In an episode that aired in October of 2024, The Past Weekend with Theo Vaughn, Vice President JD Vance dove into a heated discussion about Big Pharma’s influence, hormone therapy for kids, and the opioid crisis, including drugs like OxyContin.
The conversation shed light on how pharmaceutical companies profit from vulnerable populations, how lobbying fuels political decisions, and what’s at stake for America’s health system. This article breaks it all down in simple terms, with real quotes from the podcast, key facts about lobbying, and a look at who’s profiting—and who’s fighting back.
JD Vance and Theo Von on Big Pharma’s Profit Motives
During the podcast, Vance and Von tackled the issue of Big Pharma’s role in pushing hormone therapy for kids, particularly for gender transition procedures. They argued that pharmaceutical companies are making massive profits by exploiting young people’s vulnerabilities. Vance expressed concern about the long-term impact of these treatments, saying, “Are you not at all a little bit worried about how rich people are getting by prescribing experimental therapeutics to 9, 10, 12-year-old kids?”
Theo Von echoed this, pointing out the financial incentives driving these treatments: “It’s terrifying once pharmaceutical corporations have—they have a pattern and a history of profiting off things.” They suggested that the profitability of hormone therapy and other drugs keeps them on the market, even when risks are known.
Vance used an analogy to make his point: “My four-year-old will come to me and say ‘daddy, I’m a dinosaur.’ Want me to take him to the dinosaur transition clinic and put scales on him?” This highlights his belief that kids are too young to make irreversible medical decisions.
The conversation also touched on other medications, like vaccines and painkillers, with Vance and Von questioning why harmful drugs remain available. They specifically mentioned OxyContin, a powerful opioid produced by Purdue Pharma.
OxyContin is indeed an opioid, and despite its role in fueling the opioid crisis, it wasn’t pulled from shelves when addiction rates soared. Instead, Purdue Pharma aggressively marketed it, leading to widespread addiction and overdoses.
According to the CDC, over 70,000 drug overdose deaths occurred in the U.S. in 2021 alone, many linked to opioids like OxyContin. Purdue faced lawsuits and paid billions in settlements, but the damage was done.
OxyCotin is still available as of today, but it is not prescribed by doctors as readily as it has been in the past.
How Politicians Profit from Big Pharma Through Lobbying
Lobbying is how Big Pharma influences politicians, and it’s a big business in Washington, D.C. Lobbyists are hired by pharmaceutical companies to push for laws and policies that protect their profits.
They do this by meeting with politicians, donating to campaigns, and offering perks like speaking fees or consulting gigs after politicians leave office. This creates a system where politicians may prioritize corporate interests over public health.
Big Pharma lobbies to keep drug prices high, extend patents, and avoid strict regulations.
For example, they fought against Medicare negotiating drug prices, which could lower costs for consumers. Politicians benefit through campaign contributions and personal financial perks, ensuring their re-election or future job prospects.
Lobbying happens year-round, but it spikes during major legislative battles, like healthcare reform or drug pricing laws. For instance, when Congress debated the Inflation Reduction Act in 2022, which allowed Medicare to negotiate prices, Big Pharma spent heavily to influence the outcome.
How Are They Getting Away with It?
The lobbyist system is legal and deeply entrenched. Lobbying is protected as free speech, and campaign finance laws allow large donations through PACs and Super PACs. Transparency laws require lobbyists to report spending, but loopholes and vague disclosures make it hard to track every dollar. Plus, many politicians rely on these funds to win elections, creating a cycle of dependence.
How Much Do Lobbyists and Big Pharma Make?
In 2023, the pharmaceutical industry spent $383.6 million on lobbying, employing 1,871 registered lobbyists in D.C., according to OpenSecrets.org.
That’s more than three lobbyists for every member of Congress. Over the past 25 years, Big Pharma has spent $8.5 billion on lobbying and contributed $700 million to political campaigns, split between Republicans and Democrats. Meanwhile, companies like Pfizer and Moderna report billions in annual profits, partly from high-margin drugs like hormone therapies and vaccines.
Hormone Therapy: Costs vs. Production
Hormone therapy for kids, often used in gender-affirming care, is a profitable segment for Big Pharma. The cost of hormone therapy varies widely:
- Monthly Cost to Patients: Hormone replacement therapy (HRT) can cost $30–$100 per month without insurance, totaling $360–$1,200 per year. Puberty blockers, used for younger patients, can cost $500–$1,500 per month, or $6,000–$18,000 annually.
- Cost to Produce: Generic hormones like estrogen or testosterone are cheap to manufacture—often pennies per dose. Puberty blockers, like Lupron, have higher production costs but are still far less than retail prices. The markup is where profits lie, with companies charging 10–100 times the production cost.
At What Age Can Kids Start Transgender Hormone Therapy, and Is Parental Disclosure Required?
Transgender hormone therapy for minors typically begins around age 14 to 16, depending on medical guidelines and individual circumstances, with some protocols allowing cross-sex hormones as early as 14 per the World Professional Association for Transgender Health (WPATH) standards.
Puberty blockers, which delay puberty and are often a precursor to hormone therapy, may be prescribed as early as 10 or 11 at the onset of puberty (Tanner Stage 2).
Parental consent is generally required for minors in the U.S., though some states, like Oregon, allow teens as young as 15 to access certain treatments without parental approval.
Disclosure to parents is typically mandated for younger minors, but laws vary by state, and some jurisdictions permit confidential care for older teens under specific conditions, such as mental health evaluations or informed consent models.
Always consult local regulations and healthcare providers for precise requirements. For more details, visit the Human Rights Campaign.
Kids Taking Hormonal Gender Drugs and Undergoing Transgender Surgeries:
Recent data indicates a growing number of minors accessing gender-affirming care.
From 2017 to 2021, approximately 17,683 U.S. children aged 6 to 17 with a gender dysphoria diagnosis began either puberty blockers or hormone therapy, with around 4,780 starting puberty blockers, according to a 2022 analysis of insurance claims.
The number of minors on hormone therapy alone was at least 14,726 during this period. Transgender surgeries for minors are far less common, with 776 mastectomies and 56 genital surgeries reported among teens aged 13 to 17 from 2019 to 2021.
These figures reflect a small but increasing trend, driven by greater awareness and access to gender clinics.
These high margins incentivize companies to push hormone therapy, even for controversial uses like pediatric care, which Vance and Von criticized as “experimental.”
How Lobbyists Approach Politicians
Lobbyists use a mix of analyzed data, and money to sway politicians. Here’s how it typically works:
- Building Relationships: Lobbyists meet politicians at fundraisers, conferences, or private dinners, offering expertise on complex issues like drug pricing or healthcare policy.
- Campaign Contributions: They donate to campaigns or host fundraisers, ensuring access to lawmakers. For example, Purdue Pharma donated to both parties while downplaying OxyContin’s risks.
- Revolving Door: Many politicians become lobbyists after leaving office, earning millions. This creates an incentive to favor Big Pharma while in power.
While direct evidence of “profiting” is hard to pin down due to disclosure loopholes, some politicians are known for close ties to Big Pharma:
- Mitch McConnell (R-KY): Received over $1.5 million in campaign contributions from pharmaceutical companies since 1990, per OpenSecrets. He’s opposed drug price reforms that threaten industry profits.
- Nancy Pelosi (D-CA): Her campaign and PACs have taken over $500,000 from Big Pharma. Critics point to her slow support for Medicare price negotiation as evidence of influence.
- Joe Manchin (D-WV): Accepted $400,000 from drug companies and resisted parts of the Inflation Reduction Act that capped drug prices.
Politicians Fighting Big Pharma
Some lawmakers are pushing back against Big Pharma’s influence:
- Bernie Sanders (I-VT): Even though Bernie has extreme views, Sanders has called out the industry’s 1,800+ lobbyists and their $8.5 billion in lobbying spending. He’s pushed for Medicare-for-All and drug price caps, saying, “The pharmaceutical and health insurance lobbies have spent huge amounts of money to ensure their profits come before the health of the American people.”
- Elizabeth Warren (D-MA): surprisingly, she has advocated for transparency in drug pricing and has sponsored bills to limit patent abuses by pharma companies. The issue with Warren is that her insider activities remain undisclosed.
- Rand Paul (R-KY): Criticizes overregulation but supports lower drug prices and has opposed Big Pharma’s influence on vaccine mandates.
Lobbyists wield significant power in D.C., outnumbering lawmakers 3-to-1 in the pharma sector alone. They shape legislation, delay reforms, and protect corporate interests.
For example, the 2003 law banning Medicare from negotiating drug prices was heavily influenced by pharma lobbying, costing taxpayers billions.
Public Awareness: Social media and podcasts like Theo Von’s amplify criticism of Big Pharma, pressuring politicians to act.
Still, lobbying remains a powerful force, and reforms are often watered down.
Facts About Big Pharma and Lobbying
- Revolving Door Riches: Over 60% of lobbyists for Big Pharma are former government officials, leveraging their connections for high-paying gigs. Some earn $500,000+ annually.
- Ghostwriting Studies: Pharma companies sometimes fund studies or articles, like those cited by Dr. Sally Satel in Vance’s nonprofit, to downplay drug risks, influencing policy without public knowledge.
- Global Influence: Big Pharma’s lobbying isn’t just in D.C.—they spend billions globally to shape health policies, like pushing vaccines in developing countries.
Additional Key Information
- Vance’s Nonprofit Controversy: Vance founded Our Ohio Renewal to fight opioid addiction but hired Dr. Sally Satel, who had ties to Purdue Pharma and downplayed OxyContin’s role in the crisis. The nonprofit raised little money and was criticized as a political launchpad.
- Public Health Impact: High drug prices and overprescribing have real consequences. One in four Americans can’t afford prescribed medications, and opioid deaths continue to rise.
- Grassroots Pushback: Activists and groups like Patients for Affordable Drugs are gaining traction, using social media to call out politicians and demand reform.
JD Vance and Theo Von’s conversation peeled back the curtain on Big Pharma’s profit-driven influence, from hormone therapy for kids to the opioid crisis fueled by drugs like OxyContin.
Lobbyists, spending billions, keep this system in place, with politicians like McConnell and Pelosi reaping benefits, while reformers like Sanders and Warren fight back.
Though transparency and new laws are improving things, Big Pharma’s grip on D.C. remains strong. By understanding these dynamics—how much is spent, who’s profiting, and what’s at stake—we can push for a healthcare system that puts people over profits.
For more details on lobbying and spending, visit OpenSecrets.org.
Watch the full podcast with JD Vance below; via YouTube.
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