Big Pharma Is about to Make a Lot of Money, and That’s Good

Even though drug companies make products that better our lives, they’re subject to right-wing conspiracy theories and left-wing economic jealousy.

A s America has seen over the past decade, it is impossible to get Donald Trump to admit when he’s wrong. As of this writing, he is still claiming that he won the 2020 presidential election.

But when he’s faced with the ire of his own voters, his positions begin to morph. In the middle of 2023, Trump released a video and accompanying statement in which he began questioning whether “Big Pharma” was involved in causing a “stunning rise in autism, auto-immune disorders, obesity, infertility, serious allergies, and respiratory challenges.”

“Too often, our public health establishment is too close to Big Pharma,” said Trump. “They make a lot of money, Big Pharma — big corporations, and other special interests, and does [sic] not want to ask the tough questions about what is happening to our children’s health.”

Trump proposed a special commission to investigate the companies, broadcasting conspiracy theories started by his MAGA supporters over whether vaccines are causing illnesses. “If Big Pharma defrauds American patients and taxpayers or puts profits above people, they must be investigated and held accountable,” Trump said.

While Trump likes to portray himself as a steely, decisive leader, this was one case where he capitulated to the MAGA mob. Perhaps the biggest achievement of his administration was the public-private partnership (Operation Warp Speed) that led to a quick development of a Covid-19 vaccine. But in 2021, he was booed at a public event where he admitted to his supporters that he had gotten a Covid booster shot, which may have led him to further feed the paranoia of his anti-vaccine supporters.

Of course, the claims that young, healthy people were dropping dead from the vaccine were nonsense, as were the fever-swamp claims that the vaccine was useless. (But the vaccine was also oversold by public-health authorities as a way to “stop the spread.” According to a study released earlier this year by the Centers for Disease Control and Prevention, the vaccines were 54 percent effective in preventing transmission of the Covid virus. And while the public had higher hopes than that, the real benefit from the vaccine was keeping people who did catch Covid from suffering disastrous consequences.)

But every conspiracy needs a bad guy; a simple random stream of unfortunate events isn’t compelling unless there is a puppet master orchestrating them. So Big Pharma became the Right’s prime target. Thus, while pharmaceutical companies were working to develop means to slow the spread of Covid, deranged theories about what they were up to began to be tossed around.

Obviously, drug companies are used to negative publicity, as they have been demonized by progressives as long as they have been cranking out medicines. Their role in oversaturating the market with opioids is still a black mark on the industry, for which they will no doubt continue to pay dearly.

But there used to be an understanding among conservatives that Big Pharma, like every other industry, is in business to make money. And when pharmaceutical companies make money, our lives get better and last longer.

That is because the “excess profits” earned by drug companies often go into research-and-development efforts to create new drugs for maladies old and new and not even on the horizon. According to the Congressional Budget Office, in 2019, the year before Covid hit, the pharmaceutical industry spent $83 billion on R&D.

Further, the drug-development process is onerous, with only around 12 percent of drugs that enter clinical trials ending up being approved by the FDA for public use. Given the high cost of the development and approval (an estimated $1 billion to $2 billion per drug developed), every new drug that does make it to market effectively has to subsidize those that don’t.

And we are all better off when new drugs — to treat high blood pressure, cancer, diabetes, viral infections, and other maladies — do make it through. According to one study published by the National Institutes of Health, the Covid vaccine alone may have saved 14.4 million lives. So the more these drugs can be developed, the healthier we will all be.

And soon, a revolution in health may be upon us that could have drug companies flush with even more cash. As drug companies develop more products that include glucagon-like peptide-1 (GLP-1) agonists, such as semaglutides (e.g., Ozempic, Wegovy) and tirzepatide (e.g., Mounjaro, Zepbound), more uses for GLP-1 are being found.

Originally used to treat type 2 diabetes, semaglutides help the people who take it eat less and therefore lose weight, and by losing excess weight to improve their health. But studies are showing it can do even more, such as helping people curb their alcohol habits and reduce opioid cravings. Anecdotal evidence says it can help people stop smoking (clinical tests are under way on this claim). And some people are claiming it helps them have better sex. (Presumably, being thinner aids people in finding partners.)

This is why in 2023, semaglutides were the top-selling drug in the United States, with $38.6 billion in sales. Currently, Ozempic, Wegovy, and other brands are available only by prescription and can be pretty expensive. But some medical professionals have begun arguing that GLP-1s are safe enough to be available over the counter to anyone who wants them. That would cause prices to plummet, make them widely available, and potentially improve Americans’ health dramatically.

This would also have the added benefit of requiring fewer Americans to take expensive drugs to treat the side effects of obesity and allow them to live more active, healthier lives. (It would also shut down the black market for GLP-1s, in which people are overdosing on semaglutide alternatives at an alarming rate.)

But if Ozempic, Wegovy, and other similar drugs (which actually have been around for years) suddenly do become a magic bullet for better health, there will be one glaring side effect: The pharmaceutical companies that make these drugs will be making untold amounts of money. And even though they will be providing a product that betters a lot of lives, they will no doubt be subject to both more conspiracy theories on the right and economic jealousy on the left.

No doubt, when someone on a GLP-1 suffers a stroke, some website from deep within the armpit of the Republican Party will start blaming it on the drugs. Congressional Republicans, needing to gin up a scandal for which only they have the answers, will start scaring the public, firing off letters and holding hearings.

Democrats, of course, will bleat about “excess profits” and executive pay packages, trying to turn the public against drug companies that provide lifesaving medications. Many of the same progressives that claim Americans are entitled to free birth-control pills and reduced-cost insulin will try to handicap the very businesses that spent billions of dollars creating and perfecting those products. And this will be the case with semaglutides — what is a triumph of science may soon be deemed a human right.

But doing so would cripple the drug-development and -approval process that got us GLP-1s in the first place. Cutting drug-company profits means undercutting companies’ ability to create new drugs (which they can then sell for a profit, leading to even more discoveries).

Even more troubling is the newfound desire among Republicans to vilify the same companies that save lives. As part of Trump’s stump speech, he frequently claims he will stop funding schools that have vaccine requirements — the same vaccines that have helped us eliminate polio, smallpox, mumps, tetanus, and other formerly lethal or permanently disabling diseases.

And it is Republicans who largely are eschewing vaccines. According to Gallup, 62 percent of Republicans in 2002 recognized the importance of childhood vaccines. By 2024, that number had dropped to an appalling 26 percent.

There’s no doubt the fog of the pandemic contributed to this skepticism, with health-care experts often changing positions on the science from one week to the next. (Should we vaccinate kids? Can pregnant women get the vaccine? Should the government be implementing vaccine mandates for all employees, or is it a choice best left to private businesses?) Sadly, this skepticism cost some Americans their lives.

The politics of jealousy will no doubt lead to scrutiny of any industry that rakes in money the way the pharmaceutical companies do, and they certainly have not always behaved honorably in running their businesses. But the more money drug companies make, the better off we all are — the profit motive provides the No. 1 incentive for medical innovation and drug development.

There are villains in America when it comes to public health, but it’s not Big Pharma — it’s the central planners trying to thwart medical discoveries and the conspiracy theorists trying to undermine drug companies’ work. If those companies make a killing on GLP-1s and other vital medicines, that is a small price to pay for our well-being.