Case 20: Big Pharma’s Marketing Tactics
1. What are the ethical issues in this case?
One might be tempted to say that the primary ethical issue is unfair business practices (e.g.,
paying doctors to prescribe certain drugs or providing free items to medical students), but that
would be short-sighted. Concern over unfair business practices implies that the harm being done
2. Who are the primary stakeholders in these incidents and what are their stakes?
As noted above, the primary stakeholders of concern are the patients who are affected by Big
3. Is there any justification for the marketing and pricing tactics described in the case? Which
are acceptable and which are questionable?
The primary justification is greed—the “need” for increased profits. Other reasons given
generally fall into two categories: 1) Big Pharma’s need for high profits to fund research and
4. What ethical principles may be violated by the marketing tactics described? Do any of these
ethical principles support the companies’ actions?
These marketing tactics could be interfering with physicians’ duties to the patient, by providing
5. Big Pharma needs enormous sums of money to conduct R&D and to advance its innovations.
Do the ends justify the means because our health is at stake?
I do not think that these ends justify the means. Prescription drugs cost far more in the United
States than in other countries, indicating that something is odd. One could also point to the
6. What response do you think physicians should take when approached regarding some of the
schemes presented in this case? Are doctors in a conflict of interest situation when taking Big
Pharma’s money?
The easy answer would be to “just say no.” Unfortunately, it is unreasonable to expect that
physicians, any more than any other profession, are immune to the lure of money. Doctors face
huge costs for their initial schooling, the operations of their practices, and malpractice insurance.
They need sources of income just as much as other people. But at the least, we should expect that