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Cure or Sell: How Do Pharmaceutical Industry Marketers Combine Their Dual Mission? An Approach Using Moral Dissonance

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Abstract

Pharmaceutical industry marketers are confronted with specific ethical issues linked to the tension between the economic interest being pursued and the health mission of this sector. Indeed this dual mission could be problematic for them when the two objectives contradict each other. We use the concept of moral dissonance to examine how marketers in the pharmaceutical industry perceive the profit/health tension inherent in their sector and how they deal with it. Based on narratives of 18 marketers working in the pharmaceutical sector, our qualitative study identifies ethical conflicts of varying intensity that generate differing degrees of moral dissonance among marketers. To cope with this moral dissonance, they use the following strategies: (1) minimize the sensitivity of their activity; (2) invoke the benefits to patients; and (3) avoid behaviors that conflict with their values.

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Notes

  1. Center for Disease Control and Prevention, cited by Le Monde, January 31st, 2020.

  2. Most reduction modes are already present in Festinger’s initial work (1957) and have been supplemented by subsequent work (see Hinojosa et al. 2017; McGrath 2017; Vaidis and Halimi-Falkowicz 2007; Voisin et al. 2013 for a review of the existing work).

  3. The phenomenon of justification has given rise to numerous studies drawing on similar concepts: moral rationalization, moral justification, self-justification…

  4. Although they don’t refer to the neutralization theory, the moral disengagement mechanisms highlighted by Bandura et al. (1996) are surprisingly close to the neutralization techniques identified by Sykes and Matza in 1957 (Ribeaud and Eisner 2010).

  5. Survey from TNS Sofres in 2018.

  6. Laboratory in which a major health scandal (Mediator) took place in France.

  7. The French National Drug Safety Agency.

  8. Marketing authorization for drugs given by the health authorities in France (Autorisation de Mise sur le Marché).

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Acknowledgements

We would like to express our sincere thanks to the journal’s editor and reviewers for their thorough evaluation work and valuable advice that allowed us to advance our research significantly.

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Authors and Affiliations

  1. ESSCA School of Management, 350 avenue du Club Hippique, 13090, Aix-en-Provence, France

    Bénédicte Bourcier-Béquaert

  2. Université Paris-Saclay, Univ Evry, IMT-BS, LITEM, 91025, Evry-Courcouronnes, France

    Loréa Baïada-Hirèche

  3. ISC Paris, Membre associé GRANEM (Université d’Angers), 75017, Paris, France

    Anne Sachet-Milliat

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  1. Bénédicte Bourcier-Béquaert
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Appendices

Appendix 1: Interview Guide

I am conducting a scientific study on situations of ethical problems experienced by marketing professionals. In the interview, I would like you to tell me about problems or cases of conscience that you have encountered in the course of your duties/decision-making in marketing in France. What you say will remain strictly confidential. Neither your name nor the name of your company will be mentioned. This data will be used only in the context of publications in academic journals.

1. Could you briefly introduce yourself and say something about your job and career?

2. In your professional career (and specifically your role in marketing) have you ever been faced by a situation that has bothered your conscience? If this has happened on a number of occasions, focus on one or two that that most affected you. Can you tell me about it?

Follow-up on the description of the problem mentioned:

- Description of the problem

- Description of the organizational context (hierarchy, corporate culture, codes of ethics, legal department, etc.)

- Description of the external context (regulatory, economic, customer, sector, etc.)

- Protagonists: people or groups involved in the problem (legal/regulatory, general management, other departments, etc.)

- Focus on relations with the legal/regulatory department: description of the validation process, cases of projects rejected by the legal department

Follow-up on cases of conscience and how they were resolved:

- What did you do in this situation? And why?

- What decision(s) did you make?

- Can you explain why you chose to do this?

- Have you solicited other people (in the professional context? in the personal context?)

Follow-up on other situations giving rise to cases of conscience:

- Were there any operations where you thought you were going to cross a line?

- Were there any other decisions where you felt you were in an awkward position?

- Do you have examples of operations carried out by the competition that could have troubled your conscience if you had had to do them yourself?

3. And the fact of working in this sector, how was that initially?

Follow-up:

- Did you experience agreeing to take this job as a problem?

- Why did you agree to it?

4. Finally, are there any sectors in which you would not work? For what reasons?

Appendix 2

See Table 3.

Table 3 Adaptation of the field to its sensitive nature (from Author 2009)
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Appendix 3

See Table 4.

Table 4 Description of the sample
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Appendix 4

See Table 5.

Table 5 Elements of data collection by respondent
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Appendix 5

See Table 6.

Table 6 Coding grid for moral dissonance reduction strategies
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Appendix 6

See Table 7.

Table 7 Moral intensity coding grid from Jones (1991)
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Appendix 7

See Table 8.

Table 8 Summary table of results
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Bourcier-Béquaert, B., Baïada-Hirèche, L. & Sachet-Milliat, A. Cure or Sell: How Do Pharmaceutical Industry Marketers Combine Their Dual Mission? An Approach Using Moral Dissonance. J Bus Ethics 175, 555–581 (2022). https://doi.org/10.1007/s10551-020-04657-4

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