While the pharmaceutical industry arguably has the worst record of serious corporate crime of any industry, international law evasion rather than outright law violation has been the biggest problem in the industry. To understand how these problems can be and are being brought under control, a legal-pluralist analysis is needed that decenters criminal enforcement by the state. Consumer and professional activism and a variety of levels of self-regulation in combination with state, regional, and international regulation are all important to understanding how progress is possible. Creative work within this web of controls can actually transform lowest-common-denominator regulation into highest-common-factor regulation and self-regulation when actors are capable of thinking strategically in world-system terms.