Bad Medicine, Good Money: Hands-On With Big Pharma

I’ve never much thought about what goes into the little white tablet I swallow when I’m hungover, have the sniffles or another bout of Geek’s Disease.* It’s just chalky magic, right? Well, no: it’s the result of millions of dollars, aggressive R&D, production facilities of breathtaking size and precision, ruthless marketeering and impossibly sinister downplaying and mitigation of side effects. While medicine-themed management game Big Pharma doesn’t go for pharmaceutical industry’s jugular, Goldacre-style, its pills-as-merciless-industry approach is certainly a welcome change from the bland, smiling, comfortable faces that advertising tells us medicine are all about.

“I’m not keen on introducing obvious heavy-handed consequences, like some sort of bar which says ‘oh, you’re being evil, -20 points’” says one-man studio Tim Wicksteed, aka Twice Circled, whose upcoming pharmaceutical management/strategy game is being published by Positech, of Democracy/Gratuitous Space Battles fame. “I kind of want the player to go on their own journey. What I’d love is for a player to be super-profit-driven and do anything they can then think ‘huh. Was that the right thing to do? Did I actually make the world a better place selling loads of anti-wrinkle cream to rich Westerners?’

Wicksteed hasn’t entirely nailed down Big Pharma’s endgame as yet, but, as this is a game which is half construction and half digging deep in your organisation’s stats, he’s keen that players will be able to discern consequences if they so choose. “If you are causing side effects I’d like you to see the exact number of people who had liver failure or whatever. But also see the effects of your inaction – so if there’s an outbreak of a disease and you don’t make a drug to cure it because you don’t see the financial benefit in it, then imagine the numbers who are affected by it going up and up and up… I would love it if a player said ‘you know what, maybe it’s my responsibility because I can to save these lives.’ It’s a grey area. Is it the company’s responsibility? I don’t know.”

Again though, this is not some painstaking evisceration of the industry, and nor is it intended to be a realistic one. Your time in Big Pharma is split between researching, designing and refining medicines to then be sold at a profit, and the logistical puzzle of building chains of production line machinery within limited floor space. The latter plays like factory floor Tetris, only it’s you deciding to lob another piece into the ill-shaped clutter. Your painkiller’s barely effective, so you need to stick a few Evaporator machines into the production line to increase the pill’s strength, for example. Or your hypertension pill is giving its users nightmares, so you need to introduce Dissolvers into the chain to make it less potent. For every machine, more conveyor belts, and soon enough there’s a spaghetti tangle of production lines competing for floorspace, and a logistical headache once you research a new treatment and simply don’t have the real estate to make it in.

“When you get to those really high level cures you’re talking about quite long production lines”, explains Wicksteed. “You’re getting the concentration to a certain place, then running it through a machine to get to level 2, and then having to do that again and again… there’s up to 5 levels of cure for each cure tree. The blood one, for example, it starts off as a hypertension thing but it ends up as a cure for sickle cell anaemia. Because those machines get more advanced, they get actually get larger, so you’ll really struggle just to get one production line into a single building, let alone multiple ones.“

This aspect of the game plays vaguely like management sims of old – the cost and space issues (and pleasure of order-creation) of a Theme Park or Dungeon Keeper, but with a little Pipemania thrown in there to make it more puzzley. “The mechanical side is more Transport Tycoon or Rollercoaster Tycoon,” thinks Wicksteed. It’s cleanly, appealingly presented and, combined with a cash in/out ticker and assorted screens showing the progress towards new cures and new technology, there’s a clear sense of urgency. Like the recent Offworld Trading Company, this is a strategy game devoid of combat and finding new ways to introduce tension and drama.

In my brief time with Big Pharma on the showfloor at Rezzed earlier this month, I didn’t quite get to see how elaborate these snaking production lines will become, but the construction concept certainly seemed a logical way to add more ‘game’ to what was otherwise clicking buttons, pulling sliders and waiting in order to research, cost and improve your various drugs. You’ll spend a lot of time building, but bubbling away in the background is this R&D metagame. “There are a load of decisions I’ve made because I think it would make it a good game,” admits Wicksteed. “I’m not attached to the idea of making it ultra-realistic.”

First you send explorers out to the rainforest in search of more ingredients, yielding the strange excitement of discovering what they can do and then the more explicable excitement of establishing how much moolah they can bring in. Initial efforts will likely be retired when you come up with an improved version or discover that terrible side-effects are causing harm to your company’s standing (and making people’s lives hell, but only a weakling cares about that, right?).

Long-term, you’re improving and comboing cures to make pills which treat more serious conditions, and in turn mean even bigger profits. “Basically, cures have their own tech tree,” says Wicksteed. “If you get it to a certain point and pass it through a certain machine, then you’ll upgrade to a new cure, like it eases bronchitis or eventually cures tuberculosis. That’s the kind of thing that you’re constantly pushing for, to keep unlocking the machines and to keep finding new ingredients.“

While it’s not entirely embracing reality and it’s not an outright attack on the pharmaceutical industry, Big Pharma does try to be more grounded when it’s got something more pointed to say. “The actual mechanical production of the drugs is not necessarily accurate, but some of the stuff outside of that is more telling. The way that clinical trials will be represented in the game, we’ve actually done that quite accurately. Depending on who you choose to perform them they might be more open to, say, signing a gagging clause which means you, a private company whose interest it is in for this drug to get good results, have the full right to go ‘oh no, we’re not going to publish those results, because we don’t like them.’” If you’ve read Ben Goldacre – whose book Bad Medicine cites as ‘a big influence’ on Big Pharma – you’ll be familiar with this sinister industry manipulation of scientific research to further their own ends.

Just how far Big Pharma will tilt into this stuff remains to be seen; with the dual fundaments of plan and build in place, Wicksteed’s now trying to lock down how the game will escalate in its later stages. “In the late game I imagine there’ll be too many production lines to keep micro-managing stuff, so what you’ll be doing is trying to manipulate the market by doing clinical trials and doing more macro actions that have a broad effect, rather than creating lots of individual production lines.”

An ultimate win/loss condition isn’t established yet – it’s not like these companies who pump out pill after pill and hold the world’s health to ransom have those either, after all – “but I’d like some basic, long-term objective that you can aim towards, and you choose lots of sub-goals along the way.”

Sub-goals, presumably, like “how many people will I cause terrible things to happen to in the name of the almighty dollar?”

* What would a PC gamer be without RSI?

Big Pharma is slated for a release some time this Summer.


  1. Pantalaimon says:

    Only took about fifteen years but we finally got that prequel to Theme Hospital. Game looks really interesting!

    • socrate says:

      i think you didn’t check what this game is about its nothing like theme hospital its about making pharmaceutical company and creating new drug and medicine…

      On that note i really hope this gets more complex/realistic then this so far this just look like the factory mini game in the really old game Rogue Galaxy…and i wasn’t a big fan of that mini game to begin with and not to mention that Factorio is getting better and better and not only look better then this but also making production/assembly line is much more fun then this so far.

      • Bugamn says:

        I think you sound a bit nervous. It’s not about hospital management, but it’s still about health. And I guess that the original comment should be interpreted more as a jest than something serious.

      • Robstafarian says:

        I love that mini-game in Rogue Galaxy, and I have been looking for a more elaborate version of it ever since I finished that game.

  2. CookPassBabtridge says:

    Hurray, sort of like Big Bertha except for making antidepressants. Looks like a game I might like to have a tinker with.

  3. NathaI3 says:

    As someone who works in for a pharma contract manufacturing company, it’ll be interesting to see how this matches up to the real thing. If you have to spend 50% of your time and money preparing for regulatory audits, 25% on health and safety and the other 25% on training, it’ll be fairly accurate

  4. dsch says:

    An ultimate win/loss condition isn’t established yet – it’s not like these companies who pump out pill after pill and hold the world’s health to ransom have those either, after all

    This is obviously not the place to look for nuance on the pharmaceutical industry, but I don’t think the writer quite appreciates how precarious Big Pharma is. Even the biggest pharma companies don’t have more than twenty products under development, all of them at different stages, and any of them might not work out at any stage. In small molecule development, the patent clock starts ticking when you discover the molecule, and it often takes at least five years before a drug is on the market, so that is a quarter off the life-time of the drug before generics. Big pharma is a rat race, betting that 3 or 4 new drugs coming through the pipeline will make it to market before your previous patents run out. This is all without considering the possibility of lawsuits.

    So, sure, Big Pharma can do pretty bad things. But they can certainly fail, and the only way they “hold the world’s health to ransom” is the fact if they fail, the world’s supply of new medication will be severely reduced.

    • triclops41 says:

      Better to just put in some throw-away lines about big-bad-Pharma to sound cool and call it a day.

      So many people get their views on entire industries from schlocky Hollywood scripts and demagogue politicians.

      • triclops41 says:

        What is most ironic of all is that Pharma and games actually have very similar business models. A lot of failures, with a few big hits to pay the bills, and one exceptionally long bad streak of luck from insolvency. Taking the average drug all the way to market cost 800 million dollars, in the year 2000. Take that, GTA5!

      • FrumiousBandersnatch says:

        Don’t worry, there are still enough of us sane people that know everything is right in the world and understand there are no problems in any field whatsoever.

        • Flatley says:

          This is a great takedown because you invent a bad misrepresentation of what triclops said and then sarcastically agree with it, proving that TRICLOPS is the crazy one after all! Good job.

  5. pelle says:

    This game needs an alternative medicine mode where you do no research at all, just market any substance as cure for any disease.

  6. alms says:

    Looks cool, but from what’s on display there calling it ‘big pharma’ feels a bit dissonant to me: I understand Pharma Tycoon would be more than a little unattractive, but maybe more accurate?

  7. Dances to Podcasts says:

    The interface looks nice and clear but I feel they missed a trick by not using the unique graphic design that medicines tend to have.

  8. Bob Barker says:

    I’m hyped for this game, I love me some sim-tycoon stuff. Check out Factorio too for more assembly line madness.

  9. Mitthrawn says:

    Not to pile on Alec, but yeah, his criticisms of Big Pharma are basically wrong and seem to smack of entitlement, as though these companies are not-for-profits. As stated above, Big Pharma is an incredibly high risk, high reward industry, with the financial future of a company hanging on a single drug trial in some cases. Each drug that shows promise requires several stages of trials, each more expensive than the last. And in the end, you still may be left with nothing to show for it. Here’s a good (long) article about that very thing.

    link to