The goals of pharmaceutical policy and medical practice are often undermined due to institutional corruption — that is, widespread or systemic practices, usually legal, that undermine an institution’s objectives or integrity. The pharmaceutical industry’s own purposes are often undermined. In addition, pharmaceutical industry funding of election campaigns and lobbying skews the legislative process that sets pharmaceutical policy. Moreover, certain practices have corrupted medical research, the production of medical knowledge, the practice of medicine, drug safety, and the Food and Drug Administration’s oversight of pharmaceutical marketing.
As a result, practitioners may think they are using reliable information to engage in sound medical practice while actually relying on misleading information and therefore prescribe drugs that are unnecessary or harmful to patients, or more costly than equivalent medications. At the same time, patients and the public may believe that patient advocacy organizations effectively represent their interests while these organizations actually neglect their interests.
To address these issues, a group of lab fellows from the Edmond J. Safra Center put together a symposium of 16 articles that investigate the corruption of pharmaceutical policy, each taking a different look at the sources of corruption, how it occurs and what is corrupted. The articles address five topics: (1) systemic problems, (2) medical research, (3) medical knowledge and practice, (4) marketing, and (5) patient advocacy organizations. They are now available online and will appear in the fall issue of The Journal of Law, Medicine & Ethics.
For a summary of each article and the key themes see, Marc Rodwin, Institutional Corruption and Pharmaceutical Policy.
- Marc Rodwin, Institutional Corruption and Pharmaceutical Policy
- Lawrence Lessig, Foreword: 'Institutional Corruption' Defined
- Gregg Fields, Parallel Problems: Applying Institutional Corruption Analysis of Congress to Big Pharma
1. SYSTEMIC PROBLEMS
- Paul D. Jorgensen, Pharmaceuticals, Political Money, and Public Policy: A Theoretical and Empirical Agenda
- Marc-André Gagnon, Corruption of Pharmaceutical Markets: Addressing the Misalignment of Financial Incentives and Public Health
- Marc A. Rodwin, Five Un-Easy Pieces of Pharmaceutical Policy Reform
- Donald W. Light, Joel Lexchin, Jonathan J. Darrow, Institutional Corruption of Pharmaceuticals and the Myth of Safe and Effective Drugs
- Jennifer E. Miller, From Bad Pharma to Good Pharma: Aligning Market Forces with Good and Trustworthy Practices Through Accreditation, Certification, and Rating
2. MEDICAL RESEARCH
- Abigail B. Brown, Understanding Pharmaceutical Research Manipulation in the Context of Accounting Manipulation
- Yuval Feldman, Rebecca L. Gauthier, and Troy H. Schuler,Curbing Misconduct in the Pharmaceutical Industry: Insights from Behavioral Ethics and the Behavioral Approach to Law
- Garry C. Gray, The Ethics of Pharmaceutical Research Funding: A Social Organization Approach
3. MEDICAL KNOWLEDGE AND PRACTICE
- Sergio Sismondo, Key Opinion Leaders and the Corruption of Medical Knowledge: What the Sunshine Act Will and Won't Cast Light On
- Lisa Cosgrove and Emily E. Wheeler, Drug Firms, the Codification of Diagnostic Categories, and Bias in Clinical Guidelines
- Marc A. Rodwin, Rooting Out Institutional Corruption to Manage Inappropriate Off-Label Drug Use
- Sunita Sah and Adriane Fugh-Berman, Physicians Under the Influence: Social Psychology and Industry Marketing Strategies
- Amy Snow Landa and Carl Elliott, From Community to Commodity: The Ethics of Pharma-Funded Social Networking Sites for Physicians
5. PATIENT ADVOCATES
- Susannah L. Rose, Patient Advocacy Organizations: Institutional Conflicts of Interest, Trust, and Trustworthiness