Conflicts of Interest, Institutional Corruption, and Pharma: An Agenda for Reform

Rodwin, Marc A.

doi:10.1111/j.1748-720x.2012.00683.x

Cited by 45 publications

(37 citation statements)

References 31 publications

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“…16 Such conflicts of interest are "inevitable and pervasive in our health care system," 17 and, as illustrated by passage of the Sunshine Act, these conflicts are "as much matters of public policy and management as individual choices or social norms." 18 When confronted with the pervasiveness of financial conflicts of interest, most physicians -reflecting the psychological research showing that each of us is prone to have an optimistic, often unconscious and unintentional, bias about ourselves -will deny that they are influenced by financial transactions with industry. 19 An overwhelmingly convincing body of research, however, suggests otherwise.…”

Section: Introductionmentioning

confidence: 99%

Trust and Transparency: Patient Perceptions of Physicians' Financial Relationships with Pharmaceutical Companies

Perry

Cox

Cox³

2014

J. Law. Med. Ethics

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Financial ties between physicians and pharmaceutical companies are pervasive and controversial. However, little is known about how patients perceive such ties. This paper describes an experiment examining how a national sample of U.S. adults perceived a variety of financial relationships between physicians and drug companies. Each respondent read a single scenario about a hypothetical physician and his financial ties to the pharmaceutical industry; scenarios varied in terms of payment type of (e.g., payment for meals vs. consulting fees) and amount. Respondents then evaluated the physician on several dimensions (e.g., expertise, trustworthiness, knowledge of new treatments, moral character, focus on patients' interests). Findings revealed that perceptions of the physician were more strongly influenced by payment type than by payment amount. Specifically, respondents were quite critical of doctors who owned drug company stock or received industry payments for meals and lodging, but were more forgiving of physicians who received free drug samples (which were perceived as benefiting patients) or consulting fees (which were seen as signaling physician expertise). Interestingly, physicians who received no payments, while seen as honest, were also viewed by some respondents as inexperienced or uninformed about new treatments. Implications for public policy and future research are discussed.

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Section: Introductionmentioning

confidence: 99%

Trust and Transparency: Patient Perceptions of Physicians' Financial Relationships with Pharmaceutical Companies

Perry

Cox

Cox³

2014

J. Law. Med. Ethics

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“…Research suggests that these practices are by no means restricted to operations in emerging markets (Oldani, 2004;Rodwin, 2012;European Commission, 2013). One study conducted in 2007 showed that 83% of US physicians received gifts from the industry, while 28% received payments for services such as honoraria for speaking at conferences and consulting fees (Campbell, 2007).…”

Section: Discussionmentioning

confidence: 99%

A Bitter Pill? Institutional Corruption and the Challenge of Antibribery Compliance in the Pharmaceutical Sector

Dávid-Barrett

Yakis‐Douglas

Moss-Cowan

et al. 2017

Journal of Management Inquiry

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We investigate why top-down directives aimed at eradicating corruption are ineffective at altering on-the-ground practices for organizations that have adopted industry-wide "gold standards" to prevent bribery and corruption. Using interview and focus group data collected from leading multinational pharmaceutical firms, we unearth antecedents contributing to organizations' systemic failure to embed their anticorruption policies in business practice.We identify two tensions that contribute to this disconnect: a culture clash between global and local norms, especially in emerging markets and a similar disconnect between the compliance and commercial functions. To overcome these tensions, we suggest that organizations are likely to find it easier to implement a no gifts policy if they cease to rely on local agents embedded in local norms and that there needs to be strong evidence of boardlevel commitment to antibribery programs, innovative ways of incentivizing compliant behavior, and a fundamental rethinking of organizations' business model and remuneration practices.

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“…These problems are exacerbated by the medical community's dependence on pharmaceutical corporations for funding. 30 Most reform plans to resolve these and other problems involve new legislation, or a change in legal enforcement and administration so that tradeoffs between profit maximization and public health are not as stark. Proposals such as economist Dean Baker's plan for public funding of clinical trials 31 do not advance as legislation, largely because of industry funding of electoral campaigns and lobbying.…”

Section: What Could Have Been? the Legislative Victories For The Pharmentioning

confidence: 99%

Pharmaceuticals, Political Money, and Public Policy: A Theoretical and Empirical Agenda

Jorgensen¹

2013

J. Law. Med. Ethics

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Why, when confronted with policy alternatives that could improve patient care, public health, and the economy, does Congress neglect those goals and tailor legislation to suit the interests of pharmaceutical corporations? In brief, for generations, the pharmaceutical industry has convinced legislators to define policy problems in ways that protect its profit margin. It reinforces this framework by selectively providing information and by targeting campaign contributions to influential legislators and allies. In this way, the industry displaces the public's voice in developing pharmaceutical policy. Unless citizens mobilize to confront the political power of pharmaceutical firms, objectionable industry practices and public policy will not change. Yet we need to refine this analysis. I propose a research agenda to uncover pharmaceutical influence. It develops the theory of dependence corruption to explain how the pharmaceutical industry is able to deflect the broader interests of the general public. It includes empirical studies of lobbying and campaign finance to uncover the means drug firms use to: (1) shape the policy framework adopted and information used to analyze policy; (2) subsidize the work of political allies; and (3) influence congressional voting.

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Conflicts of Interest, Institutional Corruption, and Pharma: An Agenda for Reform

Abstract: When physicians' conflicts of interest arise from ties with drug firms, we should shift our focus to the pharmaceutical industry and improper dependencies that cause institutional corruption. This article analyzes eight forms of improper dependencies on pharma and proposes reforms.

Cited by 45 publications

References 31 publications

Trust and Transparency: Patient Perceptions of Physicians' Financial Relationships with Pharmaceutical Companies

Trust and Transparency: Patient Perceptions of Physicians' Financial Relationships with Pharmaceutical Companies

A Bitter Pill? Institutional Corruption and the Challenge of Antibribery Compliance in the Pharmaceutical Sector

Pharmaceuticals, Political Money, and Public Policy: A Theoretical and Empirical Agenda

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