1. The Advent of ‘Snake Oil’

Our symbols can give us away. For more than a century, the U.S. medical industry has often unknowingly used two similar but different insignias. The first, with one snake wrapped around a stick, is the Rod of Asclepius, the Greek god of healing. But the other one, also widely used, has two snakes coiled around a staff. That’s caduceus — associated, among other things, with thieves in Greek and Roman mythology. Indeed, if you flipped through a newspaper during the early days of America’s pharma industry in the late 19th century, you would regularly come across quacks flogging dubious tonics for all manner of ills.

2. Toffee for Worms

Fresh off the boat from Bremen, Germany, Charles Pfizer and Charles Erhart had big dreams. The cousins bought a red brick building in Brooklyn in 1849 with a $2,500 loan from Pfizer’s father and began manufacturing santonin, a deworming drug they delivered in sweet cones that tasted like toffee. That successful signature product launched what is one of the world’s largest pharma firms today. Pfizer has manufactured and distributed millions of COVID-19 vaccine doses around the world.

3. Surgical Swabs

Robert Wood Johnson cut his teeth working as a teenage apprentice at an apothecary run by relatives. But his lightbulb moment came when he heard medical pioneer Joseph Lister speak in 1876 about a stunning innovation: sterile surgery. Johnson teamed up with his brothers to start their family firm, Johnson & Johnson, which became the first to mass-produce antiseptic surgical gauze and sutures, as well as first-aid kits. By the 1890s, it had expanded to the baby and maternity products used by countless people worldwide. Like Pfizer, it too has produced a coronavirus vaccine.

4. Gelatin Coating

Lister’s lecture wasn’t the only pivotal moment for the American drug industry that year. Col. Eli Lilly, a Union army veteran whose attempts at cotton farming had failed, launched a company in 1876 with his 14-year-old son and two other employees in Indianapolis. The antimalarial drug quinine was their first major success. But it was their invention of the gelatin-coated pill — which made it easier to consume bitter drugs — that transformed modern medicine in the late 19th century. And the company’s drug Prozac, introduced in the late 1980s, was a game-changer for the treatment of depression.

5. Cereal and Coke

Neither of these is a medicine, but both have roots in the health industry. Eccentric Michigan doctor John Harvey Kellogg was brimming with ideas for his famous health resort, the Battle Creek Sanitarium. There were slapping machines and Swedish massages, but the sanatorium was also where Kellogg first experimented with the corn-based cereal that bears his name today. Meanwhile, Coca-Cola started by pitching itself as a health tonic before embracing its image as a soda. Hear these fascinating stories and many more on The Food That Build America, a special OZY and History Channel podcast.

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Toffee-flavored antiparasitics gave it its start. But things turned truly sweet for Pfizer during the American Civil War, which fueled a surge in demand for painkillers. Within seven years of the war’s start, Pfizer’s revenues had doubled. It was also a broader moment of growth for America’s chemists, as both the Union army and the Confederacy set up scientific laboratories to pull together vital drugs from raw materials.

2. No Damp Squib

Former naval doctor Edward Robinson Squibb’s journey as a pharmacist was born out of disgust. Serving during the Mexican-American War in the 1840s, he was so upset by the substandard drugs given to soldiers that he would throw them overboard. He channeled that frustration into a drive for innovation, paving the way for the global biopharma company now known as Bristol Myers Squibb.

3. World War I Bust

Across the Atlantic, Germany was a major hub for pharmaceutical innovations, none more important than Bayer’s development of aspirin. But World War I disrupted Germany’s pharma ambitions. The U.S. seized Bayer’s American assets in 1917. And in 1919, the company’s name and trademarks for the U.S. and Canada were auctioned to Sterling Products Company. It would be 75 years before Bayer could buy them back.

4. World War II Savior

Modern drugs and vaccines undergo rigorous clinical trials before they’re approved by regulators. But there’s likely never been a bigger trial for medicines than World War II. One drug withstood the test: penicillin. In earlier wars, soldiers died more often from infected wounds than from the injuries themselves. Discovered by Scottish researcher Alexander Fleming in 1928, penicillin fundamentally changed the wartime medical landscape, with the U.S. producing 100 billion units of the antibiotic every month during World War II — an impressive manufacturing feat made possible in part by moldy cantaloupes in Peoria, Illinois. It helped at least 100,000 soldiers fighting in Europe in the war’s final year.

5. Cold War Warmth

They waged ideological battles and threatened each other with nuclear weapons. But away from the public gaze, the U.S. and the Soviet Union temporarily partnered on the polio vaccine as the disease ran rampant in both nations. American Jonas Salk had developed a vaccine, but the rush to release it to the public led to 260 cases of polio from an accidentally distributed batch carrying the active virus. There was little appetite for large-scale clinical trials in America by the time a more sophisticated vaccine was developed by Albert Sabin in the mid-1950s. That’s when a team of visiting Russian scientists agreed to collaborate. The vaccine was trialed on 10 million Russian children and was adopted back in the U.S. once proven safe.

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It’s hard to imagine a world without penicillin. What is equally remarkable about the wonder drug is how it became so widespread. Alexander Fleming discovered it, and British and American researchers helped extract the compound. But it was the hectic competition for the penicillin market between all major pharma firms in the 1940s that allowed its mass production at affordable rates. Between 1943 and 1949, the price of penicillin dropped from $20 to less than 10 cents for 100,000 units.

2. Cancer Meds

It’s the next big race. A new breast cancer treatment drug from Eli Lilly is expected to finish its trial run, with the final analysis being published by the end of 2021. The drugmaker says it “has the potential to be best in class. ” It would compete against drugs from Pfizer and Novartis, deepening the rivalries between the three companies vying to treat the more than a quarter of a million American women (and more than 2 million worldwide) diagnosed with breast cancer annually.

3. The J&J Fortune

The heir to the J&J empire, 76-year-old J. Seward Johnson Sr., married his 34-year-old maid, Polish immigrant Basia Piasecka, in 1971. The feud it sparked nearly tore apart the Johnson family. Basia inherited her husband’s fortune when he died in 1983, prompting his six kids to go to court. After racking up $24 million in legal fees, Johnson’s children got 12 percent, and Basia kept the majority. As one of the world’s richest women until her death in 2013, Piasecka started an eponymous foundation and built a school for autistic children in Poland, among other charitable causes.

4. Left My Heart in Texas

Did you know that the race to implant the first artificial heart found its battleground in Texas? In one corner: Michael DeBakey, a vascular surgeon who had made the Baylor College of Medicine a global medical hot spot. In the other: his former subordinate, Denton Cooley, an ambitious surgeon with Grey’s Anatomy-esque good looks known for his lightning-fast speed and accuracy. Cooley allegedly stole a mechanical heart prototype from DeBakey’s lab, then implanted it into a man waiting for a transplant. When the patient died, the very public feud between the two reached new heights.

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From Regeneron and Roche to Sanofi and GSK, fierce rivals have forged unlikely partnerships during the pandemic. We’ve seen similar partnerships in recent years between Eli Lilly, Pfizer and Merck to bring cancer drugs to Asia. But is this model of cooperation here to stay, or is it only a mechanism to expand when convenient while competing elsewhere?

2. Will the Trust in Big Pharma Last?

The pharma industry hasn’t exactly been synonymous with trust for several years. In 2019, less than half of Americans reported having faith in Big Pharma. But the industry’s speed in working toward effective and lifesaving COVID-19 vaccines instantly helped boost that trust, even in the initial months of the pandemic. Focusing on collaboration between firms and within company ranks could be the key if they’re to build on that sentiment. Is COVID-19 the shot that Big Pharma’s been waiting for?

3. Opioid Legacy

What will accountability look like for drug manufacturers that played a role in the opioid crisis? A California case that kicked off in April might give us answers. The case is the second to actually make it to trial, with lawyers representing Santa Clara, Los Angeles, and Orange counties suing four pharmaceutical companies for making false claims and misleading the public about how addictive opioids are. While they aren’t included in that lawsuit, the Sackler family (owners of Purdue Pharma, the makers of OxyContin) have become the face of Big Pharma feeding the opioid addiction crisis. Purdue, which has filed for bankruptcy, and its owners have offered nearly $4.3 billion in settlements.

4. Zoom Study

Would you be more likely to sign up for a virtual clinical trial than a physical one? They have higher recruitment rates, lower dropout rates and higher compliance. Best of all, they are quicker and cheaper to execute, so companies spend less on them, which should keep drugs cheaper. They aren’t entirely new: Pfizer completed its first virtual trial in 2011. But the pandemic has turned isolated instances into what could be a broader strategy for the future — particularly if being location-blind can start rectifying the lack of racial diversity in most clinical studies.

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