The production of pharmaceutical knowledge

Paul Martin

Chapter 1 in Handbook of Pharmaceutical Science and Technology Studies, 2026, pp 20-25 from Edward Elgar Publishing

Abstract: Part I examines how pharmaceutical knowledge is produced, organized, and governed within contemporary capitalism. It challenges the dominant “Big Pharma” paradigm, which portrays large multinational firms as the primary engines of innovation, risk-taking, and value creation in drug development. Drawing on contributions that span political economy, sociology of knowledge, regulation, and innovation studies, the section demonstrates that many of the assumptions underpinning this hegemonic model – regarding costs, productivity, risk, and clinical value – are empirically and conceptually flawed. The chapters trace how pharmaceutical innovation is shaped by complex relations between public and private actors, contesting linear models of translation from laboratory to clinic. They highlight how public research infrastructures, regulatory frameworks, patient populations, and socio-technical imaginaries co-produce pharmaceutical knowledge and markets. Particular attention is paid to structural transformations within the industry, including financialization, the rise of biotechnology, precision medicine, new therapeutic modalities, and the growing dominance of high-priced specialist and orphan drugs. These developments are analyzed as part of a broader sociotechnical transition with significant implications for access, equity, and global health. The section also foregrounds processes of inclusion and exclusion in clinical research, showing how trial designs and regulatory practices actively constitute patient populations, often reproducing historical inequalities. Finally, it explores emerging alternatives to the dominant innovation model, including social pharmaceutical innovations, public and non-profit drug development, and new policy instruments aimed at steering innovation towards public health needs. Collectively, the chapters demonstrate how Science and Technology Studies can both deconstruct industry myths and contribute to imagining and realizing alternative pharmaceutical futures.

Keywords: Pharmaceutical innovation; Science and Technology Studies (STS); Big Pharma; Knowledge production; Regulation and political economy; Alternative pharmaceutical futures (search for similar items in EconPapers)
Date: 2026
ISBN: 9781035338443
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