Richer and more powerful than ever, pharmaceutical companies are an industry out of control, whose interests do not always coincide with the imperatives of public health.
They are called “Big Pharma”; alone, the Swiss Novartis and Roche, the Americans Pfizer and Johnson & Johnson, and the French Sanofi control most of the manufacture of drugs. To maintain their monopoly, these large laboratories would like to minimize, or even hide, certain undesirable effects caused by their products. In Europe, Dépakine, an anti-epileptic responsible for congenital malformations and neuro-developmental disorders in children exposed in utero, is at the heart of a resounding scandal. Suspected of having delayed in alerting health authorities and consumers to these known risks, Sanofi has been indicted for “involuntary homicide” among other charges. In Canada and the US, where the opioid crisis is wreaking havoc (more than a hundred deaths per day in the US, more than 10 in Canada), pharmaceutical multinationals are accused of having encouraged the mass prescription of these painkillers while concealing their highly addictive nature. In 2019, Johnson & Johnson was ordered to pay $572 million to the state of Oklahoma for endangering the lives of its citizens.
While the pharmaceutical industry largely benefits from innovations in public research, drug prices are soaring: a single course of hepatitis C treatment costs taxpayers C$90,000 in Canada, while the new gene therapy against leukemia marketed by Novartis is around $450,000 in the US. Pictures of dying babies are brought out whenever a country or its citizens threaten to balk at the price. Between intense lobbying and illicit agreements, laboratories are deploying effective strategies to preserve their exclusivity, like the same Novartis, which has managed to impose on the market a drug against AMD (age-related macular degeneration) forty times more expensive than its competitor.
At a time when the fight against COVID-19 is whetting the appetites of pharmaceutical mastodons, a new paradigm is at work in the sector, between concentration, financialization and the race to unrestrained in profit. They pose a threat to public health systems, but they are also provoking surges of resistance; between the proliferation of legal proceedings and the coalition of groups of doctors fighting against corruption in the field of health, Big Pharma will need to tread more carefully.