Pharmaceutical Networks: The Political Economy of Drug Development in the United States, 1945–1980

Pharmaceutical Networks: The Political Economy of Drug Development in the United States, 1945–1980 DOMINIQUE A. TOBBELL Pharmaceutical Networks describes how American drug firms, biomedical researchers, physicians, and Congressional reformers C  The Author 2009. Published by Oxford University Press [on behalf of the Business History Conference]. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org. doi: 10.1093/es/khp039 Advance Access publication August 12, 2009 DOMINIQUE A. TOBBELL is an assistant professor in the Program in the History of Medicine at the University of Minnesota. Contact information: Program in the History of Medicine, University of Minnesota, 510A Diehl Hall, 505 Essex St., SE, Minneapolis, MN 55455. E-mail: dtobbell@umn.edu. I thank my advisor, Ruth Schwartz Cowan, and the rest of my dissertation committee—Rosemary Stevens, Arthur Daemmrich, and Susan Lindee—for their generous support, advice, insights, and careful critique. Daniel Carpenter , my faculty mentor at the Miller Center, generously shared with me his knowledge of the Food and Drug Administration and astute analysis of the pharmaceutical industry, for which I am grateful. I owe a great debt of thanks to Louis Galambos, who generously supported this project—and its author—throughout its development. The research and writing of my dissertation was materially supported by a Miller Center Fellowship, a Rovensky Fellowship, a Haas Fellowship from the Chemical Heritage Foundation, a Lemelson Center Fellowship from the Lemelson Center for the Study of Invention and Innovation, a William Penn Fellowship from the University of Pennsylvania, and a Thouron Award. I also received a very helpful research grant from the American Institute for the History of Pharmacy. The dissertation could not have been written without the patience and dedication of the archivists at the libraries and archives I consulted, including the University of Pennsylvania Archives, the National Academies Archives, the Chemical Heritage Foundation Archives, the Library of Congress, and the Archives Center of the National Museum of American History, Smithsonian Institution . Thank you also to Jeff Sturchio for granting me access to the Merck Archives. Thanks also go to my stalwart dissertation writing group—Hilary Smith, Corinna Schlombs, Emily Pawley, and Divya Roy—who were a great source of editorial suggestions, careful critique, and encouragement throughout the writing of this dissertation. Finally, I thank Danny Muñoz-Hutchinson for his continuing support. 675 676 TOBBELL shaped the research, regulatory, and policy environments for prescription drugs in the three decades after World War II. In these decades, pharmaceutical reformers in Congress sought to secure passage of legislation that would increase the government’s control over drug development , distribution, and practice. They proposed these reforms as a way of curbing the high cost of prescription drugs and putting a break on the escalating health care costs. To defend itself against this reform movement, the American drug industry built alliances with research universities, medical schools, and professional medical societies by offering to the medical and academic communities solutions to their shared problems. These problems included a shortage of biomedical workers and the increasing authority of the government over medical practice. The industry’s solutions helped strengthen the biomedical workforce and restricted the government’s control of the health care system. Based on research in corporate archives, the papers and oral histories of pharmaceutical researchers and executives, various government and congressional documents, and the trade and biomedical literature, this dissertation shows that the current political economy of drug development, and the political culture that sustains it, evolved through the mutually beneficial relations between industry and the biomedical community.1 Pharmaceutical Networks is divided into two parts. Part I describes how the American drug industry and the medical profession came to be allies against federal reform, by detailing the relationships that drug firms developed with physicians, academic researchers, and their institutions in the decade after World War II. Part II then details the political strategies used by that pharmaceutical–medical alliance to influence public opinion and shape legislative reform in the 1960s and 1970s. In doing so, this dissertation describes the transformation of the American drug industry from a collection of disparate manufacturers into a unified and politically activist industry, one that played a significant role in the development of American health...