Not just greasy palms in Congress. Payouts (bribes) to Doctors and med schools. And billions of dollars to major media outlets -- controlling reporting and the threat of investigative journalism. [They often pay more for advertising than research.]  https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-pharmaceutical-companies-are-spending-far-more-on-marketing-than-research/  e   https://arstechnica.com/science/2019/01/healthcare-industry-spends-30b-on-marketing-most-of-it-goes-to-doctors/ https://www.drugwatch.com/featured/big-pharma-marketing/ https://www.fiercepharma.com/special-report/big-pharma-s-top-13-advertising-budgets