The most common solutions to the problem of high pharmaceutical prices have taken the form of regulations, price negotiations, or changes in drug coverage by insurers. These measures for the most part transfer the burden of drug expenditures between pharmaceutical companies and payers or between payers. The aim of this study is to propose an alternative model for the relationship between the main stakeholders involved in the price setting and purchasing of pharmaceuticals, one that encourages a more cooperative approach. We (...) draw from principles of ethics and health economics and apply them to the context of the pharmaceutical industry. The model prioritises two objectives, to make drugs financially accessible to the patients who need them, and to keep pharmaceutical companies viable and profitable. It is centered around the sharing of financial risk between the main stakeholders, which we describe as ‘enlightened risk sharing’. After establishing the foundations of this model, we expand on the type of policies that can follow these principles with current day examples. (shrink)

Promoting ethical practice within an organization has been a continuous challenge in the business ethics community. To enrich organizational practices for promoting business ethics across an organization, this paper aims to introduce the voices of practitioners working in organizations that offer exemplary practices. Based on semi-structured interviews with 21 engineers working in the health products industry, we identified 12 pervasive ethical values that we grouped to four categories: fiduciary, economic, engineering, and process values. As ethics has been embraced as a (...) core element of the ethical practice of our study participants regardless of their rankings and roles in their organizations, we investigated organizational strategies for promoting ethical practice. We identified four categories of organizational strategies: symbols, memberships, practices, and systems. Each strategy affected the 12 ethical values in different ways. Lastly, we identified three characteristics of the industry contexts that appeared to influence ethical values: customer impact, economic norms, and highly regulated industry. We discuss how the findings from this paper can potentially promote new discussions and practices in the business ethics community. (shrink)

Recently, dramatic price increases by several pharmaceutical companies have provoked public outrage. These scandals raise questions both about how pharmaceutical firms should be regulated and about how pharmaceutical executives ethically ought to make pricing decisions when drug prices are largely unregulated. Though there is an extensive literature on the regulatory question, the ethical question has been largely unexplored. This article defends a Kantian approach to the ethics of pharmaceutical pricing in an unregulated market. To the extent possible, pharmaceutical companies must (...) price drugs so that those who genuinely need them can get them without financial ruin. This requirement is an ethical side constraint, like the moral prohibitions on deception and theft, that takes precedence over a business’s interest in maximizing profit. That said, the requirement’s application is sensitive to the need to recoup the costs of research and to produce a return that financially justifies the original investment. It may not be either feasible or desirable for government to attempt to enforce the ethical requirements concerning just pharmaceutical pricing. Either price regulation or subsidy could fulfill government’s obligation to protect patients from being objectionably vulnerable to pricing decisions by private companies. (shrink)