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Big Pharma (Issues (Off-Label Prescriptions (but sometimes doctors may…
Big Pharma
Issues
Off-Label Prescriptions (but sometimes doctors may realise that some drugs may be effective for uses not mentioned by the prescription) - issue is bc pharm companies pressure them to prescribe to increase the list of uses to increase the sales of drugs
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Ethical Principles
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Justice
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Procedural
Bribery (bc it biases the decision making process. it shows favoritism (any favoritism/discrimination is violation of procedural justice))
Ethical?
Yes
Standard argument: Conventional Approach. Even if I don't do it, I'm not in the market (they see it as market expenses i.e. entrance to the market). Bc standard norms and all the big firms practice all these, if you don't want to do it, you're not even in the market (market refers to the ppl buying from you) and idw to write off the entire market (singapore and regional markets)
Another argument: they are not the one who prescribe the drugs. The doctors are professionals, they know what's right or wrong to do. (basically push to doctors)
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usually, under the disguise of conference, or making them speakers, this is how they pay for their entertainment expenses. another way is to get them to collect data on the effectiveness of the drugs, but they don't even do it.
use non-qualified people to speak, bizzare things done, exaggerated effectiveness
students feel that they are brainwashed/manipulated/obligated. gifts are not an issue, but how the gifts are given. and also how excessive it is. if too excessive, we question intention. is it appropriate to accept? e.g. free iPad?
systemic bias (usually profs will clean data by omitting data collected but this might lead to omission of impt data) sometimes may have strong theory but data don't show. can't publish this data. so there's a temptation to make sure data supports - bc academia supports this, and this leads to systematic bias. prof view: should publish and let ppl decide. esp medical research, need to publish these negative data that dont support theories
question of distributive justice. if we price too high and oppress workers to lower costs. we must know how to price to make ppl pay ie fair pricing e.g. drugs for critical illness - your life depends on it, how would they make the pricing fair
how do we put the r&d costs, the highest cost, into drugs. bc costs will affect prices e.g. they cover r&d cost e.g. 1mil / 1000 pills = cost (to doctors). and doctors usually x3 (as a guide). that's why healthcare costs keep increasing
pre-approval communciations - sometimes you feel that drugs are useful but not yet approved (bc need clinical trials) so it's actually doing harm to the paitent bc you can't prescribe