Transforming the critique of Big Pharma

Abstract

Intersecting fields of scholarship have accounted for pharmaceutical companies’ extraordinary success in promoting and profiting from their wares. This article instead tracks resistances and failures in the terrain of Big Pharma amid economic, epistemological and political challenges to their business models. Pfizer has been a key player in the rise of Big Pharma, and its fortunes since 2006 provide windows into the industry's stagnation – the failure of Pfizer's would-be blockbuster torcetrapib, the closing of its heart disease research unit, its free drug program for newly unemployed Americans. These illustrate transformations in ‘least neglected diseases’ and in pricing structures, and can be understood in the contexts of both biotech and Global South critique. Biotech companies have remained profitable by creating biologics for niche subsets of rich populations with a high willingness to pay (including lucrative treatments I call ‘drugs for short lives’). At the same time, dominant global capitalists/philanthropists have brought unprecedented funding to making treatment for AIDS and TB available to the poor and tackling long-neglected diseases like malaria. Now that pharmaceutical profits and markets seem less than infinite in their expansion and philanthropy has been pharmaceuticalized, the stakes of demands like ‘medicine for people not for profit’ are changing. STS critique of pharmaceuticals should take these transformations into account as it deepens its systemic critique of global inequality.