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Abstract

This essay outlines the broad themes of the conspiracy theory that pharmaceutical companies, regulators, politicians, and others are secretly working in consort against the public interest. This so-called Big Pharma conspiracy theory shares a number of features with other conspiracy narratives, but some features make this particular subgenre of conspiracy theory especially intractable and dangerous.
The Big Pharma conspiracy
theory Correspondence to:
Robert Blaskiewicz
Department of English
University of Wisconsin-
Eau Claire, Eau Claire, WI
USA
blaskir@uwec.edu
Robert Blaskiewicz
University of Wisconsin-Eau Claire, Eau Claire, WI, USA
Abstract
This essay outlines the broad themes of the conspi-
racy theory that pharmaceutical companies, regula-
tors, politicians, and others are secretly working in
consort against the public interest. This so-called
Big Pharma conspiracy theory shares a number of
features with other conspiracy narratives, but some
features make this particular subgenre of conspiracy
theory especially intractable and dangerous.
Keywords: Conspiracy theory, Pharmaceutical
companies, Paranoia, Vaccines
The so-called Big Pharma conspiracy theory shares a
number of features with all other conspiracy the-
ories. First, it shares the same basic plot: a relatively
small number of people are working in secret
against the public good. Second is a belief that
most people are ignorant of the truth and that only
a small number of people with secret or suppressed
knowledge (the conspiracy theorists) know the real
score. Third is the conspiracy theoristsbackward
approach to evidence: lack of evidence for the con-
spiracy is evidence for the conspiracy, as is any dis-
confirming evidence. Lastly, the way supposedly
confirmatory evidence is handled capitalizes on
common mental shortcuts, misperceptions, and
non-rational cues, which make the conspiracy the-
ories all the more memorable, compelling, and con-
tagious. This maddening mixture of mistakes makes
conspiracy theories very difficult to combat.
Big Pharma conspiracy theories, however, in all
their variety, constitute their own genre within the
larger category of conspiratorial narratives. In
much the same way that the gothic novel has its
own conventions (for example, a heroine impri-
soned, set in a dark old spooky house riddled
with hidden passages, and hints of the paranormal),
the Big Pharma conspiracy theory has a number of
conventions that set it apart from other conspiracy
theories. In this case, the villain is the
Pharmaceutical Industry. Its not the actual
pharmaceutical industry; rather it is the pharma-
ceutical industry as they imagine it. In these
stories, Big Pharmais shorthand for an abstract
entity comprised of corporations, regulators,
NGOs, politicians, and often physicians, all with a
finger in the trillion-dollar prescription pharma-
ceutical pie. Eliding all of these separate entities
into a monolithic agent of evil allows the conspiracy
theorist to mistakenly ignore the complex and con-
flicting interests that they represent. This agent is,
as are all antagonists in conspiratorial narratives,
improbably powerful, competent, and craven, and
it allows the conspiracy theorist to cast himself in
the role of crusader and defender of a way of life,
a Manichean dichotomy that was identified in
Richard Hofstadters classic treatise on Americas
recurring conspiracism, The Paranoid Style in
American Politics.
1
Like many conspiracy theories, there may be real
tangible facts that undergird the elaborate conspi-
racy theory. For instance, pharmaceuticals have
side effects, many of which are unpleasant, some
of which can be fatal. This basic fact of pharma-
cology, however, has become the basis of blanket
claims about the universal dangerousness of
pharmaceutical products. Additionally, not all
medical interventions are successful, and in our liti-
gious culture people often seem to not understand
that sometimes adverse outcomes occur when
everything is done correctly. Nowhere are these
ideas more prevalent than in conspiracy theories
involving cancer treatments. Cancer treatments are
often invasive and dangerous, and while the best
practices, in the aggregate, improve outcomes for
patients, they can still be unpleasant, even trau-
matic. They may fail certain patients entirely, so
that a patient may experience all of the side effects
of a treatment and none of the hoped-for benefits.
To the conspiracist, ubiquitous advertisements by
pharmaceutical companies become mind control
or brainwashing, while industry lobbying
becomes corruption.
259
© The European Medical Writers Association 2013
DOI: 10.1179/2047480613Z.000000000142 Medical Writing 2013 VOL. 22 NO. 4
Conspiracy theories may be a way to reassure
oneself that there is an order to our lives, that cala-
mity and disaster are not meaningless or random.
2
This in turn enables people to identify an enemy
to fight. When patients (and their loved ones) are
forced to accept a serious disease, they often experi-
ence powerlessness, especially when no cure is
available. This may itself trigger a search for a
culprit to blame for their suffering. Big Pharma is
a convenient target and is often imagined as with-
holding a cure. Indeed, a major premise of the Big
Pharma conspiracy theory is the cui bonofallacy:
he who benefits from misfortune must be the
cause of that misfortune. Such logic has been used
in other, non-medical conspiracy theories: Franklin
D Roosevelt got the war he wanted, therefore, he
was behind the Japanese attack on Pearl Harbour;
George W Bush and his handlers wanted to go to
war in the Middle East, so they brought down the
World Trade Centre as a pretence to invade Iraq;
European Jews were de-ghettoized as Napoleon
swept across the continentthey must have been
behind the revolution that led to his ascent to power.
In the case of the Big Pharma conspiracy theory,
cui bono reasoning appears in a pair of often-levelled
charges. The more common charge is that a cure is
being withheld to keep people on more expensive,
less effective medical regimes. In the case of
cancer, the cheap, easy, and naturalsuppressed
cures range from baking soda, to marijuana, to vita-
mins, to apricot kernels (which are banned because
the amygdalin they contain breaks down into
hydrogen cyanide).
3
The more extreme charge is
that diseases are deliberately manufactured mol-
ecule-by-molecule or weaponised in labs and
released onto the populace in order to give compa-
nies an excuse to sell medications. One such high-
profile accusation of this, I think, was during the
2009 H1N1 swine flu outbreak. Mike Adams, an
inexplicably popular online health guru (he calls
himself the Health Ranger) who advocates nearly
every conspiracy theory, made this charge in 2009
in a bizarre little rap called Dont Inject Me (The
Swine Flu Vaccine Song):
Dont you know the swine flu was made by
man
Pharmaceutical scam
[]
All you parents grab your kids
And shoot em up just like guinea pigs,
Inject your teens and your babies in the crib;
And when they get paralyzed,
Thats when you realize
Theres no way to undo what you did.
The big drug companies are makina killing
Collectinthe billions and gettinaway like a
James Bond villain
Cause theyre willinto do almost anything
Just to make money with the flu vaccine.
Adams actually embraces both cui bono claims, that all
you need is vitamin D to ward off the swine flu (but
that drug companies cant charge as much for it) and
that the flu was manufactured in order to sell the
vaccine. He also manages to invoke a global depopu-
lation conspiracy alongside creating a market for vac-
cines: two agendas that are hard to reconcile, as one
involves killing people and the other saving as
many people as possible by selling them vaccines.
This is a typical feature of conspiracist thought a
2012 study by Wood, Douglas, and Sutton found
that the endorsement of mutually incompatible con-
spiracy theories are positively correlated.
4
Anti-vaccine conspiracy theories play on many of
the same fears that run-of-the-mill Big Pharma con-
spiracy theories do including fears over side
effects, unnaturalsubstances in them and a
general suspicion of the profit motive in health
care but these theories are often supercharged by
the fears of parents. Parents who believe that their
children are vaccine-damagedand who are strug-
gling to understand and assign blame for an intract-
able, life-changing disease with no cure, have
created one of the most stubborn and dangerous
conspiracy theories. Following the widespread
attention received by Andrew Wakefields entirely
fraudulent 1998 Lancet article linking the MMR
vaccine to autism (withdrawn by the journal in
2011), childhood vaccination rates plummeted
below levels needed to support community immu-
nity in many areas, and children started to contract
diseases that many younger physicians had never
seen. The resilience of the conspiracy theory target-
ing vaccine manufacturers and researchers can be
seen in the fact that it persists despite over a dozen
studies demonstrating otherwise, including one
Cochrane review that had a sample size of about
14.7 million children.
5
The theory is as popular as
ever and is still pushed by the likes of Jenny
McCarthy, Generation Rescue, and innumerable
alternative medicine practitioners. Fear, it seems, is
more contagious than reason.
So, what can be done to combat the Big Pharma
conspiracy theory? Sadly, the theory will always be
around because peddlers of alternative medicine find
Big Pharma to be a useful adversary in their quest to
sell their questionable remedies and because of the
role that belief plays in peoples lives. Furthermore,
once the theory has taken root in someonesmind,
Blaskiewicz The Big Pharma conspiracy theory
260 Medical Writing 2013 VOL. 22 NO. 4
its often impossible to dislodge it, as the conspiracy
theory turns those who argue against it into paid
shillsor sheeple.Itisbesttocatchpeoplebefore
they fall into conspiratorial beliefs. Secrecy and ignor-
ance beget conspiracy theories; they are best combated
by education and transparency.
References
1. Hofstadter R. The paranoid style in American politics.
In: The paranoid style in American politics. New York:
Random House Digital, Inc.; 2008. p. 340
2. Melley T. Agency panic and the culture of conspiracy.
In: Knight P. editor. Conspiracy nation: the politics of
paranoia in postwar America. New York: New York
University Press; 2002. p. 5781.
3. Kenward M. Laetrile and the law. New Scientist. 1979
January 11; p. 88.
4. Wood MJ, Douglas KM, Sutton RM. Dead and alive:
beliefs in contradictory conspiracy theories. Soc
Psychol Personality Sci 2012;3:76773.
5. Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C.
Vaccines for measles, mumps and rubella in children.
Cochrane Database Syst Rev 2012;(2). Art. No.:
CD004407.
Author information
Robert Blaskiewicz is a Visiting Assistant Professor of
Writing at the University of Wisconsin-Eau Claire. His
research interests include the rhetoric of conspiracy
theories and other extraordinary claims, as well as veter-
anscombat narratives.
Fun with medical studies
What a shame this study has finished, as judging by
the protocol I would have quite liked to have
enrolled
Applications will be done by massage until com-
plete penetration by the medical staff.
Helen Baldwin
Scinopsis, Fréjus, France
helen.baldwin@scinopsis.com
Blaskiewicz The Big Pharma conspiracy theory
261Medical Writing 2013 VOL. 22 NO. 4
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... In such a manner, Big Pharma, considering its perceived power, is often accused of both creating demand for certain drugs by restricting access to them and of creating addiction by encouraging their overuse (Singler, 2015). It is also believed that cures for some diseases are being withheld to make people buy more expensive, but less effective medications (Blaskiewicz, 2013), and that the industry hides the side-effects of widely recommended practices, such as vaccination (Grimes, 2016). A current widely popular conspiracy theory, also rooted in this image of the pharmaceutical industry as powerful and profit-hungry, is that the pandemic is a plot by Big Pharma (Lynas, 2020;van Mulukom et al., in press). ...
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Conspiracy theories can form a monological belief system: A self-sustaining worldview comprised of a network of mutually supportive beliefs. The present research shows that even mutually incompatible conspiracy theories are positively correlated in endorsement. In Study 1 (n = 137), the more participants believed that Princess Diana faked her own death, the more they believed that she was murdered. In Study 2 (n = 102), the more participants believed that Osama Bin Laden was already dead when U.S. special forces raided his compound in Pakistan, the more they believed he is still alive. Hierarchical regression models showed that mutually incompatible conspiracy theories are positively associated because both are associated with the view that the authorities are engaged in a cover-up (Study 2). The monological nature of conspiracy belief appears to be driven not by conspiracy theories directly supporting one another but by broader beliefs supporting conspiracy theories in general.
Article
Background: Mumps, measles and rubella (MMR) are serious diseases that can lead to potentially fatal illness, disability and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness. Objectives: To assess the effectiveness and adverse effects associated with the MMR vaccine in children up to 15 years of age. Search methods: For this update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, PubMed (July 2004 to May week 2, 2011) and Embase.com (July 2004 to May 2011). Selection criteria: We used comparative prospective or retrospective trials assessing the effects of the MMR vaccine compared to placebo, do nothing or a combination of measles, mumps and rubella antigens on healthy individuals up to 15 years of age. Data collection and analysis: Two review authors independently extracted data and assessed methodological quality of the included studies. One review author arbitrated in case of disagreement. Main results: We included five randomised controlled trials (RCTs), one controlled clinical trial (CCT), 27 cohort studies, 17 case-control studies, five time-series trials, one case cross-over trial, two ecological studies, six self controlled case series studies involving in all about 14,700,000 children and assessing effectiveness and safety of MMR vaccine. Based on the available evidence, one MMR vaccine dose is at least 95% effective in preventing clinical measles and 92% effective in preventing secondary cases among household contacts.Effectiveness of at least one dose of MMR in preventing clinical mumps in children is estimated to be between 69% and 81% for the vaccine prepared with Jeryl Lynn mumps strain and between 70% and 75% for the vaccine containing the Urabe strain. Vaccination with MMR containing the Urabe strain has demonstrated to be 73% effective in preventing secondary mumps cases. Effectiveness of Jeryl Lynn containing MMR in preventing laboratory-confirmed mumps cases in children and adolescents was estimated to be between 64% to 66% for one dose and 83% to 88% for two vaccine doses. We did not identify any studies assessing the effectiveness of MMR in preventing rubella.The highest risk of association with aseptic meningitis was observed within the third week after immunisation with Urabe-containing MMR (risk ratio (RR) 14.28; 95% confidence interval (CI) from 7.93 to 25.71) and within the third (RR 22.5; 95% CI 11.8 to 42.9) or fifth (RR 15.6; 95% CI 10.3 to 24.2) weeks after immunisation with the vaccine prepared with the Leningrad-Zagreb strain. A significant risk of association with febrile seizures and MMR exposure during the two previous weeks (RR 1.10; 95% CI 1.05 to 1.15) was assessed in one large person-time cohort study involving 537,171 children aged between three months and five year of age. Increased risk of febrile seizure has also been observed in children aged between 12 to 23 months (relative incidence (RI) 4.09; 95% CI 3.1 to 5.33) and children aged 12 to 35 months (RI 5.68; 95% CI 2.31 to 13.97) within six to 11 days after exposure to MMR vaccine. An increased risk of thrombocytopenic purpura within six weeks after MMR immunisation in children aged 12 to 23 months was assessed in one case-control study (RR 6.3; 95% CI 1.3 to 30.1) and in one small self controlled case series (incidence rate ratio (IRR) 5.38; 95% CI 2.72 to 10.62). Increased risk of thrombocytopenic purpura within six weeks after MMR exposure was also assessed in one other case-control study involving 2311 children and adolescents between one month and 18 years (odds ratio (OR) 2.4; 95% CI 1.2 to 4.7). Exposure to the MMR vaccine was unlikely to be associated with autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn's disease, demyelinating diseases, bacterial or viral infections. Authors' conclusions: The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. The evidence of adverse events following immunisation with the MMR vaccine cannot be separated from its role in preventing the target diseases.
Conspiracy nation: the politics of paranoia in postwar America
  • T Melley
Melley T. Agency panic and the culture of conspiracy. In: Knight P. editor. Conspiracy nation: the politics of paranoia in postwar America. New York: New York University Press; 2002. p. 57-81.
Laetrile and the law
  • M Kenward
Kenward M. Laetrile and the law. New Scientist. 1979 January 11; p. 88.