Pharmaceutical Industry Revenue

Let’s be clear. I’m not a fan of “big pharma” which I believes does excessive profiteering on the misfortunes of individuals and families. However, I blasted someone this week for a comment about the industry “creating diseases” in increase profits.

I realized after making that response that there is a lot of information about the pharmaceutical industry that people don’t have. Unless you have some grasp of sources of revenue, it’s easy to take cheap shots at the industry and ignore the real issues that need fixing.

First, the baseline: Statista estimates global pharmaceutical revenue for 2021 to be $1.42 trillion USD.(1) That’s up from $1.27 trillion in 2020. Big numbers.

  • $794 million of the 2021 number is from prescription drug sales, excluding orphan drugs and generics. That was up from $689 million in 2020.(2)
  • Diabetes drugs account for more than $50 million of 2021 revenue.(5)
  • Covid vaccine revenue outpaced diabetes in 2021, with Pfizer reporting $36.8 billion in revenue (6) and Moderna estimated at $13.2 billion.
  • Oncology drug revenues may actually surpass the Covid vaccine numbers. That’s something I’m still exploring.
  • Finally, once the hoopla fades, profit margins on vaccines are usually much lower than the profits on other disease categories. During the Covid fire drill, profits have been absurd, but that won’t last. More vendors are entering the market (a fourth vaccine was given emergency approval for the US this week) and competition with eat at profits.
  • However, 49% of pharma revenue globally is from North America, reflecting the fact that US consumers continue to pay far more for drugs than do consumers in other countries.

What does all this mean, exactly? Simply, vaccines aren’t the mainstay of the pharmaceutical industry. No one is going to commit fraud to hype a vaccine in the way that was apparently done with opioids. Vaccines are a piece of the pharmaceutical business, not the major part of the business.

Emergencies happen and there will be significant spending to meet challenges when they do. Fire drill research and development is expensive. However, emergencies do have a defined period. While Covid-19 remains a major problem, it is no longer a fire drill — although people declining vaccination are simply begging for early entry to a nursing home.

Of greater concern is pricing and profits for established drugs like insulin. Development costs for these drugs were fully compensated years ago and manufacturing costs are known and relatively constant. Price increases amount to pure profit-taking at the expense of patients and taxpayers.





  1. Vic, great post. In short, Big Pharma makes money by inventing a drug for a new disease or a side effect that you have to take daily for the rest of your life. Just watch TV commercials for a day and categorize the newly named drug that they don’t tell you much about. A lot are supplements or add-on drugs to other drugs. Keith

    Liked by 2 people

    • One of the great sins is when companies take two Tier 1 generic drugs, combine them into a single pill, and market the combined pill at an 800% markup. I’ve seen that. Doctors will write scripts for the combination pill out of convenience, without realizing the massive increase in costs. Insurers are catching on, and refusing to pay for the combo drugs. I’ve sent several clients back to talk to their doctors about that.


      • While watching a TV news program, I understood that, over the last 18 years or so, Health Canada has dramatically refocused most of its resources — which are taxpayer-funded, of course — from consumers’ health/wellbeing, and onto assisting the pharmaceutical industry with its business interests.

        Health Canada places about four times more of its resources, notably staffing and funding, toward getting the pharmaceutical industry’s new drugs onto the market than Health Canada does on consumers’ wellbeing, notably monitoring and recording adverse effects caused by the drugs.

        Does this sound about right to you?


      • No, but I need to know more about the mechanics in order to comment. In the US, drug companies pay significant fees to regulators, covering much if not all of the cost of the approval process. I’ll look into it.

        Liked by 1 person

      • I’d like to add that Health Canada (our version of the American FDA) was established to act in Canadian consumers’ best interests, yet it’s susceptible to corporate lobbyist manipulation.

        For one thing, it allowed novelty-flavored vaping products to be fully marketed — even on corner stores’ candy counters — without conclusive independent scientific proof that the product, as claimed by the tobacco industry, would not seriously harm consumers but rather help nicotine addicts wean themselves off of the more carcinogenic cigarette means of nicotine deliverance.

        A few years before that, Health Canada had sat on its own research results that indicated seatbelts would save lives and reduce injury; it wanted even more proof of safety through seatbelts before ordering big bus manufacturers to install them in every bus.

        Liked by 1 person

      • The US has reversed and forced JUUL vaping products off the market. A lot of push back from the medical community on vaping products.


    • As disturbing as it sounds, due to increasingly common privatized research for corporate profit aims, even science, and perhaps by extension scientific ‘fact’, has become commercialized.

      Research results, however flawed, can and are known to be publicly amplified if they favor the corporate product, and accurate research results can be suppressed or ignored if they are unfavorable to business interests, even when involving human health.

      The term ‘science’ generally gets used a bit too readily/frequently, especially for political purposes. One should be very cautious against blindly buying into (what I call) speculative science, in general.

      Liked by 1 person

      • I have a particular concern about press releases regarding qualitative or preliminary exploratory research where the actual value of the findings is largely unknown. That happens a lot and its confusing to lay readers, including notably politicians.

        Liked by 1 person

  2. Dear Vic

    I don’t know if you consider the person ‘blasted’ as me ‘… the industry “creating diseases” in increase profits’. But the point is the word industry. A ‘dead’ giveaway. They are not in it for health and making people better. That is not good for the industry is it now? Any fool should see that.

    A lot of doctors are just salesmen or women for big pharma. If doctors made people better then they would be out of a job or at least earn a lot less.

    In the UK where I am from, a doctor in the practice I belong to owns the in-house pharmacy I understand. In France this is common practice I believe. Diagnose an illness, prescribe a big pharma product and make more money.

    As most big pharma drugs are neuro-toxic (it is the nitrogen atom in the chemistry that gives this away), they only make people sicker as they only manage the symptoms and will never cure. Which is big pharma’s aim of course.

    You make reference to opioids. I assume you are primarily thinking about the Sacklers.

    Vaccines are not the mainstay, merely part of their product list which they can ‘sell, sell, sell’. The USA is a hot bed of money grubbers which is why 49% of big pharma revenue globally is from North America.

    By the way, if you did mean me to be blasted, then you missed by a mile. Do research properly to give yourself a fighting chance; I like a challenge.

    Kind regards

    Liked by 1 person

    • US law bars physician self-referrals. The closest we get are orthopedic surgeons and inhouse physical therapy units. Physicians don’t own pharmacies and cannot dispense drugs. The problems come from Congress with extended patent protection for new drugs, restrictions on government agencies ability to negotiate prices, restrictions on buying drugs online or from outside the US.

      I don’t agree with your position that drugs make people sicker. Data doesn’t support that.

      I do agree that some drugs are overused and am highly supportive of deprescibing drugs among seniors as age changes the risk-reward balance. And demand for some drugs have fallen as alternative therapies have been uncovered.

      I see your blanket condemnation of the industry as too broad. Reality, as always, is more nuanced.


      • Thank you for your reply. Physicians don’t own pharmacies and cannot dispense drugs, but who is to say a wife or partner who isn’t a physician can’t do that. A conflict of interest can then arise if so.

        In the UK Rishi Sunak’s parents did or do just that according to Wikipedia.

        I did say that most big pharma drugs are neuro-toxic, not all. The ones promoted as so-called anti-viral for Covi 19 such as Remdesivir are for example. On the other hand Ivermectin which some doctors have used successfully is not neuro-toxic as such.

        It is easy to spot a neuro-toxic drug by the nitrogen atom in the atomic structure.

        The pharmaceutical industry should be roundly condemned however. They have taken elements within the natural world and over refined them so they become poisonous and harmful.

        The data supports the harm they do. These neuro-toxic drugs always come with side effect, common side effects. That is what neuro-toxic drugs do. If someone’s immune system is in good order then they should be able to resist the neuro- toxic effects.

        If not then the drugs make that individual sick to a certain degree. If the person’s immune system is very poor they may well die. It is that simple.

        Big pharma have huge amounts of money to advertise their products and ‘bribe’ people to skew data to their advantage. This is why it is said there are lies, damn lies and statistics.

        We are what we eat. If we take in poisons via neuro-toxic drugs then we are poisoned and unwell.

        The elderly do not benefit from neuro-toxic drugs any more than the young. There remain only risks for those who foolishly take neuro-toxic drugs, and the only reward is money for big pharma etc.

        They can have their ‘reward’ but they will be judged accordingly for poisoning and ultimately harming and killing people.


    • Currently the pharmaceutical industry profits from sedating and/or concealing ACE-trauma’s SYMPTOMS via tranquilizers and/or antidepressants. And I wouldn’t be surprised if industry representatives had a significant-enough say in the Diagnostic and Statistical Manual’s original composition and continue to influence its revisions/updates.

      Likely only a small percentage of physicians are integrating ACE-trauma science into the diagnoses and (usually chemical) treatments of their patients. The pharmaceutical industry profits, of course, from the continual sedation and/or concealment of ACE-trauma’s SYMPTOMS via tranquilizers and/or antidepressants.

      Also, I don’t believe it’s just coincidental that the only two health professions’ appointments for which Canadians are fully covered by the public plan are the two readily pharmaceutical-prescribing psychiatry and general practitioner health professions? Such non-Big-Pharma-benefiting health specialists as counsellors, therapists and naturopaths (etcetera) are not covered a red cent.

      For me, the $150-$200+ per hour psychotherapy fee is for a transaction for which there’s only one party that is always a winner — the therapist’s bank account.

      Liked by 1 person

      • $150 to $200 is very cheap by US standards, although there are a number of private organizations that subsidize the cost of care. Many health policies cap what a consumer can spend per year, but those caps can be as high as $12,000

        In my experience, GPs and psychiatrists can be pill pushers, but don’t necessarily do so. The consumer has to push back. Canada is also home to the deprescribing movement for older patients, a very positive step. In any case, for healthy consumers, the GP may be the only doctor they see each year and we want people to get annual physicals to try to catch any disease in its early (more treatable and less expensive to treat) stage, and making the GP no cost does that. In that, Canada is ahead of much of the US.


  3. I genuinely believe that Canadian PMs and premiers are mostly symbolically ‘in charge’, beneath the most power-entrenched and saturated national/corporate interests and institutions. Those elected heads ‘lead’ a virtual corpocracy, i.e. “a society dominated by politically and economically large corporations”.

    Powerful business interests can debilitate high-level elected officials through implicit or explicit threats to transfer or eliminate jobs and capital investment, thus economic stability, if corporate ‘requests’ aren’t accommodated. It’s a political crippling that’s worsened by a blaring mainstream news-media that are permitted to be naturally critical of incumbent governments, especially in regards to job and capital transfers and economic weakening. …

    Within our “universal” health-care system, there are important health treatments that are universally inaccessible, except for those with a lot of extra doe to blow. In Canada, somewhat similar to the U.S., people’s health comes second to maximizing profits, in particular those amassed by an increasingly greedy pharmaceutical industry.

    Indeed, when a federal Liberal government promises Canadians universal generic-brand medication coverage (and such promises almost never happen here) the pharmaceutical industry reacts with successful threats of abandoning their Canada-based R&D (etcetera) if the government goes ahead with its ‘pharmacare’ plan. Why? Because such universal medication coverage, generic brand or not, would negatively affect the industry’s plentiful profits. The profits would still be great, just not as great.

    Meanwhile, we continue to be the world’s sole nation that has universal healthcare but no similar coverage of prescribed medication, however necessary. … A late-2019 Angus Reid study found that about 90 percent of Canadians — including three quarters of Conservative Party supporters specifically — support a national ‘pharmacare’ plan. Another 77 percent believed this should be a high-priority matter for the federal government.

    The study also found that, over the previous year, due to medication unaffordability, almost a quarter of Canadians decided against filling a prescription or having one renewed. Not only is medication less affordable, but other research has revealed that many low-income outpatients who cannot afford to fill their prescriptions end up back in the hospital system as a result, therefore costing far more for provincial and federal government health ministries than if the medication had been covered.

    Recouping research and development (R&D) costs is typically cited by the powerful industry to justify its exorbitant prices and stiff resistance to universal medication coverage public plans, the latter which it’s doing in Canada. However, according to a Huffington Post story, a study conducted by the British Medical Journal found that for every $19 dollars the pharmaceutical industry spent on promoting and marketing new drugs, it put only $1 into its R&D (“Pharmaceutical Companies Spent 19 Times More On Self-Promotion Than Basic Research: Report,” updated May 8, 2013).

    Ergo, in order for the industry to continue raking in huge profits, Canadians and their health, as both individual consumers and a taxpaying collective, must lose out big time. And our elected representatives, be they federal (neo)Liberals or Conservatives, shrug their shoulders in favor of Big Pharma time and again. …

    And I also wonder: Is it just me, or is it a bit curious how the only two health professions’ appointments for which Canadians are fully covered by the public plan are the two readily pharmaceutical-prescribing psychiatry and general practitioner health professions? Such non-Big-Pharma-benefiting health specialists as counsellors, therapists and naturopaths, etcetera, are not covered a red cent. (I’ve never been much of a Coincidence Theorist). …

    And is it just me, or is it a bit curious how the sole two health professions’ appointments for which Canadians are fully covered by the public plan are the two readily pharmaceutical-prescribing psychiatry and general practitioner health professions? Such non-Big-Pharma-benefiting health specialists as counsellors, therapists and naturopaths (etcetera) are not covered a red cent.


    • “Power Elite” theories have been around since the 1950s if not before, and might describe governance in Weimar Germany before HItler upset the system. Arguably, technology makes both elite governance as well as a command economy more practical now than at any time in the past. Lenin would have had a field day with access to today’s tools.

      That said, drug costs in Canada are about 25% of what they are in the US. Most Americans would like to be able to import drugs from Canada, as the Canadian list price is in many cases roughly the same as the insurance copay for a drug here. For both countries, the insertion of venture capital into the development process poses a real threat to future pricing.


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