The Big Pharma controversy is about the wide-scale marketing malpractices used by big pharmaceutical companies in America which resulted in a series of negative implications on consumers. It revolves around pharmaceutical companies, government regulators, health professionals (or “unprofessional”), market consumers and the medical watchdogs. The dispute was formed between the supporters of the marketing tactics used by pharmaceutical representatives and the detractors to it.
Specifically it is the context that matters: Is it right, or rather ethical for the medical professionals to profit at the expense of the patients? Are there more underlying factors that led to this controversy? It is important to achieve a balance between the benefits and drawbacks of the marketing tactics used by the pharmaceutical industry; however it is more essential to consider the ethical issues pertaining to these tactics. Certainly, both the consumer welfare and health are of primary concern; but our ethical obligations are not discharged solely by a guarantee of some degree of protection from harm.
Still, I strongly believe that the health considerations of consumers should be put before profit maximization, because, unmistakably, the pharmaceutical industry has the responsibility to treat people’s health, instead of harming them. This essay will seek to examine the ethical implications of drug promotion efforts by pharmaceutical giants, the social impacts of drug promotion on consumers as well as the approaches to contain this dispute.
Key Issues To Be Discussed The key ethical issues of argument related to Big Pharma are the questionable marketing practices exercised by the pharmaceutical industry, product safety, science for sale and lobbying efforts. These critical issues have been emotive and multi-dimensional. As a result, it attracted a wide range of views about the topic. Questionable Marketing Practices The marketing efforts of Big Pharma have always been under the media spotlight and the scrutinization of the public and medical watchdogs. The pharmaceutical marketers have made use of different medium to reach to the potential consumers and professionals.
The extensiveness of the promotion efforts of the drugs had proliferated into every corners people’s lives. However, many believe that the pharmaceutical industry’s hunger for profits triumphs over their genuine desire to help the public, and that this blinded concern for profits continues to shape the future of this industry. The core of this debate is whether the high cost of drugs is justifiable by the cost of research and development done by the pharmaceutical companies. Has the money been used elsewhere?
In fact, the world’s major drug companies have been accused of spending large sums of money on promoting their drugs, rather than researching on them. Big Pharma has developed a plethora of ways to reach out to the public to advertise on their latest and greatest drugs; from television and radio spots to newspaper and internet ads. The advertising budget for the drug companies have sky-rocketed to a significant sum. In 2007, GlaxoSmithKline (GSK)’s biggest advertising price tag was attached to Advair, the firm’s blockbuster asthma medication, which rung up US$127 million in advertising spending.
The total amount of money spent on marketing by pharmaceuticals was U. S. $57. 5 billion for 2004. The total spent on domestic industrial pharmaceutical R&D was U. S. $31. 5 billion. Clearly, the promotional workings of the drug companies have shown that the U. S. pharmaceutical industry is still mainly marketing-driven. Corrupted practices among doctors and health professionals are not uncommon in the pharmaceutical industry either. Doctors or even undergraduate medical students were bombarded with logo-infested freebies by the companies, in order to persuade them to prescribe their drugs to patients.
Many physicians were subjected to financial lures by companies to convince them to favour their drugs and prescribe them. Back in 2009, a study out of Harvard University and Massachusetts General Hospital found that 84 percent of doctors have ties to drug companies, a ten percent drop from five years earlier. But roughly two thirds of doctors still accept drug samples, while 70 percent accept food and beverage incentives from drug companies. And fourteen percent continue to accept cash payments for services.
While some of these unethical practices were tapered off, not all were uprooted. Some octors did not disclose the amount of gifts and cash which they have accepted from the drug companies. They believe that their decisions on the prescription of drugs would not be influenced by the gifts which they have accepted. In my opinion, the supporters, primarily the health professionals and representatives of the pharmaceutical giants, have disregarded the genuine health implications and the high drug costs incurred to the general public in concern. They might try fending off such moral challenges by claiming that substantial amount of advertising is necessary to boost the sales of their products.
Securing more profits would also mean more money can be invested on research for better drugs. However, it is evident that the excessive promotional efforts of drugs have blinded the pharmaceutical industry, in the pursuit of more profits and sales. Their main concern of profit maximization still remains ahead of the interests of the community. Corruption practices among health professionals should also be stemmed out so that unfair and biased decisions made by doctors would not affect the drugs prescribed to consumers.
A significant sum of money should still be used for the development of better drugs to improve the quality of the lives of people. In conclusion, the principle of utilitarianism actually provides the latitude in deciding the extent of marketing efforts by pharmaceutical giants. Health professionals should not benefit at the expense of the patients. Instead, doctors should always act in the best interest of the patients. It is thus important to achieve a balance between the marketing efforts and the genuine interest for the health of the public. Product Safety The safety of the drugs produced has been a compelling issue in this argument.
Drug companies have been reportedly illegally promoting drugs for uses for which they were not approved by the authorities. The Food and Drug Administration (FDA) alleged that Astra Zeneca, an Anglo-Swedish giant, illegally promoted Seroquel, an anti-psychotic drug, for off-label purposes, specifically to physicians who do not normally treat patients with schizophrenia or bipolar disorder. Instead, they marketed it in long-term care facilities and prisons for the treatment of unapproved uses, including Alzheimer’s disease, anger management, anxiety, attention deficit hyperactivity disorder and depression.
Subsequently, it led to the recall of the drugs and AstraZeneca paid $520 million to resolve allegations for illegally marketing Seroquel for unapproved uses. Some of these unapproved drugs were marketed through different means. Very often, these off-label drugs were made from low quality materials, or were contaminated in the production process. Due to the competitive drug market, manufacturers are tempted to cut corners by outsourcing production to potentially unreliable third parties and skimp on testing the product before releasing it into the market.
As a result, some of these products could pose significant health risks to consumers. The trust consumers have on Big Pharma still remains as a big question. Should consumers continue to trust that the drugs manufactured by the pharmaceutical companies are legal and safe for consumption? There is no definite answer to it. Pharmaceuticals are responsible for saving and improving the lives of many people. However, it seemed to turn out otherwise. Again, profit maximization remains as the top priority of pharmaceutical companies.
I believe it would still take some time before the drug industry come to a conclusion between profit-making and the health considerations of the public. In my opinion, it is reasonable for drug companies to source for cheaper alternative and achieve low costs in drug production; however, it should adjust or halt the development if serious problems emerge. Thereby, it is important for drug manufacturers to be mindful of the negative consequences that their products have on consumers. Science for sale Science has always been considered an objective endeavour that removes any form of bias in researches and is inherently true and reliable.
The results should be generated independently, without bias and with the sole desire to find the best treatments. However, medical researches today, have become corrupted by money and special interests, and often misrepresent the truth to suit personal needs or corporate economic interests. The underlying motive still boils down to profit-making. Consider the example of the large and widely quoted Jupiter trial “proving” that Crestor, a cholesterol-lowering drug, could prevent heart attacks in people with normal or low cholesterol.
In this trial researchers twisted the data to suit the commercial sponsor of the study. An independent review of the Jupiter trial published in the Archives of Internal Medicine showed that it was deeply flawed and the actual data did not show any benefit for the prevention of heart disease. Most medical researches are undoubtedly funded by pharmaceutical giants. Hence, in order to introduce the product into the market, findings are often tailored to be parallel with the economic interests of the company.
I believe it is unethical for Big Pharma to pay researchers to twist the truth about bad outcomes and to sneak distorted information and marketing messages into medical journal articles. The consumers’ healths are at stake as they place much trust in the manufacturer when purchasing the products off shelves. If the research, development and distribution of drugs continue the same as it used to be, not only healthcare is at risk, but so are the research enterprise and the reputations of government bodies. The integrity of scientific research is too important to be left to the invisible hand of the marketplace.
Healthcare authorities are needed to regulate and ensure that medical results are not manipulated by selfish pharmaceutical companies which are only concern with individual gains. Lobbying efforts Pharmaceutical giants have spent heavily to lobby government bodies. Part of the high costs of drugs is explainable by the high expenditure devoted to lobbying. New disclosure reports in Congress showed that familiar players at the top of the health-care influence heap, includes $6. 2 million in lobbying by the dominant Pharmaceutical Research and Manufacturers of America (PhRMA) and $4 million by the American Medical Association.
Detractors of pharmaceutical lobby argue that the drug’s industry influence allows it to promote legislation friendly to drug manufacturers at the expense of patients. The perfect example of this is the dishonourable legacy of Nevada Senator and U. S. Senate Majority Leader, Harry Reid. Reid was exposed for accepting large sums of money from Big Pharma in order to craft and guide the health care bill in Big Pharma’s favour. The health care bill drastically expanded Big Pharma’s monopolistic control over America’s health care.
Corruption practices by healthcare regulators and government bodies are unavoidable. Acceptance of extravagant gifts and money from powerful lobbyists like Big Pharma would easily allow them to control the government and shape the public health care policies. Financially influenced politicians have their campaigns heavily funded by the pharmaceutical industry. In return, these politicians would help Big Pharma in warding off most government regulations so as to promote their drugs into the drug market. The practice of lobbying is both unethical and deceptive.
Such a notion demonstrates the unscrupulous manner in which the pharmaceutical industry runs their operations. It also illustrates that they have no qualms about manipulating the Congress and deceiving the public to achieve their ultimate goals. In my opinion, the government should keep check on these corrupted practices in the Congress and should ban any form of corrupted behaviours that have a large cost to the public. Bridging the gap between the proponents and the detractors Pharmaceutical companies should consider the impact of their actions on the society, who are also direct stakeholders to the issue.
The importance of corporate social responsibility (CSR) should be further put into actions. Big Pharma should always take actions that protect and improve the welfare of society as a whole along with their own interests. Besides safeguarding economic and legal obligations, certain responsibilities to society should be extended beyond these obligations. I believe that pharmaceutical companies which simply conduct more researches to prove the safety of their products are not going to win over the public totally.
Instead, the businesses need to develop more counter-images or cases to boost good representation. It could be better illustrated by taking the case of GlaxoSmithKline (GSK)’s initiative of selling the company’s malaria vaccine in Africa for no more than a 5 percent profit. GSK is one of the few pharmaceutical companies that succeeded in developing drugs that are beneficial in the developing world. It is thus evident that the pharmaceutical giant is not all about profit maximizing, but also have the intention to help the less fortunate people.
I strongly feel that more stringent regulation and compliance standard from the government would be one way to instill trust in the detractors after all the spotty scandals of Big Pharma. An example would be to issue stronger warnings on the bribes accepted by politicians and researchers from pharmaceutical companies. Given the complexity of the issue, it would help to eradicate any forms of bias in the short run, regardless whether it is for medical researches or bills passed on by the legislation.
All in all, it is still dependent on the integrity of researchers and politicians to weigh the risk against potential benefits derived with their own judgement. Higher transparency from the government and corporate would be crucial in determining the trust from the public and the criticism from the detractors. As such, with higher transparency, and more giving back to the society, it might help to regain the public trust and reduce detractor’s scepticism. According to the CSR Pyramid, it is undoubtedly that the biggest responsibility of the Big Pharma should still remain as profit maximization.
However, legal obligations should not be neglected as well. Corrupted actions should be eliminated from the industry and healthy marketing practices should be encouraged instead. Accurate medical researches should be bias-free and not swayed by any forms of financial lures. Health professionals should always act in the best interest of patients. The pharmaceutical scene would still require further fine-tuning before we could promote a healthy relationship between the government, the manufacturers and the consumers.
Courtney from Study Moose
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