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Before playing Big Pharma we thought that drug companies were heartless corporations that preyed on the sick to make as much cold hard cash as they could. Having now run a few drug corporations ourselves, we still think that they’re heartless and prey on the sick, but now we're obsessed with the profit margins on their drugs. We also now wonder many of them have been undercut by a superior product that doesn’t have chronic diarrhoea as a side effect.

In Big Pharma players don’t only become the head of a drug company, they become the architect of the manufacturing facility for those drugs, responsible for taking a base ingredient, like the mucus of an arctic slug, and refining it to create a migraine treatment. This is the moment-to-moment gameplay; analysing the benefits of ingredients and trying to create the best drug possible by increasing their potency through vaporisation, or decreasing it by ionising it, all while trying to avoid a powerful side effect.

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All ingredients have potential side effects, and if the players don’t pay attention to the potency they’re working with, they could produce a drug with a more powerful side effect than the positive benefits it provides. A drug with a strong side effect will get a lower Cure Rating, which means it won’t sell for as much as it could. Since the process of creating a drug costs a lot of money - you're charged for each stage of the refining and manufacturing process - players need to sell their drugs for the highest price possible, generating more profit.

But in Big Pharma players have to go further than simply balancing the books. New conditions pop up and require treatments, and players need to meet the demand fast or lose out to the competition. Competing drug companies will also produce superior drugs by fine tuning their manufacturing processes, eking out the best possible benefit with the smallest side effect, gaining a better Cure Rating and more profit as a result. Players can fight back by upgrading their technology and ingredients to reduce manufacturing costs and side effects. It’s also a good idea to hit illnesses and ailments that competitors haven’t, cornering the market instead of chasing a better rating.

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With the console version of Big Pharma it’s possible to play with the Marketing and Malpractice DLC turned on or off. The expansion brings in marketing strategy to a player’s drug corporation, requiring them to employ drug reps who will convince doctors to purchase their products over a competitor’s. The DLC also opens up the ability to run marketing campaigns for drugs, featuring fake cure rates and everything. Drug reps can even offer doctors incentives for a product, such as dinner and drinks, or some new golf clubs, a practice that’s been outlawed in the industry in real life.

Marketing and Malpractice also adds a new layer of complexity to Big Pharma’s manufacturing segment as well. Drugs can be enhanced with fanciful benefits such as ‘fast acting’. This will help shift drugs faster and for a higher price, but provides no real benefit to the end user. Furthermore, squeezing the extra machinery to implement these benefits could come at the cost of a side effect or two, something players will have to weigh up as they see their competitor’s cash flow grow to be far healthier than their own.

All of these elements are in play in every part of Big Pharma, but there’s so much more to the game than the freeplay sandbox mode. The game boasts a plethora of challenges, and an incredibly comprehensive tutorial. While some of the text has clearly been altered in updates, but not changed in the Switch port, it’s easy enough to understand how to play and what the stipulations of each challenge are. From the Beginners playlist that starts by tasking players with earning $1,000,000 in revenue over 10 years, to the Crippling Debt challenges that burden players with huge loans from the start, and even the Full Unlock levels that present insane challenges with everything unlocked from the beginning of the game, there are hundreds of hours of drug company management simulation in this, at first, deceptively small package.

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These scenarios help Big Pharma avoid the fresh start fatigue that players often feel in management simulators. The simple task of starting a new company is changed with every challenge, creating more than enough variations on the same essential gameplay experience. However, the game also offers a freeplay mode, with no stipulations or goals, and a custom game mode in which players can make the experience as easy, or as difficult, for themselves as they want.

Visually Big Pharma is reminiscent of Theme Hospital, making light of the illnesses being treated with fun animations which demonstrate an all-too-literal representation of the processes behind drug production. The game focuses on the competitive edge of this industry without making players think about the crushing reality of those who can’t afford superior treatments, that don’t make them vomit, because of the cost.

All that said, Big Pharma on Switch has some side effects of its own. As far as management simulation games go on the console, this is one of the more finicky offerings. Developers Twice Circled initially launched the game for PC in 2015, and some of the controls have suffered as they’ve moved over to the Switch. Placing machines and the belts that link them can be awkward, especially when there are belt lines running close to each other. And as you can see from the screenshots, on-screen text is also incredibly small, making it difficult to read - especially for those who might need to wear glasses and don’t want to be reminded of how old they actually are. The game could definitely benefit from a control scheme update similar to Megaquarium that greatly improves this area of the game. Considering how much is packed in here, though, it’s still a great port.


Big Pharma has a lot to offer for players who want a deep management simulator. There are a lot of systems to learn, and they take a long time to master if you want to succeed in the hardcore scenarios. The game goes further than the factory floor, bringing research, originator ingredients, and the min/max specification usually reserved for MMOs to the normal management experience. On Nintendo Switch the game suffers a little from awkward controls and text size, but the fact that a game of this scale works as well as it does on the platform eclipses its flaws once you're invested. In truth, running a global drug corporation on-the-go has never been more enjoyable, unless you’re losing money because all of your drugs cause headaches. Good luck.