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Drug company ethics and the pharmaceutical industry’s pursuit of profit

Steve Woodruff
Medications
August 26, 2009
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Ghostwritten clinical papers. Off-label marketing. Channel-stuffing. Hiding of negative data.

Pharma companies have earned a hefty percentage of the opprobrium heaped on them by a skeptical public. And it’s mainly because of a failure to heed the Golden Rule. We all know the “classical” Golden Rule: Treat others the way you’d wish to be treated. But in so many cases, drug manufacturers seem to adhere to a different version: the Gold-in Rule: Do whatever is necessary to bring in the maximum gold, without getting caught.

Business ethics can seem complicated. Frankly, I think most of it boils to down to a pretty straightforward choice:

Do I do what’s right? Or do I do what is expedient to try to ensure maximum (income/profitability/bonus/stock price/etc.)?

What is right? That’s a debate that can draw in threads from theology, philosophy, psychology, and other disciplines, but let’s not over-complicate it. How would you want to be treated in a similar circumstance?

You’re working on the clinical research side of a pharmaceutical company, and a promising drug candidate starts to show some anomalous results. Some potentially dangerous side effects. Not a whole lot, mind you, and just a bit of tweaking and data-scrubbing could get it below the threshold of statistical significance. The company has been investing millions into this product, and the pipeline is a bit thin. Do you report it? Do you “work the numbers”? Do you ignore and cover over the warning signs? How does all this impact your job?

Wrong questions. How about this – Would I give this drug to my child? Or this: How would my actions look in the newspaper, if unveiled? Conscience and truth line up with the Golden Rule. Selfish pragmatism often sides with the Gold-in Rule instead.

Just last week, I heard the inside story about a smaller pharma company that went kaput a short time ago because of a dubious and dishonest effort to prop up some quarterly sales numbers. Pleasing Wall Street for a few months. Then destroying shareholder value, jobs, and reputations for much longer. Gold-in for a little while. Gold-out thereafter. Dumb.

I would love to see pharma companies adopt the following “Golden Rule” approach as a cornerstone of their mission: The right drug, for the right patient, at the right time, in the right manner. Period. Percolated through an entire organization, this perspective would nip the vast majority of ethics issues in the bud.

What is the root cause of the parade of scandals we see in pharma (and, for that matter, in plenty of other industries)? Most of the time, we need look no further than the Gold-in Rule. We moan and groan about regulatory meddling, whistleblowing, and all the other thorny features of rules and disclosures that address wrongdoing. But who is to blame? All those who lead their companies, their teams, and themselves by the Gold-in Rule.

I’d love to see some pharma CEO take a stand squarely on the Golden Rule and drive it throughout the entire organization, come whatever may. The short-term disruption would pale compared to the long-term benefit.

Steve Woodruff is Founder and President of Impactiviti.

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Drug company ethics and the pharmaceutical industry’s pursuit of profit
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