The History of the Pharmaceutical Industry - Part One
From the first prehistoric and mythical cure called Mithridatium to the newest additions of the COVID vaccines, the history of medicine -and that of the pharmaceutical industry- is fascinating to look upon.
Humanity has long accepted the fact that we are not invulnerable to harm or disease, but this does not mean that we have ceased in trying to achieve invulnerability. For as long as humans have been inhabiting this planet, we have always tried to find an all-powerful medicine to cure all diseases and even old age. The first official attempt for such a cure dates back to the first century BC. Mithridate VI, King of the Anatolian Kingdom of Pontus, proudly proclaimed that he had found the medicinal concoction that could be used against all poisons known to mankind. Sure enough, the infamous concoction was named after him, Mithridatium. No one was entirely sure of what was in the concoction, but it did not stop Mithridatium’s popularity from growing until the Renaissance period.
However, Mithridatium was not the only remedy at the time. Before the pill-and-vaccine-dose eras, humans extracted and experimented with various herbs to create natural remedies against sickness. The people extracting and experimenting were known as herbalists. For many centuries, herbalists were what stood between the living and the dead. Until today, some of the ancient remedies remain, especially in Eastern countries. Perhaps, the most well-known herbal remedies are rooted in traditional Chinese medicines. However, modern studies have disputed the healing properties of many of these well-known ancient remedies. While some of these remedies, such as ginseng, lotus seeds, and mung beans are still largely viewed as effective against certain illnesses (sometimes even against cancers), it is still advisable that individuals discuss with their health care providers before using them.
The official beginning of pharmaceutical inspection is speculated to have dated back to 1240. King Fredrick II of Sicily, recognizing the importance of medicine, issued the documentation of the History of Pharmacopoeias, which was a series of books about drug quality standards. However, the pharmacopoeias as we know them today, only appeared in the sixteenth century. In 1540, the first law about pharmaceutical inspection was issued in London, called the Apothecaries Wares, Drugs, and Stuffs Act.
Although, nothing drastic happened in the field of medicine until the scientific revolution of the seventeenth century. The scientific revolution revealed the existence of bacteria, which allowed a new branch of science to be born: the pharmacy. One of the first drugs to be developed during this time was morphine, which was extracted from opium. However, the pharmacy had yet to grow into and become the industry we know of now. The industrial revolution of the nineteenth century was the final factor that led to the commercialization of the pharmaceutical industry, as it provided the necessary chain production and manpower to finally make profits from pharmaceutical products.
In the late nineteenth and early twentieth century, medicine from factories landed directly on the counter without any detour. One could get any kind of drug over the counter without a prescription. Pharmaceutical products were often heavily laced with opium, cocaine, and cannabis. They stood on the shelves with other chemical products like hair gel, citric acid for soft drinks, toothpaste, and even heroin. Drug regulations, if there were any at the time, were far more lenient than they are today.
Sensing easy profits in the air, many old chemical companies in Europe quickly immersed themselves into the booming pharmaceutical market. In 1668, Merck from Germany was one of the pioneers. The company played a huge role in pushing Germany into the leading position of the world in the pharmaceutical race. However, Switzerland quickly usurped the throne with their own home-based pharma companies like Bayer, Sandoz, and Roche. During this period, the lack of pharmaceutical patent laws in Switzerland posed a major problem between Switzerland and Germany, not only regarding pharmaceutical licenses but also regarding the competitive market in which they were competing. The lack of patent laws meant Swiss companies could easily claim a German product as theirs and shifted the German monopoly on the pharmaceutical market to themselves. Their competition later led to the obligatory trademarks of pharmaceutical products.
Over the Atlantic, in the United States, two German immigrants founded Pfizer, which at first focused on the chemicals business that produced dyes, soaps, etc. before switching their focus to the pharmacy. The civil war in the mid-nineteenth century boosted the rise of the pharma industry in the U.S. with its high demands for painkillers and antiseptics. After the war, several pharmaceutical companies were born, such as Lilly and Bristol Myer Squibb.
Against the seemingly uncontrollable wave of pharmaceutical products, in 1906, the FDA (Food and Drug Administration) was founded in the United States. Yet its founding did not bring about any changes right away as the ethics of the booming industry had not yet become a hot topic. Instead, it was rather common for companies to either misbrand the products or tamper with the medical ingredients. Examples of tampering include diluting quinine-containing cinchona bark powder with alum or using clay to mask poor wheat flour. It was clear that profits were sadly more valued than public health.
After the first World War, long-distance communication became easier thanks to the rapid developments of communication technology. Thus the gap between academic researchers, physicians, and pharma was greatly reduced. This led to an exponential growth of the pharmaceutical industry as new products could be discovered and developed much faster. At the same time, European countries started to adopt a national health system (NHS) modelled after England. The arrival of the NHS set up a structured system for prescription drugs and a price-fixing scheme to draw investments for new medical research. In the United States, this investment was overseen by the government.
Slowly but steadily, the ethical concerns regarding drugs spread among the public. Governments around the world started to tighten the medicine regulations with requirements on testing and proof of efficacy. Although, after over a century of lenient registration processes for pharma companies, it was already too late. The first scandal broke out in the United States in 1937 with more than one hundred unfortunate deaths caused by Elixir Sulfanilamide. The disaster forced the U.S. government to tighten drug regulations. Their first action was the implementation of the Food, Drug, and Cosmetic Act in 1938, which required drugs to be labelled with correct instructions for safe use. These labels were soon updated with compulsory governmental approvals before any drugs were allowed on the market. Then, in 1951, a doctor’s prescription was officially obligatory when individuals wanted to buy medicine. These actions proved fruitful as they helped prevent another pharmaceutical scandal from invading the U.S., one that plagued Europe and many other countries, and was also the biggest in history: the Thalidomide scandal.
Herbal medicines were the only remedies for sickness up until the seventeenth century.
The scientific and industrial revolutions are pivotal in kickstarting the rise of the pharmaceutical industry.
Ethical concerns about the pharmaceutical industry were not the center of attention during its early stages.
The first pharmaceutical disaster broke out in the U.S. in 1937, which prompted the country to tighten its regulation of drugs.