Pharmaceutical Networks: The Political Economy of Drug Development in the United States

Today, one of the most controversial innovation strategies is the one pursued by the American drug industry. These strategies, however, have been in place since the 1950s, when they were equally controversial. Critics berated the industry then, as they do now, for its high profits, its marketing strategies, the high cost of drugs, and the abundance of me-too drugs. These claims made against the industry have endured because the system of pharmaceutical innovation is so poorly understood, even by many of those who work in the system. To foster greater understanding about pharmaceutical innovation and historicize the current crisis in drug development, this dissertation examines the history of the relationships between drug companies, academic researchers, physicians, and government officials between 1945 and 1980. The 1960s and 1970s, in particular, were decades of crisis for the pharmaceutical industry as pharmaceutical reformers in Congress---as a way of curbing the high cost of prescription drugs and putting a break on escalating health care costs---sought to secure passage of legislation that would increase the federal government's control over pharmaceutical development, distribution, and practice. These periods of conflict and structural change provide a window onto the efforts of the pharmaceutical industry to build alliances with research universities, medical schools, and professional medical societies around issues of shared concern. Moreover, they reveal the mutuality of this alliance building as biomedical researchers and their academic institutions actively sought out and solicited collaborative relationships with pharmaceutical firms. The drug industry was able to build political support for itself in the second half of the 20th century and defeat the more radical agendas of pharmaceutical reformers by offering to the medical and academic communities solutions to their shared problems. These problems included a growing manpower shortage in the pharmaceutical and biomedical sciences and the increasing authority of the FDA---and the government more generally---over medical practice. In this way, the current political economy of drug development, and in particular the political culture that sustains it, can be seen as having evolved through the mutually beneficial relations of industry and key sectors of the biomedical community.