Introduction

For years, the public has viewed the pharmaceutical industry negatively. Negative public sentiment reached particularly low levels in 2019. In Gallup’s annual survey of opinions about different industries, the pharmaceutical industry ranked dead last, with 58% viewing it negatively and only 27% viewing it positively. In fact, these ratings were the lowest since Gallup began collecting data on different industries in 2001. According to Gallup’s analysis, high drug costs, massive advertising and lobbying spending and the opioid crisis have all tarnished the industry’s public image (McCarthy, 2019).

However, some data suggests that public opinion of the pharmaceutical industry dramatically improved during the pandemic (Anderson, 2021). In a March 2021 survey of likely voters conducted by the progressive think tank Data for Progress, results showed that a majority of respondents (56%) had favorable opinions of pharmaceutical companies. Gains for Pfizer and Moderna, two of the companies developing Covid vaccines, were even more notable, with 65% and 60% respectively reporting favorable opinions of these companies (Chen, 2021).

In contrast, however, Harris polls reported 45% positive perceptions in both 2022 and 2023 – lower, admittedly, than the 62% high in 2021 but still higher than pre-pandemic levels (Endpoints, 2024).

Whatever the general sentiment about the industry, we know the public is concerned about high drug prices (Lawson, 2021; Hamel et al., 2022) and the extent to which these prices are driven by profit motive. Findings in this area have been mixed. In a 2021 Kaiser Family Foundation survey, while 78% believed profit was a major contributing factor to drug prices, 68% believed research and development was a major factor as well. (Hamel et al. 2022). A recent DOAR survey, conducted in 2023, explored this issue and found that residents of New Jersey and Delaware, two states with large pharmaceutical company presences, held largely favorable views of pharmaceutical companies. Moreover, these positive views prevailed despite many respondents’ beliefs that pharmaceutical companies prioritized profits over patients.

In our latest research, DOAR expanded the study to a national sample and included additional timely topics, including the opioid epidemic and pricing issues around new weight-loss drugs.

Key Findings

Opinions of the Pharmaceutical Industry

Consistent with our 2023 research in New Jersey and Delaware, this national survey found that attitudes toward the pharmaceutical industry were more positive than negative. Forty-six percent of respondents described their opinions as generally favorable, 20% as neutral, and 34% as generally unfavorable.

Several Key Issues Drove Opinions

Respondents were asked how, if at all, three particular issues had influenced their opinions of the pharmaceutical industry: the price of prescription drugs, the development of COVID-19 vaccines, and the opioid epidemic. The most influential of these three was drug pricing; almost 60% said this had changed their opinion of the industry in a negative way. In a close second, 54% said the opioid epidemic changed their opinion, also negatively. The third, factor, however, had a largely positive effect: 41% said the development of vaccines for COVID-19 had improved their opinions of the pharmaceutical industry.

Drug Prices and Opinions About the Pharmaceutical Industry

When asked to choose among three categories of costs (research and development, manufacturing, and marketing/advertising) as well as profits made by pharmaceutical companies and to identify the main driver of prescription drug prices, 60% of the sample chose profits. It is noteworthy that among those who had earlier indicated that their opinions of the industry were negatively influenced by drug prices, 77% thought prices were primarily driven by profits. The widespread attribution of high prices to a profit motive rather than to covering operating costs explains the overwhelming negative view toward high prices.

Consistent with this, in a forced-choice question, two thirds of the sample agreed that the pharmaceutical industry is most concerned with maximizing profits, rather than with the notion that they prioritized saving lives and improving health.

While this belief in the companies’ profit motive was widely held, it was more prevalent in some subgroups than others.

Drug Pricing and Weight-Loss Drugs

The survey also revealed other concerns that the American public has regarding pricing of and access to weight-loss drugs like Ozempic and Mounjaro. We asked people who they believed was more responsible for some Americans lacking access to the newest prescription drug treatments: pharmaceutical companies that set prices too high, or insurance companies that refuse to cover the costs. Sixty percent of the sample believed pharmaceutical companies set the prices too high, denying many access to these new drugs.

Interestingly, respondents were more evenly divided on the solution for covering these high costs. In a forced choice question, just over half agreed that “Insurance companies and public programs like Medicare should cover the cost of weight-loss drugs to ensure access for all” while just under half agreed that “Insurance premiums and taxpayer costs would skyrocket if weight-loss drugs were fully covered.”

Prescription Drug Use and Opinions About the Pharmaceutical Industry

The data also offers insight into who holds the most positive views of the industry. Strikingly, views were most favorable among those who took prescription drugs on an ongoing basis. They had the highest favorability scores, followed by those who took such drugs occasionally when prescribed for illness or a short-term condition. The least favorable views were held by those who reported they never took prescription drugs.

The data suggests that those using prescription drugs regularly have a different perspective on the cost-benefit analysis from those who never take them. This finding is reminiscent of an interesting finding in our 2023 survey, that those who were significantly affected either medically or financially by the COVID-19 pandemic had more favorable views of the pharmaceutical industry and were less likely to attribute high prices to profit motives than were those less affected by the pandemic. Again, we suspect that they recognized and appreciated the massive benefits conferred by the development of vaccines and focused on those more than on cost issues. This pattern is something to bear in mind as we consider how life experiences predispose some jurors to be more or less favorable to litigants in cases involving the pharmaceutical industry.

The Role of the Opioid Crisis

Over half of the sample reported that their views of the pharmaceutical industry had changed negatively as a result of the opioid crisis. The opioid crisis had highly personal relevance for over a third of survey respondents: 35% said they and/or someone close to them had been personally affected by the misuse or abuse of an opioid such as oxycontin or fentanyl.

More broadly, however, respondents perceived opioid abuse as a problem in their communities: 31% saw it as a big problem in the area in which they lived and 40% saw it as somewhat of a problem. Moreover, they were interested and concerned about it; 70% indicated that they followed stories in the media about the opioid crisis either very closely (22%) or somewhat closely (48%).

Community exposure to opioids emerged as a significant predictor of feelings about the pharmaceutical industry. The more respondents saw opioids as a big problem where they lived, the more they perceived the industry negatively – and, the more they saw profits as the main driver of prescription drug prices. Perhaps surprisingly, though, those with personal experience with opioid abuse did not view the industry differently than others. It may be that because they had a much closer view of how the abuser (mostly someone close rather than the respondent) accessed the drug and tended to place blame further down in the supply chain – with the doctor prescribing the drug or the dealer selling it, for example.

Attitudes Toward the Pharmaceutical Industry Across the Globe

Respondents were asked to rank their opinions of pharmaceutical companies in six global regions: China, Europe, India, Israel, Japan and the United States. Not surprisingly, the US was ranked most highly (with a mean rating of 3.74/5), followed by Europe (3.36). China received the lowest rating (2.21).

A number of factors influenced respondents’ views of these global regions and particularly, of pharmaceutical companies in the US and in China. The strongest of these was political affiliation. Republicans held dramatically more negative views of Chinese companies than did Democrats.

Men and Whites viewed both Chinese companies more negatively and US companies more positively than their demographic counterparts. Additionally, those who lived in suburban or rural areas held particularly negative views of Chinese companies though they did not differ from their counterparts with regard to US companies. Conversely, those with college degrees and those with incomes over $75,000 (notably, a group less likely than others to be denied care due to cost) held more positive views of US companies than did their counterparts. These data have great utility for jury selection in cases involving Chinese and US litigants.

Who Holds the Most Positive and Negative Opinions Overall?

Finally, we examined who held the most positive and negative opinions of the pharmaceutical industry.

Key Takeaways & Recommendations

The Bottom Line

There are several important takeaways from this survey. First, we may still be seeing something of a “COVID bump” in attitudes toward the pharmaceutical industry, so those litigating cases in the immediate future may still see less of the anti-industry bias than they might expect. Evidence suggests, however, that the bump is receding, and the industry is likely to lose the favorability benefit that it briefly gained during the pandemic. In the current survey, pandemic experiences were largely unrelated to attitudes about the pharmaceutical industry, in contrast to the very strong association we saw in our survey last year. As the post-pandemic mode continues to become the new normal, even those who most appreciated the vaccine might lose their appreciation for the industry that developed it.

Second, high drug prices are a major concern for people, and many see these prices as driven largely by profit motives. The majority of survey participants hold a perception that the industry prioritizes profit over patients, which is difficult to change. Teaching jurorsabout the legitimate costs that go into drug pricing can be very helpful in this regard. Recent research by DOAR has found that jurors often find industry experts more persuasive than academic experts, which could be particularly important when offering jurors a commonsense view of how drug pricing works.

Third, the opioid crisis plays a role in people’s views of pharmaceutical companies. Interestingly, the nature of the crisis in one’s community plays a stronger role in shaping attitudes than more direct personal exposure. This is a useful point to remember when assessing the risks of a particular venue and weighing individual life experiences during jury selection.

In closing, the survey findings offer both cause for concern and cause for hope. While a majority of views were negative, we saw more positive views than have been found in other research regarding attitudes toward pharmaceutical companies. Additionally, we were able to identify those who are most likely to hold these views, an encouraging trend. DOAR will continue to track these trends and to report on new findings as they emerge.