Big Pharma’s Oligopoly on Cancer Drugs: Factors and Solutions

By Jack Miller Nov. 2, 2025

1. Introduction

Although less prevalent than other diseases, cancer has been, for a long time, a source of ailment and death for humanity. In 2023 alone, approximately 2 million new cancer cases and over 600,000 cancer deaths were projected to occur in the United States. Naturally, with such high incidents of cancer cases, pharmaceutical companies have entered and established control in the cancer drug industry, effectively becoming what is known as Big Pharma. The effects of big pharma’s monopoly on cancer drugs are devastating: according to Chairwoman Maloney of the US Congress, AbbVie— a big pharma company — charges $77,000 for a year’s supply of Humira, which is a 470 percent increase from when the drug was first released in 2013. Due to such high costs, 25% of Americans find it difficult to afford prescription drugs. Therefore, this report will examine pharmaceutical companies' primary methods to consolidate oligopolies in the cancer drug industry. By investigating the groundwork of big pharmaceutical companies, the United States can effectively combat the crisis in the cancer drug industry. 

2. Patenting: A Formula for Big Pharma Oligopolies

On a general note, pharmaceutical patents exist to provide companies with incentives for investment in the development of drugs. Typically, patents last approximately 20 years, giving holders the exclusive right to sell a patented drug. Noah Higgins-Dunn, a journalist for The Wall Street Journal, claims that patents, although intended to spur innovation, have ironically blocked innovation in the pharmaceutical industry. Higgins-Dunn states that AbbVie owns 257 patents for Humira and 150 patents for Imbruvica. Their patents entail that generic drugs for these two components cannot enter the market until at least 2036, suggesting that consumers cannot seek cheaper options and therefore have limited accessibility to critical drugs. He posits that big pharma companies such as AbbVie employ abusive patenting practices by receiving countless patents on drugs regardless of whether they are formally approved by US law. However, patents are more intricate than just an exclusive right to sell a drug. In recent years, according to experts like Olga Gurgula, while primary patents are placed on the active compound of the drug, secondary patents grant ownership to specific aspects of the drug, allowing big pharma to maintain patents even if basic patenting on active compounds expires. Thus, secondary patents lengthen a company’s exclusive right to sell a drug for more than 9 years. In fact, I-MAK reports that such prolongation of patents costs Americans over $40 million more than they would otherwise pay. However, it is crucial to note that I-MAK’s organization was established with the sole intention of addressing drug inequity, suggesting that their reports are susceptible to bias. Nonetheless, I-MAK simultaneously states its methodology transparently in its reports, lending credibility to the estimated costs of secondary patenting. 

Critics have added that lobbying contributes to big pharma’s anti-competitive agenda. According to a hearing before the US Committee on Oversight and Reform House of Representatives, when AbbVie’s executives projected that its top-selling Humira cancer drug would face competition from lower-priced drugs, AbbVie used “legally questionable tactics” to block out cheaper versions of the drug from reaching the United States until 2030. Although this hearing does not specify the exact means through which AbbVie cut competition, it provides another perspective to consider when discussing big pharma oligopolies in the context of politics. 

While experts and politicians argue that the patent system allows for oligopolies, Siddiqui and Rajkumar, members of the North American academic medical center Mayo Clinic, offer a contrasting perspective: oligopolies are inherent to the cancer industry. The cancer drug industry is unique in that since most cancers are incurable, patients are treated with the most approved cancer drugs, often sequentially or in combination. This creates a synthetic monopoly since the usage of one drug does not rule out the possibility of using other drugs. Nonetheless, the role of patenting cannot be overlooked, especially when considering the many loopholes in the patenting system that big pharma can exploit. 

3. Oligopolies: Impacts in America

Oligopolies allow big pharma companies to limit competition, significantly reducing access to cancer drugs. Notably, price gouging seems to be the most prevalent in the United States. For example, in 2015, a single syringe of Humira was priced over 1,000 dollars higher in the United States than in countries like Canada, Japan, Korea, and the United Kingdom. Moreover, while AbbVie surged its prices in the US, it dropped prices in other countries. Bernie Sanders, a senior United States senator, points out that while there is value in comparing prices between countries, analysts should also account for price changes between different periods within the United States. In the past, not a single drug sold by Johnson & Johnson, Merck, and Bristol Myers Squibb cost more than $150,000 between 2004 and 2008. From 2019 to 2024, more than half of their drugs cost over 238,000 USD. The fact that cancer drug prices have been rising in the US not only in comparison to other countries but also throughout time suggests that inaccessible cancer drugs are an issue inherent to the United States. Inevitably, there are high stakes to high costs of drugs. Basing their study on global data, Leighl and colleagues (2021) report that limited affordability of cancer drugs was significantly associated with higher symptoms of cancer and quality of life. Thus, preventing such inaccessibility is crucial, and seeking solutions geared specifically toward the US is necessary. 

4. Big Pharma’s Justifications for Exorbitant Prices

Although the need for reform in the cancer pharmaceutical industry is evident, in an attempt to prevent regulations, pharmaceutical companies employ a myriad of justifications for high prices, namely, the need for innovation. Johnson & Johnson, for instance, pointed to the 2017 Janssen U.S. Transparency Report, which states that the company must ensure the sales of its medicine invest in future research and development (R&D). Nonetheless, such justifications miss the main purpose of reforming pharmaceutical companies. According to Feldman (2018), most innovations by big pharma merely modify existing drugs to extend patents. Furthermore, Sean Dickson, the director of West Health Policy Center, and Jeromie Ballreich, a health economist at Johns Hopkins Bloomberg School argue that big pharma is no longer the main source of innovation, and maintaining their profit levels at 15-20% is counterproductive towards the goal of innovation. However, there is room for bias when considering West Health Policy Center’s agenda to “slow the trajectory of rising healthcare costs while improving access to [healthcare]…” Nonetheless, one study conducted in 2022 corroborates the report’s concerns regarding innovation, as it found that big pharma engaged in misconduct to increase sales and overcome innovation deficits. Thus, as big pharma chooses to profit rather than invest in innovation, governments warrant justification to regulate big pharma even if they claim that such regulations would decrease innovation.

5. Conclusion

Through patents, lobbying, and taking advantage of the nature of the cancer industry, big pharma keeps drug prices too high for countless Americans. As a solution, economist Dean Baker proposes nationalizing drug research and development to shift the responsibility of drug development from private companies to the National Institutes of Health. This would allow the research costs to be paid by the National Institutes of Health, and consumer prices would therefore reflect true, unhampered costs. After all, big pharma has time and again justified high drug prices by citing significant research costs. However, potential sources of error in this solution appear when discussing the characteristics of pharmaceutical companies. As aforementioned, since cancer drugs are used sequentially, big pharma companies can still charge high prices for their drugs. Nevertheless, removing justification employed by big pharma companies, nationalization of cancer drugs is a feasible model for reducing costs and thereby improving accessibility for American citizens in need. 

Works Cited

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