Video games used to be a superficial entertainment outlet where the typical goals of these games were to shoot the aliens, save the princess, or slay the dragon. Over the years, however, computer gaming technology and the people who both develop and play these games have matured simultaneously. As a result, an enormous number of games have been created that provide a unique perspective on a multitude of topics and settings and has led to the evolution of video games into a novel communications platform.

It’s with this perspective that I approached with some curiosity a recently developed computer game called Big Pharma. As an individual who has interacted with drug companies on a weekly basis for almost 15 years, I must admit I initially dismissed the premise of this game as patently ridiculous. What could Twice Circled–the game’s developers–possibly know about running a drug company?

Quite a bit it seems.

Big Pharma could have been developed as a silly mobile app with absolutely no depth or as an extremely complicated spreadsheet that fully simulates a business while completely sacrificing entertainment. The result is a game that focuses on the basic elements crucial to designing a successful drug company while never forgetting that ultimately the point of the game is to simply have fun.

As the CEO of a drug company, the vast majority of your time playing Big Pharma is spent creating the best possible mass production lines to develop products released to the public. Colorful little ingredients enter the production floor through the walls on continually moving treadmills, and the player then adds several pieces of whizzing, chugging drug development machines to the production line. This collection of machines on the production line refines and combines the ingredients into a drug that treats a particular disease. The processed drug leaves the conveyor belt on an exit chute on another wall, and dollar signs appear to indicate revenue has been made. See? The drug business is easy!

The fun of the game would be limited if designing production lines was the sole focus of Big Pharma. Surprisingly, the game slowly reveals that it has as much depth in its design as the fine print in most prescribing information pamphlets. The most direct example is in the variation of drugs that you can create to treat a multitude of maladies. There is also no such thing as a perfect drug–each product that is developed contains both positive benefits and side effects that you can enhance or suppress by attaching various combinations of machines onto your production lines. No, this is not exactly how drug development happens, but give credit to Twice Circled for understanding that most developed drugs are usually not perfect solutions. Instead, the drug developer must weigh the good against the bad for each medication and determine what balance is acceptable.

I was particularly impressed with how the game also focuses on both basic and applied research for future candidate drugs. Scientists in lab coats are hired to improve the drugs developed, rediscover new uses for mature products and evolve the production technology. Explorers in cute pith helmets are sent out into the world to identify new ingredients that can produce superior remedies. There is also a competitive element to the game. At one point, my company “FeelGreat Inc.” (you get to name your company) owned a patent on a painkiller pill, and my competitor circumvented the patent by using the same active molecule in a cream formulation. Again, not an exact simulation of the pharma world, but still a surprising discovery.

Naturally, being a relatively simplistic simulation of such a massive concept as the pharmaceutical industry, several aspects of producing and disseminating a new drug to the world are simplified or entirely absent. None of the drugs have any sort of preclinical or clinical data; it is assumes all the drugs simply work exactly as designed. Preclinical and clinical trial design and drug pipeline development–even simplified versions–are completely absent. There is also practically no inclusion of any form of drug marketing, sales, advertising, medical affairs or health care education. Finally, acquisition of products from smaller drug companies and mergers are not included either. These are concepts which can make or break even the largest pharmaceutical company, and their absence is a reminder that the developers are not fully aware of all of the gears that turn behind the scenes in the pharma world.

Ultimately, Big Pharma doesn’t address everything involved in running even a small drug company, nor should it have to. Twice Circled has rightly focused on entertainment while providing a healthy albeit simplified glimpse into the drug development world. Behind the simplistic design, however, is a deeper strategic game where the player must make both simple and complex decisions such as “should I add a second distiller to the production line to enhance my hypertension drug even though patients may begin to experience nightmares?” “Should I hire more scientists to improve my evaporators or explore that new migraine drug?” “Should I saturate the market with my wonder drug for a quick profit or lay off some staff to cut costs?” “Is my revenue better spent sending my explorers to discover new ingredients with unique properties or should I improve my Ionizer?” “Is the science or the business my top priority at the moment?” The game also provides multiple starting scenarios that further refine these questions while providing long-term variability in gameplay.

Big Pharma is currently available at several online retail outlets as well as the game website If you’ve ever wanted to step into the shoes of a pharmaceutical company CEO and save the world one drug at a time give it a try. I recommend it as a source of healthy entertainment. Sorry about the pun.

By: Nicholas DeLillo, PhD.