The term Big Pharma is used to refer collectively to the global pharmaceutical industry. According to Steve Novella the term has come to connote a demonized form of the pharmaceutical industry. Professor of writing Robert Blaskiewicz has written that conspiracy theorists use the term Big Pharma as "shorthand for an abstract entity corporations, regulators, NGOs, politicians, and often physicians, all with a finger in the trillion-dollar prescription pharmaceutical pie". According to Blaskiewicz, the Big Pharma conspiracy theory has four classic traits: first, the assumption that the conspiracy is perpetrated by a small malevolent cadre; secondly, the belief that the public at large is ignorant of the truth; thirdly, that its believers treat lack of evidence as evidence; and finally, that the arguments deployed in support of the theory are irrational, misconceived, or otherwise mistaken.
Manifestations
The conspiracy theory has a variety of different specific manifestations. Each has different narratives, but they always cast "Big Pharma" as the villain of the piece. Some of the most prominent variants include the following:
In a 2006 column for Harper's Magazine, journalist Celia Farber claimed that the antiretroviral drugnevirapine was part of a conspiracy by the "scientific-medical complex" to spread toxic drugs. Farber said that AIDS is not caused by HIV and that nevirapine had been unethically administered to pregnant women in clinical trials, leading to a fatality. Farber's theories and claims were refuted by scientists, but, according to Seth Kalichman, the resulting publicity represented a breakthrough moment for AIDS denialism.
The idea that big pharma has a cure for cancer and is suppressing it so that they can maintain a profit is believed by as much as 27% of the American public according to a 2005 survey. The argument is that pharmaceutical companies are slowing down research for a comprehensive cure for cancer by developing high-profit, single-purpose treatments rather than focusing on a supposed cure-all for all cancers; however, the idea that holding back a cure would result in more profit than presenting one is not considered a very strong argument. This manifestation also largely ignores the fact that cancer is not a single disease but instead many and that large strides have been made in the fight against it. Steven Novella writes, in Skepticblog, about the general misunderstanding and sensationalizing of cancer research that typically accompanies a conspiratorial mindset. He points out that cures for cancer, rather than being hidden, are not the cures they are initially touted to be by the media and either result in a dead end, further research goals, or a decrease in the mortality rate for a specific type of cancer. In 2016 David Robert Grimes published a research paper elaborating about the mathematical non-viability of conspiracy theories in general. He specifically showed that if there was an actual big pharma conspiracy to conceal a cure for cancer that it would take about 3.2 years for it to get exposed due to the sheer number of people required to keep it secret.
Reception
Novella writes that while the pharmaceutical industry has a number of aspects which justly deserve criticism, the "demonization" of it is both cynical and intellectually lazy. He goes on to consider that overblown attacks on Big Pharma actually let the pharmaceutical industry "off the hook" since they distract from and tarnish more considered criticisms. In his 2012 book Bad Pharma, Ben Goldacre criticises the pharmaceutical industry but rejects any conspiracy theories. He argues that the problems are "perpetrated by ordinary people, but many of them may not even know what they've done." An argument against the U.S. government taking part in the suppression of cures is the Orphan Drug Act of 1983 wherein incentives are created for developing treatments for disease which the treatments have no profitable outcomes for the companies involved. A common claim among proponents of the conspiracy theory is that pharmaceutical companies suppress negative research about their drugs by financially pressuring researchers and journals. There are in fact papers critical of specific drugs published in journals on a regular basis. A prominent and recent example was a systematic review published in the British Medical Journal showing that paracetamol is ineffective for lower back pain and has minimal effectiveness for osteoarthritis.
