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The purpose of this paper is to examine and review the available literature on ethical/unethical behaviour of pharmaceutical companies and to determine the ethical issues, unethical behaviour by analysing, summarising and categorising the factors related to these issues and unethical behaviour as were studied during the period 2008-2017. Essentially, this paper presents a critical analysis of the available literature on the subject and avenues for future research.

This paper adopted the systematic review approach to achieve the purpose of this study and examines the most relevant literature from online existing database sources, available between 2008-2017 by using the keyword search method. Then studies are categorised and summarised, using previously developed theories and frameworks, which have provided evidence to the universal consensus that ethical behavioural outcomes are dependent on the interplay of individual, organisational and environmental factors and have reordered to fulfil the purpose.

The findings identify that ethical issues related to pharmaceutical companies as were studied during the period 2008-2017 are drug pricing, drug safety and gift-giving. The organisational variables appeared to be the dominant cause of these ethical issues and unethical practices along with other determinants such as environmental and stakeholders. A large number of studies were in the western country context. Theoretical research has studied more comparatively empirical studies.

This review provides insights for understanding the ethical issues, unethical behaviour and determinants related to these issues of pharmaceutical companies and provides insights where the literature is standing. This review only includes studies between 2008-2017, which are related to the ethical issue of pharmaceutical companies, therefore, the view is only of the past 10 years papers. This review provides gaps and insight into the source of ideas for future research and will help the researchers in guiding ethics-related information in the context of pharmaceutical companies.

This study will help the practitioners and policymakers in informing about the issues that required the urgent need to solve and will shed some light to focus and formulate strategies for successful competitive advantage. This study will help researchers who are seeking information related to ethics and ethical behaviour in pharmaceutical companies.

To the best of my knowledge, this review of understanding ethical/unethical behaviour in pharmaceutical companies of the past 10 years between 2008-2017 has not been done to date. This study is filling the gap by bringing all the information about ethics in pharmaceutical companies at one place, which works as an index of ethics-related study in this specific pharmaceutical company context.

This paper aims to avail a soft approach to embracing the process of creating a business code of conduct and ethics and make it work for a pharmaceutical company [player] which wants to remain relevant before stakeholders and society, amidst escalating inducements to go against the acceptable pharmaceutical behaviour.

Data collection was guided by qualitative methodologies. A four stepwise process was followed: data collection at the case company – Kampala Pharmaceutical Industries (KPI), Uganda; validation of data collected at KPI; data collection from external stakeholders of KPI; and re-validation of KPI data based on data collected from external stakeholders. In all this, combination of semi-structured and informal interviews with CEOs, senior staff managers, non-participant observation of ethical related activities plus organizing a stakeholder engagement workshop on business code of conduct and ethics was achieved. This workshop helped document what ought to be an ideal design process to secure stakeholder buy-in of the code of business ethics. A local pharmaceutical company in Uganda, KPI was used, which, for continuous five years since its adoption of the business code of conduct and ethics, registered commercial viability without any record of unethical practices. Triangulation was used to ensure credibility and validity of the results. For data analysis, a three-stepwise process was followed, which helped develop a framework within which the collected data revealed themes which were later analyzed. For generalization of the findings, the “adaptive theory approach” was used.

When poorly introduced in an organization, the business code of conduct and ethics can work against the company simply because it will be received with “intentional rebellion” from stakeholders, notably staff. However, when a soft stakeholder engagement and consultative approach is used and followed during the business code of ethics and conduct’s design process, multiple stakeholders feel proud and are much willing to live by the promise spelt out in it. Cited notable benefits of living by the code include reputational enhancement, strategic competitiveness and increased possibilities of wining cross-border cooperation among like-minded pharmaceutical players. In the efforts to reap from the code of ethics, communication was observed as an indispensable activity. Refresher trainings to remind the stakeholders about the promises in the code are also needed as time passes by, otherwise they forget. Needless to say, rewarding those who live an exemplary life in embracing and living by the code was cited as key in sustaining the ethical agenda. Lastly, managing multiple stakeholders influences is a curvilinear fashion and involves back and forth consultations.

The lessons learnt from KPI can be borrowed and used by both global pharmaceutical players and national/local players, especially those that face challenges living by the promise of their existing codes or those without business code of conduct and ethics. That is, both players can use the suggested process to help participants in their medicine supply chain to come up with working business codes of conduct, as well as guide the stakeholder consultative process which results in stakeholder buy-in.

For many years, issues surrounding bioethics have dominated priorities of World Health Organization (WHO), UNESCO and many international and national development allies. However, there is an escalating violation of medical codes of conduct and ethics. Hence, this publication is a step toward the implementation of the principles and objectives of the UNESCO Universal Declaration on Bioethics and Human Rights which is currently challenged with a difficult question posed by life sciences – How far can we go given the dented medical relationship between ethics, medical science and freedom?

Through an analysis of the HIV-Tainted-Blood Affair in Japan, this paper explores why pharmaceutical companies act in a socially irresponsible manner. The paper suggests encouraging members of these corporations to become more conscious of their responsibility to society by developing themselves as professionals. The analysis shows that drug disasters are not caused only by a particular “special villain,” but by the structural conflict between medical professional ethics and the profit making motivation of pharmaceutical companies. In other words, the behaviors of pharmaceutical companies fall into the interstices of professional ethics.

Taking into consideration that the number of reports about pharmaceutical lobbying activities is increasing (Baleta, 2014; Boseley, 2014) and that the cost of drugs has a direct and powerful impact on both public and private healthcare, there is a need to require pharmaceutical companies to report their activity as well as reflect their considerations about the ethical implications of their work. To answer that need, this chapter explores how pharmaceutical companies communicate their corporate social responsibility activities.

This chapter explores how Pfizer, GlaxoSmithKline and Sanofi (all in the top 10 of US foundations by total giving) use their websites to articulate their CSR strategies. In order to achieve this goal, an exploratory research that combines semantic analysis of the way the mission, vision and objectives are integrated in their strategy was conducted. To do so the researchers saved the text about each company’s mission and vision from their main websites (the .com) and saved all the data associated to CSR communication and reporting included on each company website in a word document. One hundred and ninety-one pages of text were thus collected in August 2013 (67 pages of text for GlaxoSmithKline, 38 pages for Sanofi and 87 pages for Pfizer). Wordle and VOSViewer were used to gain insight into the emerging themes from the textual data collected and therefore compare the similarities and differences between the three companies.

Our findings show a strong emphasis on business-related activities for Sanofi and GSK reflected through the vocabulary used. Additionally, the two companies also portray corporate social responsibility as a tool for image and reputation building and for achieving wider yet profit-driven organisational goals. CSR messages therefore are intended to create and consolidate corporate identity. Moreover, whilst their mission focuses on patients, health, care, and access to medicine, the values are also oriented towards profit making and economic criteria. Pfizer on the other hand, although sharing some of the mission and values with the other two companies, presents itself as a more inclusive organisation with a collaborative environment and research-focused culture.

While limited in scope and sample, this chapter raises many valuable questions for future research about the pharmaceutical sector’s understanding and definition of CSR and their differences and similarities in their online discourse and vocabulary in comparison with other profit-driven industries. Moreover, it raises questions about the style and nature of corporate communications and whether this should be consistent with that associated with CSR as well as whether it imposes the creation of a company-ego.

This chapter promotes an alternative exploratory method of online discourses through computer-aided techniques.

This research paper aims to investigate the impact of pharmaceutical marketing on the prescription behavior of physicians. It further examines whether the use of various promotional techniques including advertisements, sales promotions, personal selling and direct marketing by pharmaceutical companies influences the prescription behavior of doctors. Based on the increasing ethical concerns regarding the promotion of specific drugs for personal gains, the research also investigated the moderating role of ethical ideology in the above relationship.

To accomplish the research goals, quantitative research methods were used. Using the online questionnaire, data were collected from 93 doctors working in government and private hospitals in Pakistan, and structural equation modeling technique was used to analyze the impact of pharmaceutical marketing techniques on the prescription decisions of physicians.

The findings suggested that marketing strategies of pharmaceutical companies positively influences the prescription behavior of doctors. Further, physicians having weak ethical standards are likely to be strongly influenced by the marketing and promotional practices of companies.

The research is pivotal in understanding the perspective of doctors and the ethical considerations that need to be addressed while devising the marketing campaigns by pharmaceutical companies. Further, these findings provide important implications regarding the essential linkage between ethical values and the development of right marketing tools.

To the best of the authors’ knowledge, this research is one of the first few to empirically develop and test the role of moral values followed by physicians when they take prescription decisions. Based on the findings, future researchers are encouraged to further investigate the need of setting boundaries for pharmaceutical companies and restricting their usage regarding the promotional tactics.

In an effort to build a useful conceptual framework that enhances understanding and permits practical application of ethics, this paper aims to understand the relationship and impact of Islamic marketing ethics on brand credibility. Nowadays, recognizing the ethical dilemmas associated with business is an important aspect of marketing strategy (Murphy et al. 2012). As known, the pharmaceutical industry has access to a deep pool of resources with the potential to maintain an esteemed reputation for offering innovative products that improve the public’s health and well-being (Kim and Ball, 2013). However, recent years have yielded several high-profile safety issues associated with particular medications along with a growing perception that pharmaceutical companies are unethical and drive up healthcare costs by prioritizing profits over consumer needs (USA Today/KFF/Harvard SPH, 2008). Therefore, the reputation of the pharmaceutical industry has been damaged with only 11 per cent of individuals considering pharmaceutical companies to be trustworthy (Harris Interactive Poll, 2010). Thus, the pharmaceutical industry in Yemen is the target of this paper and the relationship between its brands’ credibility and Islamic marketing ethics has been highlighted.

In a study of 106 respondents, exploratory and confirmatory factor analysis were conducted to understand the relationship, between brand credibility and Islamic marketing ethics. Correlation and regression analyses were performed to evaluate the hypothesized relationships between the variables.

Significant and positive relationships were confirmed between brand credibility and Islamic marketing ethics, namely, Annasihah, Al-Istiqamah, Al-E’etedal, Al-Ihsan, As-Sidq, Attaqwa and Al-Amanah. The eighth Islamic marketing ethic, Attasamoh, has been rejected.

The paper evaluates brand credibility in relation to Islamic marketing ethics in the pharmaceutical industry in Yemen. Islamic marketing ethics have been confirmed as a new variable that correlates with brand credibility and helps in boosting the level of credibility.

Drugs and pharmaceuticals assume importance in the healthcare system today for their capacity to replace costly treatments like surgery. The pharmaceutical industry is considered capital intensive and building a new product costs as much as $900 million. Though the cost of developing a new product is significantly low in a country like India, it is substantial. Therefore, perhaps, companies try to go for incremental innovation. This apart, finding new symptoms to promote products, hiding major side effects, publishing data mixing the outcomes of different studies, publishing major outcomes in reputed journals and poor outcome studies in less important journals are some of the strategies being adopted by pharmaceutical companies. The purpose of this paper is to analyze these issues and their impacts on the Indian economy. As most of the Indian pharmaceutical companies are in private hands, this paper focuses on the possible plight of Indian poor in the changing world order.

This paper draws upon earlier research undertaken by the author. His experience from the pharmaceutical industry as well as the published works of other researchers also helped complete the work.

The analysis of this paper indicates that in order to avoid the loss of revenue and to keep their businesses floating, drug and pharmaceutical companies resort to information manipulation.

The research is limited to the author's ability to review literatures in the field of marketing and corporate ethics related to drugs and pharmaceuticals. As competition and economic liberalization would have a significant impact on pharmaceutical brand‐success, therefore, perhaps, drug companies would resort to manipulations for survival. This paper is an attempt to alert the society to these sorts of information laundering.

This paper would perhaps provide consumers with necessary information to understand the unethical practices being adopted by drug companies and help them consider what exactly to look for and would press for their right to good health.

This paper is the record of original work done by the author. It would probably fulfil an identified need and would perhaps help the society fight unethical practices being adopted by pharmaceutical companies.

The learning outcomes are as follows: what tasks are to be done by medical representatives in pharmaceutical industry? This study also highlights various competencies required to do effective selling in this industry; analyzes and discusses different unethical practices going on in the market; explains why ethical norms are necessary in sales context when sales targets are already achievable with unethical means; and develops and comments on strategies Flori Pharmaceutical can make to overcome on these unethical issues. What should be the response of Dahar to the email of Naveed khan? What course of action should be taken by Dahar in the deceitful reporting case of Mohsin Ali?

Flori is considered a leading and growing multinational organization in the highly competitive environment of Pakistan pharmaceutical industry with over 40 years of experience. The company aims to command a leading position in developing new health-care products as it offers a wide range of diabetic, cardiovascular, respiratory and vitamin products based on quality as a result of high research and examination. Recently, an email to Bilal Dahar on March 2017 from Flori’s star sales person Naveed Khan has forced management to take some strong decisions regarding ethical norms and values to be adopted by medical representatives of Flori pharmaceuticals. The email highlighted the issues related to sales pressure which are leading toward unethical sales practices. Dahar just not have to maintain Flori’s ethical code of conduct but he and his team also has to work hard to achieve more than 26% growth rate in sales revenue as compared to last year. Dahar knew that the highly competitive environment of pharmaceutical industry has led most of the stake holders to indulge in unethical behavior to achieve their individual targets. He knew that this is dangerous in long term for the multinational organizations such as Flori pharmaceuticals as if the similar behavior continues, the sales culture and values of the organization would be on stake. He also has to decide what decision to be taken against deceitful reporting issue of one of the top-performer territory managers, who was key person in helping Flori to close the sales year 2016 with the revenue of Rs. 6.4bn, a 26% growth over the last year. The case is rich enough to provide a platform regarding management of several ethical challenges in pharmaceutical selling and developing strategies based on them.

BBA, MBA final year.

Teaching Notes are available for educators only.

CSS 8: Marketing.

Using the pharmaceutical sector as a microcosm of the health sector, we highlight the most prevalent structural and policy issues that make this sector susceptible to corruption and ways in which these vulnerabilities can be addressed. We conducted a literature review of publications from 2004 to 2015 that included books, peer-reviewed literature, as well as gray literature such as working papers, reports published by international organizations and donor agencies, and newspaper articles discussing this topic. We found that vulnerabilities to corruption in the pharmaceutical sector occur due to a lack of good governance, accountability, transparency, and proper oversight in each of the decision points of the pharmaceutical supply chain. What works best to limit corruption is context specific and linked to the complexity of the sector. At a global level, tackling corruption involves hard and soft international laws and the creation of international standards and guidelines for national governments and the pharmaceutical industry. At a national level, including civil society in decision-making and monitoring is also often cited as a positive mechanism against corruption. Anticorruption measures tend to be specific to the particular “site” of the pharmaceutical system and include improving institutional checks and balances like stronger and better implemented regulations and better oversight and protection for “whistle blowers,” financial incentives to refrain from engaging in corrupt behavior, and increasing the use of technology in processes to minimize human discretion. This chapter was adapted from a discussion piece published by Transparency International UK entitled Corruption in the Pharmaceutical Sector: Diagnosing the Challenges.

The purpose of this study is to analyze newspaper coverage of ethical issues in the pharmaceutical industry.

The top five US newspapers were audited over two years and yielded 376 articles, which appeared as front‐page stories or editorials. First, headlines were analyzed and categorized as positive, negative, or neutral toward the industry. Next, the full‐text of each article was analyzed and ethical issues in each article were categorized. Then, articles were evaluated to determine whether the opposing point of view was included. Finally, comparisons were made between the identified issues and the issues cited by PhRMA, the pharmaceutical industry's trade association.

Analysis of the ethical issues revealed different results for the two years. In 2004, the most common issues covered were drug pricing, data disclosure and importation/reimportation. In 2005, drug safety was the number one issue, due to Vioxx^® with drug pricing a distant second. Headlines were negative 57.1 percent in 2004 and 43.9 percent in 2005. Full‐text articles were negative 69.5 percent in 2004 and 60.1 percent in 2005. The opposing point of view was included 77.7 percent in 2004 and increased to 82.7 percent in 2005. Ethical issues cited by PhRMA, (e.g. drug pricing), received heavy coverage but several identified issues were not on PhRMA's list, notably drug safety.

Pharmaceutical companies need to take action to address the negative impression about them.

This research establishes a practical methodology to evaluate newspaper coverage of ethical issues involving the pharmaceutical industry.