This chapter looks at the second side of P&R negotiations: the biopharma industry. It describes its activities, other players in its ecosystem, revenues, challenges, and how to make it contribute more to the public good. It goes deep into the reasons behind Pharma’s problems and negative reputation, including the tension between health and profit, pricing abuses, negative sales and negotiation tactics, the popular perception of drug prices, and what a correct perception of drug prices would need to incorporate. The readers will gain a tremendous understanding of what really goes on behind the scenes, of the negative tactics used by the industry players, and how that negatively impacts our health. This chapter concludes by discussing what changes are needed so that the industry can deliver much more public good, much more affordably, across its different players instead of the ineffective actions that have been taken so far.