, to be convinced by socialist rhetoric lobbying for federally-sponsored pharmaceutical programs to curb the influence of large corporations. However, banking expectations upon the success and innovation prowess of a system despite the removal of extrinsic motivational factors is senseless. As it currently stands, federal and state-level public health organizations lack the organization, funding and preparation necessary to marshal, by themselves, a comprehensive response to any public health crisis of pandemic proportions. And until the day arrives in which such a coordinated response is in the cards, pharmaceutical corporations are here to stay as the only entities with the sheer manpower and resources capable of generating effective drugs and vaccines. 

While the pharmaceutical industry has myriad shortcomings, it is simply not practical to single-mindedly criticize pharmaceutical companies. The intrinsically human drive to work for an incentive, to innovate for hopes of material gain, is crucial to the pioneering of medical marvels and the efficiency of our pharmaceutical industry. 

Only by recognizing both the currently unparalleled resources that private pharmaceutical companies bring to medical innovation and the social responsibilities we must hold these companies accountable to can we pursue better policy and adequately integrate and reconcile the responsibilities that these industries hold to society. As the health care industry moves toward greater transparency from Big Pharma, we see a glimmer of hope ahead: A system better-equipped for social impact, with incentives necessary to drive entrepreneurial innovation intact. 



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