In 2022, pharmaceutical companies spent approximately $108 billion on R&D globally, while investing nearly $30 billion on marketing to healthcare professionals and over $7.6 billion on Direct-to-Consumer (DTC) advertising in the U.S. alone, with overall digital pharma ad spending expected to have hit ~$20 billion in 2024.

Recent studies from JAMA and Health Affairs indicate that DTC advertising continues to significantly increase prescription drug spending and utilization. Drugs promoted directly to consumers consistently rank among the best-selling medications, with sales for DTC-advertised drugs increasing substantially faster than those that aren't heavily marketed. Most of this spending increase results from increased utilization rather than price increases.

Among the many reasons cited for this increase is "growth in the number of patients diagnosed with conditions that can be treated with pharmaceuticals." It remains more than just semantics to note that these conditions are rarely described as being "cured" or "healed" by pharmaceuticals, but merely "treated."

Pharma profits and human losses
In 2023, combined global pharmaceutical industry revenues exceeded $1.5 trillion, with profits of the top 20 companies of approxmiately $184 billion. Contrast that with the combined U.S. hospital revenue (over 6,000 facilities) of about $1.16 trillion, with profits at about 5.2% = approximately $60 billion, much of which was concentrated in large for-profit hospital chains.

Even more sobering, recent research published in the Journal of Patient Safety estimates that adverse drug reactions may contribute to over 170,000 deaths annually in the U.S. – making medication errors and adverse effects the 4th leading cause of death in America.

Yet on the health insurance front, pharmaceutical spending continues to be a major driver of healthcare costs, with prescription drug expenditures rising at 11.4% in 2023 – still outpacing overall inflation and general healthcare cost increases.

It seems that the human affinity for "the quick fix" has become so strong – so cellular – that we're clamoring to ingest more of the pills that constitute one of the leading causes of death in this country! Or are we being driven to do so? I still remember reading 'Two, Four, Six, Eight... This Pill Works Great!' in the Wall St. Journal, back in 2003!

Treatments, not cures
Somewhere along the way, healing became the purview, not of the human mind/body system, but of the sick care, er, health care system. Healing no longer came from within the body, it came from the hands of the physician, from the equipment of the hospital, from the pills of the pharmaceutical companies.

Oliver Wendell Holmes said, "If all the medicine in the world were thrown into the sea, it would be bad for the fish and good for humanity." Notwithstanding the era from which the quote comes, we would do well to consider the following current news stories regarding pharmaceuticals:

• FDA Black Box Warnings - The FDA continues to add serious warnings to numerous popular medications. For example, SSRI antidepressants still carry warnings about increased risk of suicidal thoughts, particularly in young adults. These medications (including updated versions) remain among the most prescribed in America despite these concerns.

• Diabetes Medications and Cancer Risk - Several popular diabetes medications have been flagged for potential increased risk of certain cancers, yet they remain heavily prescribed and advertised.

  

• Opioid Crisis Aftermath - After years of pharmaceutical companies aggressively marketing opioid painkillers as safe while downplaying addiction risks, the resulting epidemic has claimed over 727,000 lives since 1999. Major settlements totaling over $50 billion have been reached, yet the human toll continues.

• COVID-19 Vaccines - While these have undoubtedly saved millions of lives, the accelerated approval process and limited liability for manufacturers raise important questions about pharmaceutical regulation and risk assessment.

• Precision Medicine Pricing - New "targeted" therapies for cancer and rare diseases often cost hundreds of thousands of dollars annually per patient, raising serious questions about access and equity in healthcare.

But supplements need more regulation
Meanwhile, regulatory agencies continue pursuing increased oversight of dietary supplements and natural remedies. In 2022, the FDA announced new initiatives to "strengthen regulation of dietary supplements," despite the remarkably low incidence of serious adverse events compared to pharmaceuticals.

Major medical organizations regularly express concern about Americans' use of natural supplements like Melatonin (naturally produced by the body), Glucosamine (naturally produced by the body), and herbal remedies, while pharmaceutical companies fund research questioning their efficacy. Yet these same entities remain largely silent about the astronomical costs and serious side effects of many prescription medications.

The last word
Pharmaceutical research has been a significant part of the evolution of Western medicine. Its contributions are many, and pharma's usefulness in easing the symptoms of disease has been regularly validated. But the body's own internally-produced medicine, self-healing powers, and curative nature are primary, and we must remember our own role in healing. When we begin to believe that drugs can cure us, we embark upon the path towards pharmania, and as the above notes indicate, that path can be more perilous today than ever before.

Human health is, first, a human issue, not a pharmaceutical one, and it is primarily a personal responsibility, not a corporate one. As they say in Economics 101, "Caveat Emptor."

~ Mark Head
© 2025. All Rights Reserved.

*Leading Causes of Death in the U.S. (2023):

• Heart disease: ~700,000

• Cancer: ~600,000

• COVID-19: ~185,000

• Accidents: ~170,000

• Stroke: ~150,000 (Data from CDC)

Aspirations
"A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses."
~ Hippocrates, "Regimen in Health"

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