When the Georgian Competition and Consumer Agency (GCCA) announced this summer that four pharmaceutical companies had been fined more than 559,000 GEL for inflating medicine prices by up to 3,000 percent, the numbers shocked the public. Yet the details shocked even more. The inflated prices, investigators discovered, were not tied to research, manufacturing, or logistics: they reflected the costs of gold jewelry, European trips, luxury hotels, cosmetic and dental procedures, fines, and corporate parties — a carnival of excess financed invisibly by patients at the pharmacy counter.
For many, this was a story of corruption, a question of bad actors punished by regulators. But the deeper resonance of the scandal lies elsewhere. It forces us to ask: What happens when the act of healing, once considered sacred, becomes entangled with the rituals of luxury?
The image of the pharmacist has historically oscillated between healer and merchant. In Renaissance Europe, the apothecary was a figure of ambivalence — part scientist, part tradesman, part magician. He sold herbs, minerals, and sometimes exotic powders carried from the East, always negotiating between cure and commerce.
Marcel Mauss’s classic essay ‘The Gift’ (1925) helps illuminate this dual role. Medicine was rarely just a transaction; it carried the weight of reciprocity, obligation, and symbolism. A physician’s service often came with gifts in return, gestures of gratitude that bound healer and patient together. In premodern villages, this gift economy helped stabilize trust.
But the pharmaceutical scandal in Georgia shows what happens when the Maussian gift is industrialized. The “gifts” no longer flow between patient and healer. They circulate upward — from desperate patients paying inflated bills, to executives funding dental implants in Tbilisi or champagne banquets in Vienna. What once created bonds now creates fractures.
Georgia is hardly unique. Around the world, the pharmaceutical sector has been a stage for scandals where medicine and luxury intertwine.
United States, 2019: Executives at Insys Therapeutics bribed doctors with luxury trips and speaking fees to push a fentanyl spray, worsening the opioid epidemic; patients bore the financial and bodily costs.
Italy, 1990s: The Tangentopoli investigations exposed how pharmaceutical firms funneled inflated medicine prices into political kickbacks, luxury lifestyles, and bribery networks.
China, 2013: The British company GlaxoSmithKline was fined nearly $500 million after revelations that it paid for lavish conferences, sexual services, and gifts for doctors to promote its drugs.
Japan, 2014: Novartis was accused of financing luxury marketing campaigns that distorted prescription practices.
Thorstein Veblen, in ‘The Theory of the Leisure Class’ (1899), described how elites signal their superiority not through necessity, but through waste — goods and rituals designed to be visibly excessive. A diamond necklace does not feed; it dazzles. A conference in Paris does not cure disease; it impresses.
When pharmaceutical companies roll the costs of cosmetic treatments, banquets, and European retreats into the price of medication, they enact this Veblenesque logic. What results is a grotesque reversal: the sick finance the theater of the healthy. This is where sociology intersects with morality. In the traditional gift economy, generosity flowed toward the vulnerable, affirming community. In the pharmaceutical carnival, resources are extracted from the vulnerable, affirming hierarchy.
The fine of 559,358 GEL is, in economic terms, modest. For multinational corporations, such penalties often become little more than the cost of doing business. After the 2008 financial crisis, banks paid billions in fines, yet continued many of the same practices. Fines deter when they strike at reputation, not just revenue.
The central question is not how high the fine should be, but how societies imagine the relationship between health, wealth, and care. If medicine is understood as a commodity like any other, its price can always include champagne. If medicine is understood as a social covenant — a promise that no one will be left to suffer for lack of treatment — then its corruption is intolerable.
The Georgian case is a reminder that every pill is political. Each tablet carries within it the weight of philosophy (What is a fair price for life?), anthropology (How do societies bind healer and patient?), and sociology (How do trust and power circulate through medicine?). Until these questions are answered, fines will remain symbolic, and patients will continue to bear invisible costs far beyond their prescriptions.
By Ivan Nechaev
