Why Big Pharma Conspiracy Theories Fail

“Whenever I see the U.S. government, its subordinate governments, the UN, the drug industry, the CDC, the AMA, the American hospital association–all these vast powers within the medical and scientific world–united in pushing one extremely expensive thing and crushing any dissent, I think its time to have another look.”

– Lew Rockwell

Despite their many contradictory claims, one constant about conspiracy theories regarding Big Pharma–or, as author Tom Woods calls it, “the pharmaceutical-industrial complex”–is that they all ignore the role of individuals and the complex relationships between them. They treat all the diverse public and private actors as one monolithic entity, with identical interests and the same nefarious goal: crushing you, the consumer! Fortunately, the real world is not like Lew Rockwell’s paranoid dystopia.

When we see every reputable doctor, university, hospital, health organization, research laboratory, private company, and government agency studying the same question and converging towards a similar set of answers, this is the result of competitive scientific discovery, not a centralized plot to lie to the world. These groups are not “unified.” They’re disconnected, disorganized, and diverse, with differing incentives, motivations, and goals. When they all tend to agree on something–like, say, the fact HIV really causes AIDS–it’s less likely to be some vast conspiracy and more likely that the evidence actually demonstrates that.

1) The FDA and business have different interests. The FDA does act as an anti-competitive force, and it does harm the consumer, but not in the way conspiracy theorists claim. As Milton Friedman liked to point out, the FDA actually has strong incentives to be conservative in with its approach to drug approval. To government bureaucrats, even if a treatment could save millions of lives, a slim possibility that it could harm a few hundred outweighs its potential benefit. FDA officials are dragged before Congress for approving drugs that harm people, not for delaying drugs that could save them. The FDA’s approval process, driven by an excess of caution, takes on average a decade per drug. If a new treatment could save ten thousand lives a year, 100,000 will die before it is legal.

“Better safe than sorry”? Better for whom? The precautionary principle of has become enshrined in policy to protect bureaucrats, not consumers or businesses. Just because there is a government agency that regulates an industry doesn’t mean it is helping businesses to scam people for money. Would conspiracists make the same claims about the National Highway Safety Administration? Is the Seat Belt-Industrial Complex just tricking you into buying restraining harnesses and airbags to make an extra couple bucks per car?


2) The members of the “complex” are competing. Similar to how they conflate the interests of the FDA and corporations, conspiracy theorists act as if all the companies that make up the so-called “complex” are actually a single entity with the same incentives. But these businesses are all in competition with each other, striving for the dollar-votes of consumers. They have powerful incentives to undermine each other, expose bad drugs, and prove to customers that their own are better, safer, more effective. Just the phrase “Big Pharma” implies the whole scientific research process and pharmaceutical industry is just one big cartel, hellbent on defrauding consumers. Would conspiracy theorists apply the same logic to Whole Foods, Wegmans, and Big Grocery? At what point does this logic, which could be applied to any product or industry, dissolve into utter paranoia? Consumers are not helpless, and the whole world is not out to get you (and Netflix isn’t brainwashing you, either).

3) Individuals within government and industry have different interests than those they work for. Conspiracy theorists seem to believe that all of the individuals who work for the FDA and drug companies really want to rip off consumers for monetary gain. This is the fraying ends of every conspiracy theory—how many people are “in on” the vaccine, GMO, and the chemotherapy scams? How many doctors, pharmacists, lab technicians, geneticists, and chemical engineers are killing their own families with these foods, drugs, and treatments? Would they really poison their own children just to make a few bucks for the shareholders? And what about all the scientists and university researchers who promote these same lies? Not only does this require an extraordinary level of evil from millions of sane, compassionate people, it ignores the competitive, bottom-up processes that drives economic, social, and scientific progress.

Even though conspiracy theories often seem superficially complicated, they only work by reducing the world into a very simple, one-dimensional place: there is one all-powerful, all-seeing, and all-knowing group of “elites” who manipulate and control the economy, the media, the academe, and the world at large. People who don’t see this are either deluded sheeple or, as Lew Rockwell calls us, agents of the regime. It is a worldview that explains everything and asks for nothing. But reality is a much more complicated, more dynamic, and indeed more interesting place than that.

Related: Why Libertarians Should Support Science-Based Medicine 

The Editors

Senior editors of the Skeptical Libertarian.