{"id":37177,"date":"2016-08-05T12:21:33","date_gmt":"2016-08-05T11:21:33","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=37177"},"modified":"2016-08-05T12:22:57","modified_gmt":"2016-08-05T11:22:57","slug":"when-i-use-a-word-the-pharmaceutical-industry-the-definite-article","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2016\/08\/05\/when-i-use-a-word-the-pharmaceutical-industry-the-definite-article\/","title":{"rendered":"Jeffrey Aronson: When I use a word . . . \u201cThe pharmaceutical industry\u201d\u2014the definite article"},"content":{"rendered":"

\"jeffrey_aronson\"<\/a>A colleague recently asked me to point him to \u201can authoritative definition of \u2018pharmaceutical industry\u2019.\u201d<\/p>\n

The term is one that few have tried to define, perhaps thinking that there is no need. I have searched the many books on my shelves that deal with the iniquities of drug companies, and the few that praise them or are neutral, and have found no definitions. In a few cases an index will cross-reference \u201cpharmaceutical industry\u201d to \u201cdrug companies\u201d, but that\u2019s as far as it goes.<\/p>\n

The website of the Association of the British Pharmaceutical Industry (ABPI) states that the association represents \u201cinnovative research based biopharmaceutical companies, large, medium, and small\u201d, which could be taken as a definition. And the US Census Bureau has defined<\/a> the US pharmaceutical industry as \u201ccompanies engaged in researching, developing, manufacturing, and marketing drugs and biologicals for human or veterinary use\u201d.<\/p>\n

However, I think that to refer to \u201cthe pharmaceutical industry\u201d as if it was a single entity is misleading<\/a>. There are large and small pharmaceutical companies; companies that deal primarily in new compounds, in some cases specialising in biologics; companies that deal primarily in what are loosely called \u201cgenerics\u201d; companies that deal primarily in over the counter medicines; and small companies that spearhead investigations of new compounds before handing them over to bigger companies to develop and market. Some companies do more than one of these things.<\/p>\n

The large companies that are at the forefront of innovation have enough similarities to warrant lumping them together under the heading of \u201cBig Pharma\u201d, a term that is usually treated as a singular noun and was first used at the start of the 1990s to refer to large multinational pharmaceutical companies collectively. This includes companies such as AstraZeneca, GlaxoSmithKline, Johnson & Johnson, Merck & Co, Novartis, Pfizer, Roche, and Sanofi\u2014companies that are big by any standards, and certainly as judged by their global sales<\/a>.<\/p>\n

\"aronson_the_pharma_industry\"
The front cover of the paperback edition of Little Science, Big Science<\/em> by Derek J de Solla Price (Columbia University Press, 1965)<\/figcaption><\/figure>\n

The use of the word \u201cbig\u201d in this sense mirrors its use in terms such as \u201cBig Agriculture\u201d, \u201cBig Business\u201d, \u201cBig Oil\u201d, and \u201cBig Tobacco\u201d. Not to mention \u201cBig Science\u201d<\/a>, a concept that started to become popular in the 1960s, following an article in Science<\/em> by the physicist Alvin M Weinberg<\/a> and Derek de Solla Price\u2019s exquisite little book Little Science, Big Science<\/em>, based on his 1962 George B Pegram lectures (picture).<\/p>\n

The problem in defining \u201dthe pharmaceutical industry\u201d lies not in the word \u201cindustry\u201d nor in the word \u201cpharmaceutical\u201d, but in the word \u201cthe\u201d. For a small word, it uses up a lot of dictionary space. In the print version of the second edition of the Oxford English Dictionary<\/em> \u201cthe\u201d takes up four pages and has three separate entries, as a demonstrative adjective and pronoun, an obsolete relative pronoun, and an adverb. The first of these has 34 sections and about 60 subsections. The etymology and variant forms alone consume nearly a page.<\/p>\n

The demonstrative adjectival form of \u201cthe\u201d is also called the definite article, for good reason. In its general use, it signifies or marks an object already mentioned or known or, as the dictionary puts it, contextually particularised. \u201cA drug\u201d is some drug. \u201cThe drug\u201d is a specific drug.<\/p>\n

James Joyce ended Ulysses<\/em> with \u201cthe least forceful word I could possibly find . . . the word \u2018yes\u2019, which is barely pronounced, which denotes acquiescence, self-abandon, relaxation, the end of all resistance.\u201d When searching for a word with which to end Finnegans Wake<\/em>, known simply as Work in Progress<\/em> when fragments of it were being published, he found \u201cthe word which is the most slippery, the least accented, the weakest word in English, a word which is not even a word, which is scarcely sounded between the teeth, a breath, a nothing, the article the.\u201d But \u201cthe\u201d punches above its weight. It reifies the noun to which it is attached. When politicians, for instance, talk about \u201cthe international community\u201d they want us to think that such a thing exists. Talking about \u201cthe pharmaceutical industry\u201d suggests likewise.<\/p>\n

Jeffrey Aronson<\/strong> is a clinical pharmacologist, working in the Centre for Evidence Based Medicine in Oxford’s Nuffield Department of Primary Care Health Sciences. He is also president emeritus of the British Pharmacological Society.<\/em><\/p>\n

Competing interests:<\/strong>\u00a0None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"

A colleague recently asked me to point him to \u201can authoritative definition of \u2018pharmaceutical industry\u2019.\u201d The term is one that few have tried to define, perhaps thinking that there is […]<\/p>\n

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