COVID Vaccine Wins Make Big Pharma Look Heroic

Amidst the national euphoria over the COVID-19 vaccines, it's hard to believe that just two years ago, Big Pharma was essentially hated. In a 2019 survey, Gallup found that the public had unfavorable opinions about drug makers by a margin of more than 2-1, landing them at the bottom of the industry rankings. Today public approval is way up. In a Harris Poll released last month, the pharmaceutical companies soared in popularity, from 32% before the pandemic to 62% today.

For some observers, the switch has caused doleful worry that the cherished political goal of forcing the industry to reduce prices might have to be postponed, possibly for several years. Maybe. But here's a prediction I'm sure will come true: Hollywood is going to need a new villain.

Wait, what?

The identity of the evildoer in a thriller represents an effort by the writer to get in touch with the audience's fears. The story works precisely because the bad guy represents a class of people we wish someone would punish. It's no accident that "Lethal Weapon 2," released in 1989 at the peak of public concern about both drugs and the apartheid regime, featured as its villains South African drug dealers.

So where's the audience's id been lately? If we take television and film as our barometer, for the past thirty years we've been busily hating Big Pharma. Consider:

In the hit CBS series "Clarice" a pharmaceutical company is suspected of killing people who know about the fatal side-effects of its new drug. There's a 2011 episode of the excellent "Person of Interest" where - well, pretty much the same thing. In "Coming Down Hard," a 2004 episode of "Law and Order," the evil pharmaceutical company didn't order anyone killed. But the CEO still faced trial for second-degree murder for covering up data that the company's new anti-depressant caused a higher rate of suicide. And let's not forget 2005's "The Constant Gardener," where Ralph Fiennes discovers that a drug company has been indifferently killing Kenyans in the process of testing a new TB drug.

Finally, there's the granddaddy of them all, "The Fugitive" (1993), where federal marshal Samuel Gerard (Tommy Lee Jones) is chasing Richard Kimble (Harrison Ford), a surgeon framed for murdering his wife. And who set up the frame job? Right: Devlin-McGregor, a pharmaceutical behemoth, which was worried about negative results in - you guessed it - a clinical trial of a new drug, and decided to put the witnesses out of the way.

I'm not saying that the corralling of evil corporate honchos can't be enjoyable to watch, and these movies and shows are great fun. But put aside the notion that the CEO picks up the phone and calls a hitman when something goes wrong with a clinical trial, and the illusion that a bad trial result would ruin a company. ("That's why we have disclaimers and insurance," snarls the CEO of one fictional company - as it happens, correctly.) The reality of Hollywood's favorite corporate villain is much different.

For one thing, due to the rise of pharmacy benefit managers and other intermediaries, the share of gross revenues from drug sales that goes to the manufacturers has been declining steadily, and currently lies somewhere south of 40%. For another, even before the excitement over the COVID vaccines that will likely lead to trillions of dollars in increased global GDP, Big Pharma was capturing only a fraction of the benefits of new drugs.

Consider Cox-2 inhibitors, prescribed for chronic pain and inflammation. A well-known 2012 study found that the removal from the market of one of the most popular - Vioxx - led to a decline of 0.35% in U.S. labor force participation and an astonishing $19 billion in lost wages. The point isn't that Vioxx shouldn't have been recalled; it's that a drug becomes a blockbuster because its benefits far exceed the maker's profits. As a 2019 review of the academic literature confirms, the health care savings due to pharmaceutical innovation significantly outweigh the costs.

That's not to say that the pharmaceutical industry behaves better than any other or hasn't made its share of mistakes, many of them tragic.To take an obvious example, although the opioid epidemic that's claimed tens of thousands of lives is driven mostly by illicitly manufactured drugs, the pharmaceutical companies must also shoulder their share of the blame. But if Big Pharma's status as Hollywood's favorite corporate whipping-boy was in part a response to the industry's own wrongdoing, the companies' current status as heroes is more in line with their overall contribution to the public weal.

So the next time you stream 1988's hilarious "Big Business," when you get to the scene where Bette Midler, playing the CEO of Moramax, snaps out the iconic line "There are drugs for those things and we make most of them!" don't just laugh - think about applauding.