The "Cost of Business"

A report released by Public Citizen, shows that "stronger enforcement is needed to deter pharmaceutical manufacturers from continuing to break the law and defraud federal and state health programs," according to a press statement. The report catalogues all major financial settlements and court judgments between pharmaceutical companies and federal and state governments from 1991 through 2015, which totaled $35.7 billion. The pharmaceutical industry's $711 billion in global net profits from just one decade (2003-2012) dwarf the $35.7 billion in penalties recovered over the last quarter century.

Within that 25-year span, overcharging of government health insurance programs—mainly drug pricing fraud against state Medicaid programs—was the most common violation, while the unlawful promotion of drugs was the single transgression that resulted in the largest financial penalties. Big Pharma giants GlaxoSmithKline and Pfizer reached the most settlements (31 each) and paid the most in financial penalties—$7.9 billion and $3.9 billion, respectively—to the federal and state governments.

Dr. Sidney Wolfe, founder and senior adviser to Public Citizen's Health Research Group, "Breaking the law shouldn't be profitable, especially not when patients' health and lives are on the line." He added: "Larger financial penalties, especially for repeat offenders, and jail time for executives implicated in criminal activity might actually change the calculus, so that the consequences of lawbreaking are no longer just a cost of doing business for Big Pharma."

The Pharmaceutical Research and Manufacturers of America (PhRMA) lobbying association "has worked to obscure recent scandals in drug pricing, arguing simply that pricing is complex." Furthermore, they add, "The biomedical research and development system that PhRMA defends has failed the sick, bankrupted public programs, and left millions of poor people to die worldwide," according to Public Citizen. PhRMA is pushing for longer-term monopolies in corporate-friendly trade agreements like the Trans Pacific Partnership (TPP) and the Transatlantic Trade and Investment Partnership (TTIP), despite evidence that such deals would delay the production and availability of lifesaving, affordable generic medicines.