Alex Chow wanted to make the perfect drug. So he bought factory space and set up equipment to pump out a pharmaceutical that worked wonders, with no side effects. Problem was, that put him into ruinous debt. So he switched strategies, creating cheap drugs with bad side effects. Bingo. The money rolled in.
And that’s exactly how Big Pharma is supposed to work.
Not Big Pharma, the pharmaceutical industry. Big Pharma, the computer game.
The brainchild of British computer game developer Tim Wicksteed, Big Pharma lets you build your own pharmaceutical company from the ground up. You start with a factory floor, some raw materials, and a wad of cash. You can use your funds to build equipment that turns the ingredients into drugs. When pills — or sachets, syringes, or creams — exit your factory, the simulation lets you know how much they sold for on the market.
The game isn’t completely true to life, and Wicksteed said it’s not supposed to be. For one thing, you can’t manually set the price of your drugs. For another, there’s no regulatory body to review them.
But Wicksteed said he designed it to force players to grapple with real-world ethical dilemmas. Indeed, one player posted code online that jacks up the prices of certain drugs; referring to the pharma exec who did just that, he calls it “Martin Shkreli’s Mod.”
As Chow found, creating incredibly effective drugs can hurt your bottom line. They might not command a high-enough price to be profitable — or they might cure the disease altogether, reducing demand for the drug.
“I started to realize curing people too quickly was a bad way to make a profit,” said Chow, a freelance video game artist in Toronto. He was more successful when he made the drug a bit flawed, so customers “keep buying and buying and buying,” he said.
“I’m doing exactly what I think is morally incorrect,” Chow said. “But I guess, for the sake of the game, I kind of have to do it.”
Big Pharma was released in August, just before drug pricing took off as a hot political issue in the US.
The pharmaceutical industry lobbying group Pharmaceutical Research and Manufacturers of America, or PhRMA, which has been trying to improve drug companies’ public image, declined to comment on the game. But some players have drawn clear parallels between the cartoonish simulation and real-world events.
“Martin Shkreli’s Mod” increases the price of malaria, AIDS, and HIV medication by about 5,500 percent, according to the creator’s Reddit post. That’s meant to mimic the price hike Shkreli made with a decades-old drug, Daraprim, used to fight infection in AIDS patients.
Brooklyn pharmacist Jennifer Rabbin-Lau, who has played the game, said the Shkreli code shows how irresistible it is to chase profits once you start playing.
“You want that money,” Rabbin-Lau said of the game. “I don’t care that you need this drug or you’re gonna die. You just want the money.”
While Wicksteed made the game for the general public, the scientific and medical community is also starting to take note. The Lancet reviewed Big Pharma in October, noting that it shows players “how easy it is to be villainous once the debts are piling up and the next big breakthrough is the only thing that matters.”
And Rachel Sachs, an academic fellow at Harvard Law School, is thinking of including the game in a class she’s teaching in the spring about innovation in the pharmaceutical industry.
Wicksteed said he hopes the game makes people think critically about the pressures facing the industry. Most players “start off trying to make the best cure possible and realize that’s not going to make the most money. They start thinking in different ways,” he said.
“For me,” Wicksteed said, “that’s mission accomplished.”