ABSTRACT
The pharmaceutical industry, with more than US$1 trillion in sales annually and the highest level of profits of any major industry, is a nearly ubiquitous presence of the modern world. In this chapter I provide an overview of the industry's “ghost management” of medical science. This is when drug companies and their agents control or shape multiple steps in the research, analysis, writing, publication and dissemination of science, in ways that may not be entirely visible. Through constant and multiple interventions, drug companies have become the most influential of contributors to medical knowledge, and have normalized both their seen and unseen presence. We can see this as part of a political economy of medical knowledge, in which a small set of actors have established a certain measure of dominance over the economy as a whole.
