Big Pharma Business Model Explained by Cardiologist Aseem Malhotra

APRIL 2025 -
Dr. Aseem Malhotra has highlighted how the Numbers Needed to Treat (NNT) exposes the drug industry’s misuse of statistics to exaggerate benefits, manipulate doctors, and mislead patients. Speaking on the topic, he explains that NNT breaks down even unverified, industry-funded trial data—likely already skewed to favor drugs—and reveals their minimal real-world impact.

For instance, he notes that for individuals at risk of a heart attack but without prior events or severe blockages, statins offer just a 1% benefit over five years. This means 100 people must be treated for one to avoid a heart attack or stroke, with no life prolongation. For those who’ve had a heart attack, the benefit rises slightly: 1 in 39 to prevent another event, 1 in 83 to extend life.

Dr. Malhotra ties this to the 2015 "Choosing Wisely" initiative by medical royal colleges, published in the BMJ, which urged doctors to communicate such statistics transparently for true informed consent—an ethical standard still unimplemented in clinical practice. Why? He argues it’s because fully informed patients opt for fewer treatments, threatening the drug industry’s profits.

He warns that if this level of consent were standard in the NHS, it could collapse Big Pharma overnight—a outcome they’d fiercely resist. Expanding on this, Dr. Malhotra points to a broader agenda. He references Casey and Calley Means, now linked to Robert Kennedy Jr. and the Trump campaign, who’ve highlighted the commodification of sick children as a profit driver.

He goes further, asserting that the industry manipulates disease thresholds—lowering cholesterol markers, for example—to convince the healthy they’re at risk, expanding drug use. In a 2019 Cambridge Union debate against AstraZeneca’s CEO, he opposed the motion "We need more new drugs," interpreting it as a push to medicate more people. The BMJ, despite his controversial reputation, still invited him to represent this stance.

Dr. Malhotra predicts a chilling future: children on statins as young as 15, a move already floated in recent Mail Online reports to "slash heart attack rates." He’d foreseen this, warning months ago that post-COVID vaccine hype would embolden Big Pharma to push more drugs, capitalizing on their "hero" image—a narrative he deems false. The endgame? Laws mandating statins for school entry, normalizing lifelong medication from childhood. He urges resistance to protect future generations.