$126 billion in penalties.
The pharmaceutical industry has paid over $126 billion in penalties since 2000, with systematic patterns of fraud that treat legal settlements as business expenses rather than deterrents.
Purdue Pharma settlement (2020)
Deaths linked to opioid epidemic
Medical articles ghostwritten by industry
The scale of criminal fines.
Pfizer - $2.3 Billion (2009)
Largest healthcare fraud settlement in history. Illegal promotion of Bextra for off-label uses at dangerous dosages. Kickbacks through lavish trips and speaking fees. Fourth settlement since 2002 - designated "repeat offender."
GlaxoSmithKline - $3 Billion (2012)
Concealed cardiovascular risks of Avandia causing 83,000 heart attacks. Promoted Paxil to children despite FDA rejection and increased suicide risk. Bribed doctors with spa treatments and hunting trips.
Johnson & Johnson - $2.2 Billion (2013)
Promoted Risperdal to elderly despite stroke risks. Marketed to children before pediatric approval, causing male breast growth. Paid kickbacks to nation's largest pharmacy chain.
The opioid epidemic: engineered addiction.
Purdue Pharma - $8.3 Billion (2020)
- • Admitted to criminal conspiracy
- • Knew OxyContin was being diverted for abuse
- • Trained sales reps to downplay addiction risks
- • Targeted high-prescribing doctors regardless of suspicious patterns
- • Result: 500,000+ overdose deaths
Industry-Wide Conspiracy
McKesson: $150M fine. Cardinal Health: $44M. AmerisourceBergen: $885M. Together they flooded 76 billion opioid pills into U.S. communities over 7 years.
Clinical trial manipulation.
Merck - Vioxx Scandal
- • Concealed evidence that Vioxx doubled heart attack risk
- • Ghost-wrote medical journal articles hiding risks
- • Created fake medical journal
- • Caused an estimated 88,000-140,000 heart attacks (40% fatal)
- • $4.85 billion settlement with 27,000 plaintiffs
Systematic Ghostwriting
Industry writes 40% of medical journal articles through ghostwriters. Prominent doctors paid to add names to pre-written studies. Negative trial results routinely suppressed or spun positively.
Price manipulation & patent gaming.
Insulin Price-Fixing Cartel
- • Eli Lilly, Novo Nordisk, Sanofi raised prices 1,200% in lockstep
- • Internal emails showed coordinated increases
- • Americans dying from rationing
- • Same insulin 10x cheaper abroad
EpiPen Monopoly Abuse
- • Mylan raised prices 500%
- • CEO salary: $2.5M → $18.9M
- • $465M settlement for overcharging Medicaid
Regulatory capture & the revolving door.
11 of 16 FDA medical reviewers who worked on drug approvals now work for pharma.
Former FDA Commissioner Scott Gottlieb joined Pfizer board months after leaving.
FDA receives 75% of drug review budget from industry "user fees."
FDA approval rate increased from 60% to 96% after user fee system.
Pharma pays doctors $2.4 billion annually in "consulting" and speaking fees. Doctors who receive payments prescribe 39% more brand drugs.
A business model built on fraud.
Companies treat multi-billion dollar penalties as operating expenses, with fraud settlements averaging just 5% of annual revenues. Until penalties exceed profits and executives face personal criminal liability, this cycle of corruption will continue.