|Some dare call it|
|What they don't want you to know!|
“”"Tell your doctor..." Tell your Doctor? Shouldn't your doctor tell you what drugs you need? If you tell your doctor, isn't he just a dealer at that point?
|—Bill Maher, Victory Begins at Home|
Big Pharma is the nickname given to the pharmaceutical industry. Critics of the industry often use this nickname when discussing abuses by the industry, including:
- Trying to suck every penny out of the pockets of the sick, injured, dying, and hypochondriacs;
- Inventing new maladies so people will buy more drugs;
- Renaming old maladies so people will think their conditions are more serious, making them more willing to pay higher prices for prescriptions.
Woo merchants such as homeopaths stridently blame most or all opposition on Big Pharma. However, as scientifically-literate critics of both Big Pharma and woo (e.g. Ben Goldacre) point out, "Repeat after me: pharma being shit does not mean magic beans cure cancer."
 Advertising of prescription drugs
While many countries allow over-the-counter drugs to be advertised, only the United States and New Zealand allow prescription drugs to be advertised on television. Many critics[Who?] believe Big Pharma has abused this tolerance by pushing drugs that may not be effective or applicable to their conditions on viewers. In the United States, TV advertisements for pharmaceuticals must list the major side effects that were detected during the drug's safety trials; this disclosure can give the false impression that older drugs (the ones that came out before TV advertising was an option) are safer than all these newfangled drugs, when in fact the older drugs tend to have just as many side effects as the new ones do. (The litany of side effects for aspirin, for example, would fill several pages.)
In the United States democracy, no such re-examinations have been forthcoming. To prevent any change which would impact their profits, the healthcare industry spends 4 times as much as defense contractors lobbying in Washington. To the contrary, the latest update to the Medicare program for senior medical care ("Medicare Part D") explicitly prevents the government from negotiating prices with Big Pharma for the drugs it buys. The taxpayers' largesse toward Big Pharma was spearheaded through the selfless efforts of Senator Chuck Grassley (a Republican from Iowa). Of course, it's purely a coincidence that the medical industry is the leading contributor to Grassley's political fundraising. Great job, GOP.
Thanks, in part, to televised pushing of prescription drugs, the United States -- which makes up five percent of the world's population -- accounts for 42% of the money spent on prescription drugs. Meanwhile, as a result of this abuse, the New Zealand government is reconsidering whether it should continue to allow Big Pharma to advertise prescription drugs on television.
 Naming maladies, disease mongering, and medicalization
Big Pharma often enlists the help of advertising executives to coin names for new maladies and rename old maladies to try to expand the number of prescriptions written. One new malady is Restless Leg Syndrome or RLS, which is caused by too much stress, not enough sleep and the use of stimulants (caffeine mostly), alcohol, H2-histamine blockers, iron deficiency or insufficiency, and certain antidepressants. Back in the day when people only worked one job, RLS wasn't much of a problem. However, because Americans now need to work two or three jobs just to make ends meet, RLS is much more common today. RequipTM, as a result, is the RLS treatment most often advertised on American TV.
Because old diseases don't have the emotional punch that three- and four-letter acronyms have and the fact in order to sell a drug it has to treat a disease, Big Pharma regularly practices Newspeak and creates new names or even new diseases, which has been coined "disease mongering" or "medicalization". These new names are often three to four words long, allowing for them to form a catchy acronym for the condition. One example is Erectile Dysfunction or ED. It's bad enough when she says "it happens to every man" at some time. It's worse when, a few days later, her family and friends start addressing you as "The Old Softie." Priapism is the term for that certain side effect where the man has a prolonged erection without being aroused. Thank the advertising firm for Cialis,TM which was the first to incorporate the "four-hour erection"
boast warning in their product's commercials.
One of the big problems with Big Pharma is the practice of ghostwriting. This involves pharmaceutical companies paying off doctors to slap their names on some glowing review or commentary, which is little more than an advertisement for a product and then attempt to slip it into medical journals. A particularly egregious case of this was when pharmaceuticals hyped menopausal hormone replacement therapy for off-label therapies and downplayed the risk of breast cancer. In one instance, Merck even managed to get an entire bogus journal set up by Elsevier called the Australasian Journal of Joint and Bone Medicine.
 Publication bias
Another problem with the influence of pharmaceutical corporations is the possibility of publication bias in research they sponsor. Pharmaceuticals carrying out their own clinical trials must register the trials in a database by law, but they are not required to disclose the results of all of their trials. This enables them to inflate the effectiveness of a drug by sitting on negative trial data. Ben Goldacre is a noted critic of the way in which pharmaceutical companies refuse to release the data from negative and inconclusive trials.
Historically, most pharmaceuticals were not tested on female lab rats, (or, for that matter, on female humans), however, in May of 2014 the NIH requires that to recieve their funding studies include roughly 50/50% ratios of male to female cells, lab rats, and human subjects. This notably does not mandate these standards for all drug tests in the US, only those funded by the NIH. In 1993 the FDA repealed a 16-year-old policy that has excluded most women with “childbearing potential” from the earliest phases of clinical trials. 
 Conspiracy theories
While the pharmaceutical companies, as shown above, do have a lot to answer for regarding their business practices, some critics of Big Pharma go way, way beyond the realm of well-deserved criticism of these corporations.
The groups that push Big Pharma conspiracies tend to fall into two camps which often overlap: alternative medicine cranks, quacks, and other woo-meisters as well as stock conspiracy theorists. Big Pharma plays the villain in the quack persecution complex as it works tirelessly to suppress their "brilliant cures." The general train of thought behind those who reject evidence-based medicine is that the entirety of medical science (or "Western medicine") is fraudulent and all the studies and experiments are bogus. Any studies showing inefficacy of a treatment are immediately latched onto as "proof" that medical science is bunk by Joseph Mercola and Mike Adams types. Then there are the really cranky cancer conspiracies revolving around the idea that Big Pharma invented the cure for cancer but is covering it up. This is a popular one among raw foodists who believe raw food is "the cure that Big Pharma doesn't want you to know about." There is also a new bunch of fringe theorists, who think that all cancer is a fungus, and that all scientific studies on cancer are therefore frauds. This is all supported by one Italian Onconlogist, called Tullio Simoncini. Ironically, he is under investigation for fraud and homicide after his treatments killed a woman with breast cancer.  Anti-vaxers also live on Big Pharma conspiracy theories. This opens the door for the woo-meisters to peddle their bullshit, because, you see, they actually care about you while Big Pharma has a profit motive and they don't. Nuh-uh, no profit motive for quackery at all. Just pure all-natural goodness like nature intended, naturally, of course.
The conspiracy theorists generally come from the viewpoint of the relationship between Big Pharma and the government. Usually this involves the use of chemtrails or water fluoridation as mind control substances to prepare us to accept the coming New World Order. Either that or they are being used to intentionally keep us sick so Big Pharma can rake in the dough by causing our illnesses and then selling us the cure. The "cancer industry" conspiracy goes even further, including everybody even tangentially involved with oncology.
So, yes, pharma sucks. But it's not involved in a scheme to depopulate the planet, put mind control chemicals in the water supply via fluoridation, or suppress cancer cures.
 See also
- Big science
- Big Placebo
- Brave Maverick Doctor
- Shill gambit
- Essay:Big Pharma is funding the Anti-vaccine movement
- PhRMA website
- "The Drugs I Need": Cartoon by Consumers Union satirizing Big Pharma's TV ad campaigns.
- Science-Based Medicine's topic for pharma issues
- Ben Goldacre's Big Pharma posts
- When "Big Pharma" Makes It Tough to be a Skeptic by Rebecca Watson
- Gagnon M-A, Lexchin J (2008) The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States. PLoS Med 5(1)
- The Big Pharma Conspiracy, Georgia Tech Conspiracy Wiki
- The Sins of Big Pharma, Point of Inquiry interview with Barry Beyerstein
- ↑ It should be noted that the hypochondriacs would gladly pay every sou they have, no matter what Big Pharma does. On a second thought, there are alternatives like surgery that they are willing to pay for.
- ↑ As opposed to inventing better drugs so more people would become addicts.
- ↑ Paxil Progress Forum: New Year's Resolutions for Big Pharma
- ↑ http://twitter.com/bengoldacre/status/15857117862
- ↑ http://www.imdb.com/video/hulu/vi1549575961
- ↑ "Bill to Let Medicare Negotiate Drug Prices Is Blocked", New York Times, April 18, 2007
- ↑ Opensecrets.org campaign funding entry for Sen. Chuck Grassley
- ↑ 8.0 8.1 CBS News, A Nation of Pill-Takers 
- ↑ RequipTM website 
- ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1369125/
- ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122833/
- ↑ http://www.fda.gov/downloads/drugs/newsevents/ucm453718.pdf
- ↑ http://orgasminc.org/about-synopsis.php
- ↑ Pun intended
- ↑ The big secret they are keeping from us is why it's four hours and not three and a half.
- ↑ Fugh-Berman AJ (2010) The Haunting of Medical Journals: How Ghostwriting Sold “HRT”. PLoS Med 7(9). (See also further commentary by Steven Novella.)
- ↑ Merck Makes Phony Peer-Review Journal, Bio Ethics, further Merck and Elsevier Create "Peer-Reviewed" Advertorial. See also further commentary by Orac.
- ↑ Publication Duty for Big Pharma, PloS Medicine
- ↑ http://www.nejm.org/doi/full/10.1056/NEJM199307223290429
- ↑ NaturalNews types love these sort of things, like (warning: link contains high levels of bullshit) this one placebo study that apparently proves medical science to be definitively wrong in everything. (The other dumb thing about this is, if all these medical studies are bogus and a medical study is done on bogus research, how is this new study any more valid from their point of view?)
- ↑ Another Cure for Cancer? Steven Novella
- ↑ Cancer is A Fungus and It Is Curable By David Icke
- ↑ Breast Cancer Patient Sylvia Dies After Being Treated by Tullio Simoncini with Sodium Bicarbonate
- ↑ There may be some truth in these theories occasionally, the BBC takes seriously an unproved allegation that a drug company is blocking licensing of a relatively cheap presumably less profitable drug to treat an eye condition. NHS 'must step in' over Avastin row