>>The most profound medical discoveries of my time were penicillin and the Salk vaccine, neither of which came from big pharma.

OK, but neither of those affects heart disease, which is what takes down men like us before our time. That's the nature of healthcare: once the specter of infection was controlled, other diseases raised their heads. I suppose we could have stopped at penicillin and Salk.

>>During the 60's cortisone was heralded as a miraculous cure for arthritis and now it's rarely prescribed and in some cases its use is prohibited.

Asbestos was happening then as well. Maybe you should rail against the building products industry on the same grounds. ;-)

>>In fact, many of the "blockbuster" drugs have been shown to be relatively useless, or in the case of Celebrex mortally harmful.

Nah, that's too far. Everything from anesthetic drugs through antibiotics through heart medications through immunosuppressives for organ transplants through glues for prostheses, all researched and commercialized at a cost of billions by big pharma. Penicillin is relatively useless today, replaced by broader spectrum drugs that also are being overused leading to resistance. Unless new drugs keep being researched and deployed, we may well find ourselves at the mercy of infection again.

>>I've had several "small" pharma clients and I've seen that there are a lot of people working diligently, but they're making huge, huge paydays while doing it.
Some of the margins are obscene.

I've never seen a small pharma make $ while people are working diligently- that's the money drain portion. The big $ comes later- and not usually for small pharma because they can't afford the billions to get there. More usually they're occupying a niche doing something very well.

>>The myth that the high prices fund research is convenient, but it's just that.. a myth.
>>They fund political influence, huge estates and other toys for the principal owners.

Too cynical. If it costs billions to research a drug, asks yourself what sort of return other industries expect if they invest a billion with no certainty of return. Unless you're willing to slap the other industries the same way, all you're saying is that it's uncool to research drugs so take your $ elsewhere.