The story of Big Pharma begins with the evolution of medicine from small-scale, localized practices to a global, multibillion-dollar industry. The roots of modern pharmaceuticals can be traced back to ancient apothecaries, where remedies were crafted from natural ingredients like herbs and minerals. These early pharmacists laid the groundwork for scientific exploration, yet their operations were often informal, relying on traditional knowledge rather than rigorous testing.

The 19th century marked a pivotal turning point with the rise of industrialization and the advent of chemical synthesis. Pioneers in chemistry discovered how to isolate active compounds, such as aspirin from willow bark, transforming medicine from an art into a science. This period saw the birth of pharmaceutical companies that began producing standardized drugs on a large scale, laying the foundation for today's industry.

As the field advanced, so did the pursuit of patents. Patents were initially intended to protect innovation and encourage research, but they also introduced the potential for monopolization. By securing exclusive rights to produce and sell certain medications, pharmaceutical companies gained unprecedented power over pricing and distribution. While patents incentivized progress, they also set the stage for conflicts between public health needs and corporate profits.