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Medicine, Health Care and Philosophy

, Volume 16, Issue 2, pp 249–264 | Cite as

Big Pharma: a former insider’s view

Scientific contribution

Abstract

There is no lack of criticisms frequently levelled against the international pharmaceutical industry (Big Pharma): excessive profits, dubious or even dishonest practices, exploiting the sick and selective use of research data. Neither is there a shortage of examples used to support such opinions. A recent book by Brody (Hooked: Ethics, the Medical Profession and the Pharmaceutical Industry, 2008) provides a précis of the main areas of criticism, adopting a twofold strategy: (1) An assumption that the special nature and human need for pharmaceutical medicines requires that such products should not be treated like other commodities and (2) A multilevel descriptive approach that facilitates an ethical analysis of relationships and practices. At the same time, Brody is fully aware of the nature of the fundamental dilemma: the apparent addiction to (and denial of) the widespread availability of gifts and financial support for conferences etc., but recognises that ‘Remove the industry and its products, and a considerable portion of scientific medicine’s power to help the patient vanishes’ (Brody 2008, p. 5). The paper explores some of the relevant issues, and argues that despite the identified shortcomings and a need for rigorous and perhaps enhanced regulation, and realistic price control, the commercially competitive pharmaceutical industry remains the best option for developing safer and more effective medicinal treatments. At the same time, adoption of a broader ethical basis for the industry’s activities, such as a triple bottom line policy, would register an important move in the right direction and go some way toward answering critics.

Keywords

Big Pharma Market manipulation Medicalization Pharmaceutical industry ethics Triple bottom line policy 

Notes

Conflict of interest

Having worked in research & development for some 30 years the author is in receipt of an occupational pension from the pharmaceutical industry. He is not a spokesman for the industry and the views expressed are entirely his own.

References

  1. Adams, C.P., and V.V. Brantner. 2010. Spending on new drug development. Health Economics 19(2): 130–141.PubMedCrossRefGoogle Scholar
  2. Angell, M. 2004. The truth about the drug companies. How they deceive us and what to do about it. New York: Random House.Google Scholar
  3. Arrow, K. 1963. Uncertainty and the welfare economics of medical care. The American Economic Review LIII 5: 941–973.Google Scholar
  4. Ashford, E. 2006. the inadequacy of our traditional conception of the duties imposed by human rights. Canadian Journal of Law and Jurisprudence XIX 2: 217–235.Google Scholar
  5. Baker, D. 2009. Free market myth. Boston Review January/February (online edition). Downloaded from : http://bostonreview.net July 2009.
  6. Brennan, R., L. Eagle, and D. Rice. 2010. Medicalization and marketing. Journal of Macromarketing 30(1): 8–22.CrossRefGoogle Scholar
  7. Brody, H. 2005. The company we keep: Why physicians should refuse to see pharmaceutical representatives. Annals of Family Medicine 3(1): 82–85.PubMedCrossRefGoogle Scholar
  8. Brody, H. 2008. Hooked: Ethics, the medical profession and the pharmaceutical industry (Pbk.) Lanham, Maryland, USA: Rowman, & Littlefield Publishing, Inc.Google Scholar
  9. Brown, H. 2004. Miracle cure meets medical reality. The Lancet 364: 1747–1748.CrossRefGoogle Scholar
  10. Buckley, J., and S.Ó. Tuama. 2005. International pricing and distribution of therapeutic pharmaceuticals: An ethical minefield. Business Ethics: A European Review 14(2): 127–141.CrossRefGoogle Scholar
  11. Burke, E. 1984. Reflections on the revolution in France, Conor Cruise O’Brien, ed. London: Penguin Books, 1984), pp. 151–152. Quoted in O’Neill (2005).Google Scholar
  12. Canguilhem, G. 1991. The normal and the pathological. New York: Zone Books.Google Scholar
  13. Chang, P.L. 2006. Who’s in the business of saving lives? Journal of Medicine and Philosophy 31: 465–482.Google Scholar
  14. Ciulla, J.B. 2007. The importance of leadership in shaping business values, chapter 6 In Corporate Ethics and Corporate Governance, eds. Zimmerli, W.C., K. Richter and M. Holzinger. Berlin: Springer.Google Scholar
  15. Civan, A. and B. Köksal. 2010. The effect of newer drugs on health spending: Do they really increase the costs? Health Economics 19(5): 581–595.Google Scholar
  16. Cosans, C. 2009. Does Milton Friedman support a vigorous business ethics? Journal of Business Ethics 87: 391–399.CrossRefGoogle Scholar
  17. Daniels, N. 2004. Justice, health and healthcare, chapter 1. In Health care policy, Shannon, T., ed. Oxford UK: Rowan and Littlefield Publishers Inc.Google Scholar
  18. Dworkin, R. 1993. Justice in the distribution of health care. McGill Law Journal 38(4): 883–898.PubMedGoogle Scholar
  19. Elkington, J. 1997. Cannibals with forks: the triple bottom line of 21st Century Business. Oxford: Capstone Publishers.Google Scholar
  20. Feinberg, J. 1980. Rights, justice and the bounds of liberty: Essays in social philosophy. Princeton: Princeton University Press.Google Scholar
  21. Finegold, D., P. Singer, A. Daar, C. Bensimon, M. Eaton, B. Godard, B. Knoppers, and J. Mackie. 2005. Bioindustry ethics. London: Elsevier Academic Press.Google Scholar
  22. Finegold, D., and A. Moser. 2006. Ethical decision-making in bioscience firms. Nature Biotechnology 24(3): 285–290.PubMedCrossRefGoogle Scholar
  23. Fitzpatrick, M. 2006. Big Pharma—paper tiger. British Journal of General Practice 56(525): 309.PubMedGoogle Scholar
  24. Fox, N.J., and J. Ward. 2008. Pharma in the bedroom …and the kitchen…. The pharmaceuticalisation of daily life. Sociology of Health & Illness 30(6): 856–868.Google Scholar
  25. Goldman, A.H. 1980. Business ethics: Profits, utilities, and moral rights. Philosophy & Public Affairs 9(3): 260–286.Google Scholar
  26. Goldman, M. 2003. Pharmafocus. Downloaded from: www.inpharm.co./new/infernal-focus.
  27. Grabowski, H. 2004. Are the economics of pharmaceutical research and development changing? Productivity, patents and political pressures. Pharmacoeconomics 22(Suppl. 2): 15–24.PubMedCrossRefGoogle Scholar
  28. Gray, J. 2008. It depends, pp. 8–11. In Does the free market corrode moral character? Thirteen views on the question. Pennsylvania: John Templeton Foundation.Google Scholar
  29. Grossman, G.M., and E.L.-C. Lai. 2008. Parallel imports and price controls. RAND Journal of Economics 39(2): 378–402.CrossRefGoogle Scholar
  30. Henry, D., and J. Lexchin. 2002. The pharmaceutical industry as a medicines provider. The Lancet 360: 1590–1594.CrossRefGoogle Scholar
  31. Hevey, R. and C-C. Ling. 2012. Global financial challenges: Opportunities for strengthening R&D research in targeted drug delivery. Future Medicinal Chemistry 4(1): 1–5.Google Scholar
  32. Huber, P. 2006. Of pills and profits: In defense of Big Pharma. Commentary. Manhattan Institute for Policy Research. Downloaded October 2010, from: www.manhattan-institute.org.
  33. Humber, J.W., and R.F. Almeder (eds.). 1997. What is disease? Totowa: Humana Press.Google Scholar
  34. Jack, A. 2008. Balancing Big Pharma’s books. British Medical Journal 336: 418–419.PubMedCrossRefGoogle Scholar
  35. Kassirer, J. 2005. On the take. How medicine’s complicity with big business can endanger your health. New York: Oxford University Press.Google Scholar
  36. Kola, I. 2008. The state of innovation in drug development. Clinical Pharmacology & Therapeutics 83(2): 227–228.CrossRefGoogle Scholar
  37. Kola, I., and J. Landis. 2004. Can the pharmaceutical industry reduce attrition rates? Nature Reviews 3: 711–715.PubMedCrossRefGoogle Scholar
  38. Lane, C. 2007. Shyness: how normal behavior became a sickness. New Haven: Yale University Press.Google Scholar
  39. Larmore, C. 1999. The idea of a life plan. Social Philosophy & Policy 16(1): 96–112.CrossRefGoogle Scholar
  40. Larrère, C. 2010. Ethics and nanotechnology: The issue of perfectionism. HYLE- International Journal for Philosophy of Chemistry 16(1): 19–30.Google Scholar
  41. Lévy, B-H. 2008. Certainly. Or does it? pp. 28–30, In Does the free market corrode moral character? Thirteen views on the question. Pennsylvania: John Templeton Foundation.Google Scholar
  42. MacIntyre, A. 1999. Social structures and their threats to moral agency. Philosophy 74(3): 311–329.Google Scholar
  43. Markle, G., J. Petersen, and M. Wagenfeld. 1978. Notes from the cancer underground: Participation in the laetrile movement. Social Science & Medicine 12: 31–37.Google Scholar
  44. Marco, C., J. Moskop, R. Solomon, J. Gelderman, and G. Larkin. 2006. Gifts to physicians from the pharmaceutical industry: An ethical analysis. Annals of Emergency Medicine 48(5): 513–520.PubMedCrossRefGoogle Scholar
  45. Mintzes, B. 2006. Disease mongering in drug promotion: Do governments have a regulatory role? PLoS Med 3(4): e198.PubMedCrossRefGoogle Scholar
  46. Mittra, J. 2005. Pharmaceutical industries: Do they prefer treatment to cure? The Biochemist 27(3): 32–34.Google Scholar
  47. Moynihan, R., I. Heath, and D. Henry. 2002. Selling sickness: The pharmaceutical industry and disease mongering. British Medical Journal 324: 886–891.PubMedCrossRefGoogle Scholar
  48. Mullin, R. 2003. Drug development costs about $1.7 billion. Chemical Engineering News 81:8.Google Scholar
  49. Nordenfelt, L. 1993. On the relevance and importance of the notion of disease. Theoretical medicine and Bioethics 14(1): 15–26.CrossRefGoogle Scholar
  50. Nordenfelt, L. 2007. The concepts of health and illness revisited. Medicine, Healthcare and Philosophy 10: 5–10.CrossRefGoogle Scholar
  51. O’Neill, O. 1988. Children’s rights and children’s lives. Ethics 98(3): 445–463.CrossRefGoogle Scholar
  52. O’Neill, O. 1996. Towards justice and virtue: A constructive account of practical reasoning. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  53. O’Neill, O. 2005. The dark side of human rights. International Affairs 81: 427–439.CrossRefGoogle Scholar
  54. Radoilska. L., and D. Scott. 2005. Trust in the Pharmaceutical Industry: A philosophical perspective. Report produced by the forum for philosophy in business, Faculty of Philosophy, University of Cambridge. Google Scholar
  55. Rawlins, M. 2004. Nature reviews. Drug Discovery 3: 360–364.PubMedCrossRefGoogle Scholar
  56. Reisel, W., and L.M. Sama. 2003. The distribution of life-saving pharmaceuticals. Viewing the conflict between social efficiency and economic efficiency through a social contract lens. Business and Society Review 108(3): 365–387.Google Scholar
  57. Robinson, J. 2001. Prescription games. Money, ego and power inside the global pharmaceutical industry. London and Sydney: Simon & Schuster UK.Google Scholar
  58. Sandel, M. 2004. The case against perfectionism. The Atlantic online April: 1–11. Accessed March 2011.Google Scholar
  59. Savulescu, J., and N. Bostrom (eds.). 2009. Human enhancement. Oxford: Oxford University Press.Google Scholar
  60. Scherer, F. 2004. The pharmaceutical industry—Prices and progress. New England Journal of Medicine 351(9): 927–932.PubMedCrossRefGoogle Scholar
  61. Segal, S. 2007. Is health care special? Journal of Political Philosophy 15(3): 342–361.CrossRefGoogle Scholar
  62. Sen, A. 1993. Does business ethics make economic sense? Business Ethics Quarterly 3(1): 45–54.CrossRefGoogle Scholar
  63. Steinman, M., M. Shlipak, and S. McPhee. 2001. Of Principles And Pens: Attitudes and practices of medicine housestaff toward pharmaceutical industry promotion. American Journal of Medicine 110: 551–557.PubMedCrossRefGoogle Scholar
  64. Tuominen, N. 2010. Defensive patent protection strategies in the pharmaceutical industry—A response to a legal problem? Thesis for Degree of Master of European Studies, College of Europe, Bruges. Downloaded from: www.mayerbrown.com/public_docs/Thesis_Nicoleta_Tuominen.pdf. Universal Declaration of Human Rights. Adopted by UN General Assembly Resolution 217A (III) of 10 December 1948.
  65. Vernon, J., J. Golee, and W. Keener Hughes. 2006. The economics of pharmaceutical price regulation: Refocusing the debate. American Journal of Law and Medicine 32: 175–192.PubMedGoogle Scholar
  66. Wager, E. 2003. How to dance with porcupines: Rules and guidelines on doctors’ relations with drug companies. BMJ 326: 1196–1198.PubMedCrossRefGoogle Scholar
  67. Wolff, J. 2011. Pharmaceutical cost-control. A thought-piece for the future of healthcare in Europe conference 13 May 2011. Downloadable at http://www.ucl.ac.uk/european-institute/comment_analysis/commentary/healthcare (Accessed: October 1, 2011).
  68. Wulfson, M. 2001. The ethics of corporate social responsibility and philanthropic ventures. Journal of Business Ethics 29: 135–145.CrossRefGoogle Scholar
  69. Zall, M. 2001. The pricing puzzle. Modern Drug Discovery 4(3): 36–38, 41, 42.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.Centre for Applied EthicsCardiff UniversityCardiffUK

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