A. David Lewis analyses recent X-Men titles to uncover the problem with Big Pharma as a main antagonist
For decades, the X-Men comics, television shows, and films have featured superpowered characters fighting dastardly villains and social intolerance. Now, events in their latest monthly comics have turned their struggle into the problem of Big Pharma. The mutants’ annual gala became a calamitous bloodbath as their enemies struck both physically and, to much surprise medicinally. Audiences can interpret the impact of this assault as a reading of pharmacovigilance failure and the locked system in which such drugs operate.
In recent years, the X-Men titles have undergone a radical overhaul. Starting with 2019’s House of X and Powers of X series written by Jonathan Hickman, the characters have shifted from Professor Charles Xavier’s school of superheroic do-gooders to genuine players on the world stage. These longtime characters have established their own nation-state on the island of Krakoa: an exotic, verdant land that provides astonishing flora and medicines which Xavier and his allies repurpose and offer to the rest of the world in exchange for their sovereignty. In short, the X-Men have evolved from a team to a people, with pharmaceuticals – not daring-do – being their value to the world beyond their borders.
Of course, the X-Men and their fellow mutants still face widespread bigotry and prejudice. This is now amplified by their position as a potent force in geopolitics. Their chief opposition Orchis, a mixed group of scientists and soldiers intent on destroying Krakoa and its people, fear mutants will become the dominant species on the planet. (There are definite and deliberate overtones here of the antisemitic “Great Replacement” doctrine fueling white supremacists, such as Charlottesville, VA’s 2017 “Unite the Right” rally.) Many have tried to destabilize the new mutant homeland, but none had succeeded until Orchis’ long-planned attack in this month’s X-Men: Hellfire Gala (2023)#1.
In Tim Webber’s essay “The History of Krakoan Medicine, Explained” (2023), the medicinals and their distribution are detailed as such:
One of these miracle drugs, Human Drug L, extends human life by five years. Another one of these pills, Human Drug I, functions as a universal antibiotic. Finally, Human Drug M treats so-called “diseases of the mind,” such as dementia. Many of the world’s nations accepted Xavier’s offer, and these medicines quickly became Krakoa’s chief export and the backbone of the island’s economy. (n.p.)
In exchange for their recognized status as a people and a land, the mutants of Krakoa offered the world new, revolutionary medications that would provide longer life and fight other ailments. Just how these drugs were cultivated would remain a proprietary secret, however, with the X-Men even establishing a black market in those countries that did not agree to their terms. Little did Xavier’s people know that their enemies had spliced their own secrets into the medicines.
In effect, Orchis shattered the island’s economy by activating a furtive signal in the pills that can cause humans to succumb to an involuntary and “lethal frenzy.” Xavier is thus forced to move all mutants off-planet or else the drugs will trigger worldwide, resulting in immense human casualites. Orchis made Krakoa’s strength into their weakness: their pills now came with a deadly dark side. One of their enemies sums it up nicely: “You’ve been peddling medicine with a back-door kill switch.”
John Abramson of Harvard Medical School has long warned of the latent dangers hiding in our real-world medicines. In Sickening: How Big Pharma Broke American Health Care and How We Can Repair It (2022), Abramson credits the profit motive of most major drugs companies serving the U.S. as driving the prescription of various products – not cautious, evidence-based medicine. Journalist Troy Farrah (2022) pinpoints Abramson’s message as a warning against the “corrupted scientific process that drastically needs reform… [A]s an increasing amount of medical research is funded by drug companies, it creates a perverse incentive to develop treatments that are profitable.”
There are some real-world parallels to this super-fiction. For instance, in Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients (2012), Ben Goldacre recounts the Cardiac Arrhythmia Suppression Trial (CAST) which was at first promising but later proved deadly. “The drugs prevented the abnormal rhythms [of the heart], so everyone thought they must be great: they were approved on to the market to prevent sudden death in patients…” (p. 133). However, alluring the drugs may have been at first, they were ultimately lethal to the very population doctors were trying to save. “We had been cheerfully handing out tablets that killed people (it’s been estimated that well over a hundred thousand people died as a result)” (pp. 133-134). Goldacre calls this a failure of “pharmacovigilance,” the need for any drug, no matter how potentially amazing, to have its safety needs properly assessed.
Orchis’s fictional threat of corrupted pharmaceuticals also has a real-world parallel in the money driving Big Pharma sales. Americans, both well and ill, are backed into a fiscal “fight-or-flight” crisis when it comes to their health, crushed under the weight and the impetus of the dollar sign. In the comics, the mutant-citizens had a relatively altruistic motive for offering the Human Drugs L, I, and M – namely their own liberation. Orchis’s perversion of the drugs – and their threat to the human population – can be read as more closely mirroring the real-world dangers that the industry introduces in its pursuit of revenue, not health.
For instance, Goldacre highlights the sinisterly circular nature of such pharmacovigilance, both in the U.S. and across Europe. The EMA committee tasked with monitoring dangerous side effects in approved medications “still reports to the Committee for Medical Products for Human Use, which is the one that approves [the drugs] in the first place” (Goldarce 2012, p. 163). And, in the U.S., the Food and Drug Administration rarely outright removes a questionable medication, instead releasing warning letters or altering the label of the pharmaceutical. “But, amazingly, when a regulator decides to notify doctors about a side effect, the drug company can contest this, and delay the notice being sent out for months, or even years” (p. 163). Orchis has no plans to alert the world’s human population of the mutant drug’s deadliness; it is far more effective to hold them hostage, as it were, and use as a threat to subdue the X-Men, thereby compromising their island safe haven.
In short, the drive to market medicines ahead of their proper testing and careful application is their own figurative “kill switch.” The price tag attached to some drugs is their own undoing, while the financial shortcuts employed by several prescription manufacturers likewise embeds danger in them. The X-Men may have overwhelming odds stacked against them in recovering from and then defeating Orchis. But as Farrah suggests, “corporate interests have infected nearly every aspect of the American medical system,” thereby making it “difficult to fix.”
Supervillains are unnecessary. The U.S. healthcare system can be its own nemesis.
About the Author
A. David Lewis is an Assistant Professor of English and Health Humanities at MCPHS University in Boston, Massachusetts. In addition to being a 2014 Eisner Award nominee and a 2023 national judge, he has written extensively on Graphic Medicine and served as co-editor of Pandemics and Epidemics in Cultural Representation (Springer, 2022). Currently, Lewis the Program Director for the Master of Health Sciences degree at his institution and the Co-Editor of the open-access Graphic Medicine Review journal with the Lamar Soutter Library at the UMass Chan Medical School.
References
Abramson, John. 2022. Sickening: How Big Pharma Broke American Health Care and How We Can Repair It. Boston: Mariner Books.
Farah, Troy. 2022. “A Doctor’s Impassioned Critique of Big Pharma.” Salon. 19 March. Available from: https://www.salon.com/2022/03/19/a-doctors-impassioned-critique-of-big-pharma_partner/.
Goldarce, Ben. 2012. Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients. New York: Faber and Faber.
Webber, Tim. 2023. “The History of Krakoan Medicine, Explained.” Marvel.com. 3 August. Available from: https://www.marvel.com/articles/comics/krakoan-medicine-explained-x-men.
