 Along with the CIA, the Illuminati, the Zionist Council, and the Skull and Bones, no single idea so obsesses those people on the fringe who call themselves truthers, as large pharmaceutical companies, or as they are ubiquitously known, big pharma. When the name is invoked, we know what is coming as a scathing indictment of a shadowy evil entity. Whether the discussion is about the cost of healthcare, or whether drugs or vaccines are safe, or why alternative medicine is being suppressed for mainstream use. It's very useful to have a scapegoat to blame the world's problems on. And there have been some breathtakingly amoral actions taken by individuals on behalf of certain pharmaceutical companies. I'd like to review a few facts about the real pharmaceutical industry. I'll attempt to be somewhat neutral in tone, although I fully expect to be attacked from both sides as a result. As often as possible, I will give objective facts and let the viewer decide what to make of it, but I do intend to editorialize a bit at the end. My goal here is to be thought provoking, to spark reasonable discussion. I'm not a shill for any company, and my own employer is not in the business of pharmaceuticals, and is nowhere on the scale of these companies. For the sake of disclosure, I did once work at a small pharma as a formulations chemist until they realized I was unqualified to do so. This was during my grad school days, and I'm fairly certain I remain untainted by the experience, except perhaps a slightly irrational fear of physical chemistry. I participated in no amoral activities, except perhaps the occasional office prank in a company stapler that somehow ended up at my house. Let's start with the industry itself. The top five pharmaceutical companies in order of 2008 revenues are Johnson & Johnson, Pfizer, GlaxoSmithKline, Roche, and Sanofi Aventis. The first two are considered U.S. companies, and the other three are European or British. On the list below number 12, the numbers fall off rapidly to companies that are a few billion or so dollars in revenue. Perhaps we could call these little pharma. How big is the industry as a whole? The top 10 companies have the same revenue combined as Walmart. The largest pharma, Johnson & Johnson, had about the same revenues as UPS or Lowe's. The amounts are staggering, but these are multinational companies with international distribution and manufacturing. When we look at profits, however, the comparisons level somewhat. The big oil companies like ExxonMobil and Royal.Shell post profits of two to four times the total profits of any pharmaceutical company, but they represent a lower percentage of revenue. This makes pharmaceutical companies a desirable and stable investment, even if the revenues are much lower than in retail, oil, or insurance industries. So my conclusion from these facts are that pharmaceutical companies are big entities, but smaller than the huge companies in many other industries, and that while they make fewer dollars in profit, they have an excellent return on investment. As to their conduct, let me first state that we would be challenged to find any morality in business anywhere. I think we all invoke very negative images when we imagine Walmart, British Petroleum, Exxon, McDonald's, and of course companies like Pfizer and Novartis. Why? Because they're amoral entities. We might imagine white men in business suits smoking cigars in a boardroom somewhere laughing about how much money they're making. And for all I know, that's what's actually going on. But with a little research, we can find out who actually owns these companies. Pfizer, for example. 63% of Pfizer's stock is owned by banks, pension funds, 401Ks, and mutual funds. The largest single owner, other than the reptilians of course, is Barclays Bank. The second largest shareholder may be Fidelity, the number one mutual fund agency in the US. 1% of the stock goes to Pfizer's top employees, and the remaining 36% are held by individual investors, employees, and other institutions, including university endowments, nonprofits, and so forth. I take from this that Pfizer is owned by lots of people, from all walks of life. People with 401Ks and pensions, as well as a number of big investors. 1% of the stock is held by the fat white men in the big boardroom smoking the cigars. They clearly have a vested interest in the continued success of the company, and they have the power to steer the company's large-scale activities. What about the history of such companies? Pfizer is no angel, not by any stretch of the imagination. The most well-known case is their action in Nigeria in 1996. During an outbreak of meningitis there, a completely experimental drug called Trovan was given for free to the infected. The administration of this drug was linked to the deaths of 11 children and injuries of another 19. The out-of-court settlement was for $75 million, including $10 million in paid legal fees, $30 million to the regional government, and $35 million to victims and families. It does nothing to excuse their actions, but it's worth noting that 15,000 people died of the disease during the outbreak. Only 200 were treated with the experimental drug, and 30 of those led to severe or fatal health effects. The lawsuit, which was never tried in open court, alleged that Pfizer did not tell parents they were free to refuse the drug and instead take an older, well-accepted alternative from a charitable medical group. If these allegations are true, the behavior is reprehensible. Other notable failures at Pfizer include a heart valve they acquired from a company called Convexo Concave that were defective, possibly resulting in the deaths of 500 heart valve patients. It's not clear if the fault should have been detected, but a federal court ruled against Pfizer to the amount of $200 million. They have a poor environmental record as well. According to the EPA, Pfizer is among the top 10 companies in America with the most numerous emission sources. On the positive side, they receive top marks for corporate equality in GLBT hiring, are a top-rated employer, and the diversity of the workforce is high and balanced. They employ 137,000 people around the world with the largest concentration in Groton, Connecticut. They're also the second largest research investment in pharma, investing $11 billion in R&D in 2008, being eclipsed only by research giant Genentech at $16 billion. Large pharmaceutical companies can be examples of the abuses and misuses of Western medicine when applied at a large for-profit scale. I'm completely in favor of oversight on these entities. They develop and manufacture our medicines and medical devices. I have kids, and I want them to be safe. If there's a backlash against the pharmaceutical industry, they'll have brought such actions on themselves by not doing a better job of self-policing, being compliant with ethical and legal standards. It's a shame we have a political system that permits large corporations to have such influence. But once both entities exist in the way they do, government and corporate, it's hard to imagine things playing out any differently. What I am specifically not advocating here is an abandonment of reason, logic, and scientific method. I hope we can all agree on this point. Finding unethical practices deplorable is not the same as endorsing unscientific or unproven alternative therapies. Using big pharma's actions to justify abandoning the most effective medical tools we have in our arsenal is no more logical than abandoning plastic because we dislike oil companies, or not eating store-bought food because we dislike modern agriculture. Of course, there are people who do each of these things, and that's their right. But I think they've sacrificed the good with the bad, which is no kind of progress. If you're looking for honest, informed answers to your medical questions, you probably won't get it from the news channel. You won't get it on talk radio. You won't get it from full-page ads and magazines or on TV. You certainly won't get it from the internet, blogs, or YouTube. In fact, I know of only one way for a non-scientist to be reasonably certain that the health advice they get is in their best interest. Is this guy? Or this guy? Or this woman? Your friendly neighborhood physician, licensed and experienced. If you find one that makes you nervous, that seems to be pushing drugs, or that you just don't trust, find a new one. These people are responsible for the health of their patients, medically, legally, ethically. Some may be relatively rich, but they aren't servants of a multi-billion dollar company. Maybe a few are. I can't say that every doctor is purely ethical and good. But you should be able to find one that you trust. Talk to them, discuss your concerns. Eventually, everyone has to make a decision on what's best for them and their loved ones. Thanks for watching.