How did Big Pharma Sink to the Bottom of U.S. Industry Rankings?

By Keith Willis

I found this Gallup survey disheartening after spending most of my career in the pharmaceutical industry. It’s hard to imagine that we are ranked even lower than the Federal Government considering the level of partisanship for the last decade. Data suggests that almost 50% of physicians can see life without pharmaceutical sales reps and only 44% of physicians see sales representatives on a regular basis. Physicians can get much of their information from digital sources versus the traditional sales call and have grown tired of the rep spiels that have changed little over the years.

For the last twenty years there has been a discussion in the US on the cost of drugs and how much people pay compared to other countries. Politicians on both sides of the aisle have made this a center piece of their campaign. Bill Clinton’s proposed Healthcare plan in 1993, the Medicare Modernization Act in 2003, Healthcare reform that was passed in 2010 and American Patient First the Trump Administration blueprint to reduce drug cost in the United States.

In 2019 drug prices increased by 10%, five times the rate of inflation and higher than the cost of living. While the cost of drugs make-up a small percentage of overall pharmaceutical cost, many patients are skipping medications because of their cost. The cost of Insulin has doubled in the last five years while many patients don’t see the value in the minor changes to a drug that’s been around for 100 years.


The sunshine act was passed in 2009 to create more transparency with the financial relationships between healthcare providers and manufactures. The thought was that some of these arrangements created a conflict of interest where physicians would write more expensive drugs when cheaper options were available.

Pharma has never done a good job on selling the public on the value that companies bring to society. Many people are living a higher quality of life because of pharmaceuticals companies but think there are conspiracies about the lack of cures chronic conditions like diabetes, cancer, aids and other diseases. They believe pharmaceutical companies make more money for treating and not curing chronic diseases. Never mind the cure to Hepatitis C, big advances in cancer treatment and increased survivability for patients. Many Aids patients have HIV levels that are undetectable and can live relatively normal lives.

I remember interviewing a candidate who wanted to be a pharmaceutical sale rep because he was a type 1 diabetic. He felt that he would not be living with his disease without the discovery of Insulin or other treatments that had been discovered. Over 100 years ago children with diabetes lived maybe a year and adults lived two years. Patients would waste away in constant pain, loss of limbs, blindness, kidney failure and eventually death. The discovery of Insulin has had significant impact on the quality of patient lives and life expectancy.

Vaccines take a beating even though millions of lives have been saved. Recent advances include the Hib and Pneumococcal vaccines which have decreased the number of cases of influenza, bronchitis and ear infections and Pneumonia for children. In the early 1950’s Polio – was one of the most feared diseases with 10% of patients becoming paralyzed- is almost cured. This was the disease the afflicted Franklin Roosevelt, 32nd President of the United States. There is so much information encouraging parents not to have their children vaccinated that there is an increase in diseases like whooping cough, measles, and mumps. Other diseases like tuberculosis, scarlet fever and cholera are also making comebacks. Antibiotic resistance is also on the rise, and these diseases can have devastating effects. Many pharmaceutical companies are not pursuing antibiotics because of the cost. Resistance has reached a critical point for society.

There is also the current opioid epidemic where pharma sales and marketing has come into question. There are other players involved but pharma has played a primary role. This article does an excellent job of chronicling the opioid epidemic: The Opioid Epidemic.

Part two will explore some possible solutions to improve the public perception of the pharmaceutical industry! I would love your thoughts on how the pharmaceutical industry became rank so low.

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