Peak Pharma : Toward a New Political Economy of Health

Abstract

This book argues that we have reached the ‘peak’ of a particular model for pharmaceutical innovation—the neoliberal value model that has been in place since the early 1980s. ‘Peak’ designates a state where a given and socially significant resource becomes rarer, more difficult to access, and more expensive, to a point where the balance of societal costs incurred and value gained reaches a tipping point. We argue that the neoliberal pharmaceutical system is reaching its ‘peak’ in several vital respects: peak pricing, peak concentration, peak financialization, peak expansion. We thus use the term to signal the crisis and possible end of an era-defining business model in the pharmaceutical sector. The book presents empirical research and synthesizes a large body of knowledge that is currently spread across political economy, sociology, STS, organization studies and the history of medicine to trace the long-wave movements between the pharmaceutical industry, its discontents, and regulators. Specifically, we follow the multiple market failures that the neoliberal regime created and the various contestations and attempts at market repair these failures engendered. Projecting what might follow post-peak, we sketch two scenarios. The first is a dystopian one, the pharmafeudal value regime, where the alienation and exclusion the system has fostered is being driven ever-further through developments in so-called personalized medicine. The second is a more optimistic, dare we say utopian, one that we call the commons-based value regime, where current experiments with alternative pharmaceutical economies are systematically supported and come to represent a true alternative to the current market forces at play. We close this book with a set of recommendations for policymakers and activists interested in fostering such an alternative pharmaceutical model.