Pharmaceutical marketing

Modeling the effects of pharmaceutical marketing

Abstract

Successful innovation of prescription drugs requires a substantial amount of marketing support.

There is, however, much concern about the effects of marketing expenditures on the demand of
pharmaceutical products (Manchanda et al., Market Lett 16(3/4): 293-308, 2005). For example,
excessive marketing could stimulate demand for products in the absence of a fundamental need.
It also has been suggested that increased marketing expenditures may reduce the price elasticity
of demand and allow firms to charge higher prices (Windmeijer et al., Health Econ 15(1): 5-18,
2005). In this paper, we present the outcomes of an empirical study in which we determine the
effects of pharmaceutical marketing expenditures using a number of frequently used
"standardized" models. We determine which models perform best in terms of predictive validity
and adequate descriptions of reality. We demonstrate, among others, that the effects of
promotional efforts are brand specific and that most standardized models do not provide
adequate descriptions of reality. We find that marketing expenditures have no or moderate
effects on demand for pharmaceutical products in The Netherlands.

Leeflang, P., & Wieringa, J. (2010). Modeling the effects of pharmaceutical marketing. Marketing
Letters, 21(2), 121-133. Retrieved April 7, 2020, from www.jstor.org/stable/40604725

Gap- Does pharmaceutical marketing increases the demand of the drug.

Do Pharmaceutical Marketing Activities Raise Prices? 

Abstract

The impact of direct-to-consumer (DTC) advertising of prescription drugs on consumers has

become the focus of considerable debate. Given rising health care costs, the question whether
DTC advertising and other forms of promotion increase the price of prescription drugs is
particularly important. This study uses data on name brand drugs in five major therapy classes
marketed in the United States during 2001–2005 to test the effect of DTC advertising and other
promotional variables on the price elasticity of demand. The predictions of two competing
theories on the economic effects of advertising are used as a basis for forming the hypotheses.
The data indicate that, in general, there is not a significant relationship between DTC advertising
and price elasticity in these five categories. Given the inverse relationship between elasticity of
demand and price, the findings do not support the position that consumers pay higher prices as a
result of DTC advertising in the pharmaceutical industry.

Capella, M., Taylor, C., Campbell, R., & Longwell, L. (2009). Do Pharmaceutical Marketing
Activities Raise Prices? Evidence from Five Major Therapeutic Classes. Journal of Public Policy
& Marketing, 28(2), 146-161. Retrieved April 7, 2020, from www.jstor.org/stable/25651620

Gap – to find out the convincing factor that pharmaceutical promotions should have which
increases the price of prescription drugs.
The Effects of Pharmaceutical Marketing and Promotion on Adverse Drug
Events and Regulation

Abstract

This paper analyzes the relationship between postmarketing promotional activity and reporting of
adverse drug reactions (ADRs) by modeling the interaction between a regulator (the FDA) and a
pharmaceutical firm. Promotion-driven market expansions enhance profitability yet may involve
the risk of inappropriate drug prescriptions, leading to regulatory actions against the firm. We
empirically test the relationship between drug promotion and reporting of ADRs using an
innovative combination of commercial data on pharmaceutical promotion and FDA data on
regulatory interventions and ADRs. We provide some evidence that increased levels of
promotion and advertising lead to increased reporting of ADRs for certain conditions.

David, G., Markowitz, S., & Richards-Shubik, S. (2010). The Effects of Pharmaceutical Marketing
and Promotion on Adverse Drug Events and Regulation. American Economic Journal: Economic
Policy, 2(4), 1-25. Retrieved April 7, 2020, from www.jstor.org/stable/25760083

Gap – How can the regulation in buying can be improved for drugs which have high effects

Unhealthy marketing of pharmaceutical products: An international public

health concern
Abstract

I consider the current state of pharmaceutical marketing vis-à-vis ethical and legal standards and
advocate measures to improve it. There is abundant evidence of unethical or illicit marketing. It
fuels growing concerns about undue corporate influence over pharmaceutical research,
education, and consumption. The most extensive evidence of industry transgressions comes
from the United States (US), where whistle-blowers are encouraged by financial rewards to help
uncover illicit marketing and fraud. Outside the US increasing evidence of transgressions exists.
Recently I have observed a range of new measures to align pharmaceutical marketing practices
with ethical and legal standards. In the interest of public health, I highlight the need for additional
and more profound reforms to ensure that information about medicines supports quality and
resource-efficient care

Mulinari, S. (2016). Unhealthy marketing of pharmaceutical products: An international public

health concern. Journal of Public Health Policy, 37(2), 149-159. Retrieved April 7, 2020, from
www.jstor.org/stable/43948846

Gap- how to increase efficiency in pre-screening of promotional material and active

monitoring of promotions.
Physicians-Pharmaceutical Sales Representatives Interactions and
Conflict of Interest: Challenges and Solutions
Abstract
Physician-industry relationships have come a long way since serious debates began after a
1990 Senate Committee on Labor and Human Resources report on the topic. On one side, the
Sun Shine Act of 2007, now a part of the Patient Protection and Affordable Care Act that
mandates disclosure of payments and gifts to the physicians, has injected more transparency
into the relationships, and on the other side, numerous voluntary self-regulation guidelines
have been instituted to protect patients. However, despite these commendable efforts,
problem persists. Taking the specific case of physician-pharmaceutical sales representative
(PSR) interactions, also called as detailing, where the PSRs lobby physicians to prescribe
their brand drugs while bringing them gifts on the side, an August 2016 article concluded that
gifts as small as $20 are associated with higher prescribing rates. A close examination reveals
the intricacies of the relationships. Though PSRs ultimately want to push their drugs, more
than gifts, they also bring the ready-made synthesized knowledge about the drugs, something
the busy physicians, starving for time to read the literature themselves, find hard to let go.
Conscientious physicians are not unaware of the marketing tactics. And yet, physicians too
are humans. It is also the nature of their job that requires an innate cognitive dissonance to be
functional in medical practice, a trait that sometimes works against them in case of PSR
interactions. Besides, PSRs too follow the dictates of the shareholders of their companies.
Therefore, if they try to influence physicians using social psychology, it is a job they are
asked to do. The complexity of relationships creates conundrums that are hard to tackle. This
commentary examines various dimensions of these relationships. In the end, a few
suggestions are offered as a way forward.

Patwardhan, A. (2016). Physicians-Pharmaceutical Sales Representatives Interactions and

Conflict of Interest: Challenges and Solutions. Inquiry, 53, 1-5. doi:10.2307/26369639

Gap- to eliminate the scarcity of ready-made up-to-date current usable information about the
physicians in the industry.

Pharmaceutical Advertising to Consumers: Corporate Profits vs. Public Safety

Abstract
There is a problem in the pharmaceutical industry today. Instead of viewing drug companies
as miracle workers out to heal the world, consumers now see the industry as a collection of
greed-driven, heartless corporations. Scandal seems to be a routine occurrence, and firms are
so desirous of the next blockbuster that they spend billions of dollars developing the latest
and greatest erectile dysfunction drug instead of the latest and greatest cancer drug because it
will lead to higher profits. Add to this the millions requiring even higher returns and further
eroding consumer confidence, and pharmaceutical companies find them selves in a serious
situation.

Lansing, P., & Fricke, M. (2005). Pharmaceutical Advertising to Consumers: Corporate Profits vs.
Public Safety. Business & Professional Ethics Journal, 24(3), 23-36. Retrieved April 7, 2020,
from www.jstor.org/stable/27801386

Gap- how Rules can be made to control of scandal in drug industries

The Ethics of Drug Development and Promotion: The Need for a Wider
View
Abstract

Ethical issues at the interface between the medical profession and the pharmaceutical industry
have generally been approached from the vantage point of medical professionalism, with a focus
on conflict of interest as the key ethical concern. Although conflicts of interest remain important,
other ethical issues may be obscured unless a wider perspective is adopted. Besides medical
professionalism, the ethics of the clinical therapeutic relationship, ethics of public health, and
business ethics all provide additional insights.

Brody, H. (2012). The Ethics of Drug Development and Promotion: The Need for a Wider
View. Medical Care, 50(11), 910-912. Retrieved April 8, 2020, from
www.jstor.org/stable/41714598

Gap- the unethical contact between the doctor and the companies to promote a certain type of
drug which are been prescribed for common problems.

Ethical Considerations in the Use of Direct-to-Consumer Advertising and

Pharmaceutical Promotions: The Impact on Pharmaceutical Sales and
Physicians
Abstract

The influence of direct-to-consumer advertising and physician promotions are examined in this
study. We further examine some of the ethical issues which may arise when physicians accept
promotional products from pharmaceutical companies. The data revealed that direct-to-consumer
advertising is likely to increase the request rates of both the drug category and the drug brand
choices, as well as the likelihood that those drugs will be prescribed by physicians. The data
further revealed that the majority of responding physicians were either neutral or did not feel that
accepting some types of gifts from pharmaceutical companies affected their ethical behaviors.

Parker, R. S., & Pettijohn, C. E. (2003). Ethical Considerations in the Use of Direct-to-Consumer
Advertising and Pharmaceutical Promotions: The Impact on Pharmaceutical Sales and
Physicians. Journal of Business Ethics, 48(3), 279–290. Retrieved from
www.jstor.org/stable/25075184

Gap- what level does the promotional gifts affects the physicians in prescribing the drugs

SELF-REGULATORY CODES OF CONDUCT: ARE THEY EFFECTIVE IN

CONTROLLING PHARMACEUTICAL REPRESENTATIVES'
PRESENTATIONS TO GENERAL MEDICAL PRACTITIONERS?
Abstract

Self-regulatory codes of conduct are used to control the promotional practices of the
pharmaceutical industry, but the effectiveness of these codes in controlling pharmaceutical
representatives' presentations has not been examined. This is a matter of concern because
pharmaceutical representatives have more influence than any other promotional media on
prescribing practices. The authors developed a method for monitoring the oral presentations of
pharmaceutical representatives when promoting products to medical practitioners. Sixteen audio-
recordings, detailing 64 medicines, were obtained; 38 of the 64 products were prescription-only
medicines. Information on indications and on dosage and administration was commonly
provided, but information on other areas of drug knowledge, particularly product risk, was
minimal. Thirteen presentations contained at least one inaccuracy when compared with
Australian Approved Product Information. Presentations did not always comply with current
guidelines in the Code of Conduct. The Code provides only limited standards for pharmaceutical
representatives' presentations, and no active monitoring system is in place to ensure adherence
to the code. There is an urgent need for policy development on the role of pharmaceutical
representatives, their standards of practice, and regulation of their activities to ensure they
contribute to the appropriate use of medicines.

Roughead, E. E., Gilbert, A. L., & Harvey, K. J. (1998). SELF-REGULATORY CODES OF

CONDUCT: ARE THEY EFFECTIVE IN CONTROLLING PHARMACEUTICAL
REPRESENTATIVES' PRESENTATIONS TO GENERAL MEDICAL
PRACTITIONERS? International Journal of Health Services, 28(2), 269–279. Retrieved from
www.jstor.org/stable/45130652

Gap- Are oral presentations given by the sales representatives are according to the codes of
conduct?

Interactions of Doctors with the Pharmaceutical Industry

Abstract

Objective: To assess the opinions and practice patterns of abstetrician-gynaecologists on

acceptance and use of free drug samples and other incentive items from pharmaceutical
representatives. Methods: A questionnaire was mailed in March 2003 to 397 members of the
American College of Obstetricians and Gynecologists who participate in the Collaborative
Ambulatory Research Network. Results: The response rate was 55%. Most respondents thought
it proper to accept drug samples (92%), an informational lunch (77%), an anatomical model
(75%) or a well-paid consultantship (53%) from pharmaceutical representatives. A third (33%) of
the respondents thought that their own decision to prescribe a drug would probably be influenced
by accepting drug samples. Respondents were more likely to think the average doctor's
prescribing would be influenced by acceptance of the items than theirs would be (p<0.002).
Respondents who distributed drug samples to patients indicated doing so because of patients'
financial need (94%) and for their convenience (76%) and less so as a result of knowledge of the
efficacy of the sample product (63%). A third (34%) of respondents agreed that interactions with
industry should be more strictly regulated. Conclusion: Obstetrician-gynaecologists largely
indicated that they would act in accordance with what they think is proper regarding accepting
incentive items from pharmaceutical representatives. Although accepting free drug samples was
considered to be appropriate more often than any other item, samples were most commonly
judged to be influential on prescribing practices. The widely accepted practice of receiving and
distributing free drug samples needs to be examined more carefully.

Morgan, M. A., Dana, J., Loewenstein, G., Zinberg, S., & Schulkin, J. (2006). Interactions of
Doctors with the Pharmaceutical Industry. Journal of Medical Ethics, 32(10), 559–563. Retrieved
from www.jstor.org/stable/27719714

Gap- what level does the promotional gifts affects the physicians in prescribing the drugs
Thick Prescriptions: Toward an Interpretation of Pharmaceutical Sales
Practices
Abstract

Anthropologists of medicine and science are increasingly studying all aspects of pharmaceutical
industry practices-from research and development to the marketing of prescription drugs. This
article ethnographically explores one particular stage in the life cycle of pharmaceuticals: sales
and marketing. Drawing on a range of sources-investigative journalism, medical ethics, and
autoethnography-the author examines the day-to-day activities of pharmaceutical salespersons,
or drug reps, during the 1990s. He describes in detail the pharmaceutical gift cycle, a three-way
exchange network between doctors, salespersons, and patients and how this process of
exchange is currently in a state of involution. This gift economy exists to generate prescriptions
(scripts) and can mask and/or perpetuate risks and side effects for patients. With implications of
pharmaceutical industry practices impacting everything from the personal-psychological to the
global political economy, medical anthropologists can play a lead role in the emerging scholarly
discourse concerned with critical pharmaceutical studies.

Oldani, M. J. (2004). Thick Prescriptions: Toward an Interpretation of Pharmaceutical Sales

Practices. Medical Anthropology Quarterly, 18(3), 325–356. Retrieved from
www.jstor.org/stable/3655456

No Research Gap

Tricks and Truths of Drug Marketing: An Insider's Experience of an

Indian Pharmaceutical Organization
Abstract

The present article aims at providing some detailed insights into the cultural and ethical
dimensions of pharmaceutical sales and marketing practices in India. The first author had six
months of experience in the field of pharmaceutical marketing. This experience has been used
as a means to understand the complementary elements of the subject concerned like business-
network, strategies, roles and relations of various stakeholders, nature of exchange as well as
intentions around transactions and practices from an insider's perspective. By a continuous
interpretation of multiple layers of consciousness implicit within the first authors experience and
with systematic recreation of his reactions, this article shows how Indian drug representatives are
trained, what they do on a daily basis and also about their socialization process within corporate
culture which has long eluded the anthropological studies of pharmaceuticals. Thus, it provides
an ethnographic perspective or representation of how the networks, relations and ideologies are
structured and organized, and in general, how things work in the Indian pharmaceutical industry.

Banerjee, A., Das, A., & Chakrabarti, G. (2011). Tricks and Truths of Drug Marketing: An
Insider's Experience of an Indian Pharmaceutical Organization. Asian Journal of Social
Science, 39(5), 581–604. Retrieved from www.jstor.org/stable/43497844

NO gap
A Framework for Understanding Ethical and Efficiency Issues in
Pharmaceutical Intellectual Property Litigation

Abstract

Developing and applying a framework for understanding the complexities of economic and legal
considerations in two recent Supreme Court rulings was the focus of this research. Of especial
concern was the protection of intellectual property in the pharmaceutical industry. Two cases
from 2013 were selected: FTC v. Activis (loosely characterized as "pay for delay") and
Association for Molecular Pathology v. Myriad Genetics, Inc. (loosely characterized as "can you
patent genes?"). Part of the rationale for the selection was the importance of the Supreme Court
rulings and the importance of the pharmaceutical sector. A qualitative content analysis of the
Court's reported decision in each case was analyzed. Since ethical considerations may or may
not be consistent with efficiency considerations of plaintiffs, defendants, or the courts, both
efficiency and ethical arguments were included. Equally important to the understanding of the
economic and ethical issues in the two above- mentioned cases was the development of a
rationale for including and excluding a variety of ethical theories, A rationale for this framework is
the societal and organizational impacts on the myriad of stakeholders in the pharmaceutical
sector. We suggest that this framework can be applied to other industries and other complex
conflicts among stakeholders as well.

Oppenheimer, M., LaVan, H., & Martin, W. F. (2015). A Framework for Understanding Ethical
and Efficiency Issues in Pharmaceutical Intellectual Property Litigation. Journal of Business
Ethics, 132(3), 505–524. Retrieved from www.jstor.org/stable/24703607

Gap- what are the criteria that a court has to take to describe ethical and unethical in pharma

Ethically Questionable Behavior in Sales Representatives — An Example

from the Taiwanese Pharmaceutical Industry
Abstract

Recent corporate disgraces and corruption have heightened concerns about ethically
questionable behavior in business. The construct of ethically questionable behavior is an under-
portrayed area of management field research, and deserves further studying, especially in sales
positions. This study uses four variables from the human resource management field to explain
the ethically questionable behavior of sales representatives in the pharmaceutical industry.
These variables include frame pattern, commission structure, behavior control type, and
marketing norm perceptions. This work uses a 2  2  2  2 subject experimental design, and 328
fully completed questionnaires for logistic regression analysis. Results suggest that a medical
representative in a loss frame (compared with a gain frame), in a high commission structure
(compared with a low commission structure), in loose behavior control (compared with strict
behavior control), and in a low perception of marketing norm (compared with a high perception of
marketing norm), is more likely affected by heuristic biases and make an ethically questionable
choice.

Hsu, Y.-H., Fang, W., & Lee, Y. (2009). Ethically Questionable Behavior in Sales
Representatives — An Example from the Taiwanese Pharmaceutical Industry. Journal of
Business Ethics, 88, 155–166. Retrieved from www.jstor.org/stable/41413273

Gap- The complexity of the key players in the market from the producers to the suppliers
COMPULSORY LICENSING OF PHARMACEUTICAL PATENTS: AN
UNREASONABLE SOLUTION TO AN UNFORTUNATE PROBLEM
Abstract

This articles assesses the desirability of enacting a pharmaceutical patent compulsory licensing
scheme to reduce cost based availability limitations. After providing background on patent law
and compulsory licensing as well as the basic operation of the pharmaceutical industry, the
economics of compulsory licensing of pharmaceutical patents is analyzed. The analysis suggests
that a compulsory licensing of pharmaceutical patents is undesirable.

Fisch, A. M. (1994). COMPULSORY LICENSING OF PHARMACEUTICAL PATENTS: AN

UNREASONABLE SOLUTION TO AN UNFORTUNATE PROBLEM. Jurimetrics, 34(3), 295–315.
Retrieved from www.jstor.org/stable/29762343

Gap- how to identify the present existing non licensed patents which are in the market unethically

Pharmaceutical Company Gifts: From Voluntary Standards to Legal

Demands

Abstract
For a long time, medical ethicists have urged the medical profession to alter its relationship
with the pharmaceutical industry. Individual physicians, medical organizations, and academic
institutions have taken some steps toward reform, but problems re- main. Now state and
federal governments, dissatisfied with the profession's efforts at self-regulation, are pressing
for further change.

Dresser, R. (2006). At Law: Pharmaceutical Company Gifts: From Voluntary Standards to Legal
Demands. The Hastings Center Report, 36(3), 8–9. Retrieved from www.jstor.org/stable/4625630

Gap- what level does the promotional gifts affects the physicians in prescribing the drugs

Transnational Pharmaceutical Corporations and Neo-Liberal Business

Ethics in India
Abstract

The author critiques the expedient application of market valuation principles by the transnational
corporations and other large firms in the Indian pharmaceutical industry on a number of issues
like patents, pricing, irrational drugs, clinical trials, etc. He contends that ethics in business is
chiseled and etched within the confines of particular social structures of accumulation. An
ascendant neo-liberal social structure of accumulation has basically shaped these firms' sharp
opposition to the Indian Patents Act, 1970, government administered pricing, etc. The author
contends that the practice of neo-liberal economics is strongly associated with a "one
dimensional" ethics that privileges market valuation principles over all others. This seems to
inevitably generate a social counter-movement that struggles for social protections. He critiques
neo-liberal business practices from a perspective that derives from the work of the economic
anthropologist Karl Polanyi. Before the present phase of liberalization in India, markets were
"managed", but without a "welfare state" in place. Moving toward deregulation of the markets
without a welfare state in place is unethical. Keeping the debilities of the institutional framework
of public policy in mind, the author adopts a Polanyian perspective that places its trust and hope
in the growing social legitimacy of the counter-movement in opposition to both neo-liberal
business practices and the degenerate behavior of state agencies.

D'Mello, B. (2002). Transnational Pharmaceutical Corporations and Neo-Liberal Business Ethics

in India. Journal of Business Ethics, 36(1/2), 165–185. Retrieved from
www.jstor.org/stable/25074701

Gap- No gap

Understanding Firm, Physician and Consumer Choice Behaviour in the

Pharmaceutical Industry
Abstract

This paper argues that the pharmaceutical industry represents an exciting opportunity to carry
out academic research. The nature of the industry allows researchers to answer new questions,
develop new methodologies for answering these questions as well as to apply existing
methodology to new data. The paper opens with some industry background, then provides a brief
overview of some important research areas and discusses the open questions in each area.
Issues of data type and availability are also discussed.

Manchanda, P., Wittink, D. R., Ching, A., Cleanthous, P., Ding, M., Dong, X. J., … Xie, Y. (2005).
Understanding Firm, Physician and Consumer Choice Behavior in the Pharmaceutical
Industry. Marketing Letters, 16(3/4), 293–308. Retrieved from www.jstor.org/stable/40239894

Gap- To find the indirect factors that are involved in the consumer decision of purchasing the
medicines.

Moral Psychology and the Intuition that Pharmaceutical Companies

Have a 'Special' Obligation to Society
Abstract

Many people believe that the research-based pharmaceutical industry has a 'special' moral
obligation to provide lifesaving medications to the needy, either free-of-charge or at a reduced
rate relative to the cost of manufacture. In this essay, I argue that we can explain the ubiquitous
notion of a special moral obligation as an expression of emotionally charged intuitions involving
sacred or protected values and an aversive response to betrayal in an asymmetric trust
relationship. I then review the most common arguments used to justify the claim that the
pharmaceutical industry has a special moral obligation and show why these justifications fail.
Taken together, these conclusions call into question the conventional ideologies that have
traditionally animated the debate on whether the pharmaceutical industry has special duties of
beneficence and distributive justice with respect to the impoverished in dire need of their
products.

Huebner, J. M. (2014). Moral Psychology and the Intuition that Pharmaceutical Companies Have
a 'Special' Obligation to Society. Journal of Business Ethics, 122(3), 501–510. Retrieved from
www.jstor.org/stable/42921451

Gap- the psychological mechanics underlying shared intuitions about moral agency and
moral obligation as applied to the prescription drug industry.

The Business Ethics of Pharmacists: Conflicts Practices and Beliefs

Abstract

This paper represents the responses of 377 pharmacists to a mail survey examining their views
concerning ethical conflicts and practices. Besides identifying the sources of ethical conflicts,
pharmacists were asked how ethical standards have changed over the last 10 years as well as
the factors influencing these changes. Conclusions and implications are outlined and future
research needs are examined.

Vitell, S. J., Rawwas, M. Y. A., & Festervand, T. A. (1991). The Business Ethics of Pharmacists:
Conflicts Practices and Beliefs. Journal of Business Ethics, 10(4), 295–301. Retrieved from
www.jstor.org/stable/25058232

Gap- a study comparing chain pharmacists with independents concerning various ethical
issues

Pharmaceutical Advertisements: How They Deceive Patients

Abstract

Pharmaceutical advertising is one of the most important kinds of advertising that can have a
direct impact on the health of a consumer. Hence, this necessitates the fact that it is essential for
advertisers of such products to take special care and additional responsibility when devising the
promotional strategies of these products. In reality, it has been observed that pharmaceutical
product advertisers often promoted their products to achieve their own goals at the potential risk
of having an adverse effect on the consumer's health. This type of advertising is most often seen
in over-the-counter drug product advertisements, and not as often in the case of prescription
drug advertisements, which is relatively new. This article analyzes various purposes of
advertising pharmaceutical products and also the potential problems that arise from the way
pharmaceutical products have quite frequently been promoted.

Chandra, A., & Holt, G. A. (1999). Pharmaceutical Advertisements: How They Deceive
Patients. Journal of Business Ethics, 18(4), 359–366. Retrieved from
www.jstor.org/stable/25074060

Gap- How to find the right target audience and advertising strategy before developing a
particular advertisement just based on the product.

Marketers' Norms and Personal Values: An Empirical Study of Marketing

Professionals
Abstract

This study explores the relationships among marketers' deontological norms and their personal
values. Based on the review of theoretical works in the area of marketing, hypotheses
concerning the relationships among marketers' norms and their personal values were developed
and tested. Data were collected from 249 marketing professionals. Results from canonical
correlation analysis generally indicate that marketers' norms can be partly explained by personal
values. Marketers' pricing and distribution norms, information and contract norms, and norms
pertaining to marketers' honesty and integrity were significantly related to the personal values
emphasizing "excitement," "warm relationships with others," "fun and enjoyment in life," and "a
sense of accomplishment."

Rallapalli, K. C., Vitell, S. J., & Szeinbach, S. (2000). Marketers' Norms and Personal Values: An
Empirical Study of Marketing Professionals. Journal of Business Ethics, 24(1), 65–75. Retrieved
from www.jstor.org/stable/25074267

Gap- role of values in marketers' ethical decision-making

Keeping Modern in Medicine: Pharmaceutical Promotion and Physician
Education in Postwar America
Abstract

Recent critiques of the role of pharmaceutical promotion in medical practice invoke a nostalgic
version of 1950s and 1960s medicine as representing an uncomplicated relationship between an
innovative pharmaceutical industry and an idealistic and sovereign medical profession—a
relationship that was later corrupted by regulatory or business practice changes in the 1980s or
1990s. However, the escalation of innovation and promotion in the pharmaceutical industry at
mid-century had already provoked a broader crisis of overflow in medical education in which
physicians came to use both commercial and professional sources in an attempt to "keep
modern" by incorporating emerging therapeutics into their practices. This phenomenon was
simultaneously a crisis for the medical profession—playing a key role in attempts to inculcate a
"rational therapeutics"—and a marketing opportunity for the pharmaceutical industry, and
produced the structural foundations for contemporary debates regarding the role of
pharmaceutical promotion in medical practice. Tracing the issue from the advent of the wonder
drugs through today's concerns regarding formal CME, we document how and why the
pharmaceutical industry was allowed (and even encouraged) to develop and maintain the central
role it now plays within postgraduate medical education and prescribing practice.

GREENE, J. E. R. E. M. Y. A., & PODOLSKY, S. C. O. T. T. H. (2009). Keeping Modern in

Medicine: Pharmaceutical Promotion and Physician Education in Postwar America. Bulletin of
the History of Medicine, 83(2), 331–377. Retrieved from www.jstor.org/stable/44448759

No gap

The Perceived Role of Ethics and Social Responsibility: A Scale

Development
Abstract

Marketers must first perceive ethics and social responsibility to be important before their
behaviors are likely to become more ethical and reflect greater social responsibility. However,
little research has been conducted concerning marketers' perceptions regarding the importance
of ethics and social responsibility as components of business decisions. The purpose of this
study is to develop a reliable and valid scale for measuring marketers' perceptions regarding the
importance of ethics and social responsibility. The authors develop an instrument for the
measurement of the perceived role of ethics and social responsibility (PRESOR). Evidence that
the scale is valid is presented through the assessment of scale reliability, as well as content and
predictive validity. Finally, future research needs and the value of this construct to marketing are
discussed.

Singhapakdi, A., Vitell, S. J., Rallapalli, K. C., & Kraft, K. L. (1996). The Perceived Role of Ethics
and Social Responsibility: A Scale Development. Journal of Business Ethics, 15(11), 1131–1140.
Retrieved from www.jstor.org/stable/25072838

Gap- To conduct future studies that examine PRESOR using a sample of marketing
practitioner
Do Pharmaceutical Marketing Activities Raise Prices? Evidence from
Five Major Therapeutic Classes
Abstract

The impact of direct-to-consumer (DTC) advertising of prescription drugs on consumers has

become the focus of considerable debate. Given rising health care costs, the question whether
DTC advertising and other forms of promotion increase the price of prescription drugs is
particularly important. This study uses data on name brand drugs in five major therapy classes
marketed in the United States during 2001–2005 to test the effect of DTC advertising and other
promotional variables on the price elasticity of demand. The predictions of two competing
theories on the economic effects of advertising are used as a basis for forming the hypotheses.
The data indicate that, in general, there is not a significant relationship between DTC advertising
and price elasticity in these five categories. Given the inverse relationship between elasticity of
demand and price, the findings do not support the position that consumers pay higher prices as a
result of DTC advertising in the pharmaceutical industry.

Capella, M. L., Taylor, C. R., Campbell, R. C., & Longwell, L. S. (2009). Do Pharmaceutical
Marketing Activities Raise Prices? Evidence from Five Major Therapeutic Classes. Journal of
Public Policy & Marketing, 28(2), 146–161. Retrieved from www.jstor.org/stable/25651620

Gap- Further research should investigate additional therapy classes to validate these results
and determine whether the findings are generalizable beyond these five classes.

Attention to 'Details': Etiquette and the Pharmaceutical Salesman in

Postwar American
Abstract

This paper provides a sketch of the emerging role of the pharmaceutical salesman, or 'detail
man', in the growth years of the American post-World War II pharmaceutical industry. Using
training manuals, trade literature, in-house company newsletters, memoirs, and a variety of other
published sources, the paper follows the delicate tactics employed by salesmen and their
managers in their attempts to recast drug salesmanship as a 'professional service' fulfilling vital
functions within medical education. As they worked to legitimate their presence in the nation's
hospitals and clinics, particular emphasis was given to precise management of the etiquette of
doctor-salesman interaction. Ultimately, the techniques employed by mid-century salesmen and
their managers were to prove successful in generating a widespread acceptance of the industry
representative within the clinical spaces of hospital and clinic. Indeed, many of the practices of
market research and market strategy employed across the pharmaceutical industry today have
their origins in the practices of the individual detail man. Exploration of the postwar
pharmaceutical salesman as an overlooked historical 'type' provides significant insights into the
intersection of medicine and the consumer marketplace during the later 20th century.

Greene, J. A. (2004). Attention to 'Details': Etiquette and the Pharmaceutical Salesman in

Postwar American. Social Studies of Science, 34(2), 271–292. Retrieved from
www.jstor.org/stable/3183045

No research gap
Do We Need Stronger Sanctions to Ensure Legal Compliance By
Pharmaceutical Firms?

Abstract

The increasing number of enforcement lawsuits against pharmaceutical firms and the large size
of settlement payments suggest that misconduct is widespread and even risks slipping into the
banalities of ordinary business practices. It also raises questions as to whether current sanctions
are an effective means to ensure compliance. This article explores the causes of the frequent
illegal conduct, why prosecutors rarely use the strongest sanctions in their arsenal—criminal
penalties and debarment from participation in public programs—and asks whether the use of the
strongest sanctions would be desirable. Prosecutors might not use the strongest penalties
available because of divided enforcement authority or because they prefer to seek monetary
penalties to support their budgets. Moreover, strong sanctions might be perceived as imposing
steep collateral damages on the general public and being politically costly. If prosecutors are
reluctant to impose the strongest possible sanctions, then policymakers need to develop
alternative responses. One option is to create stronger economic penalties than the ones that
currently exist. Corporations and their managers have incentives to increase their income, and
their pursuit of profit sometimes leads these managers to violate the law. To deter illegal conduct,
legislation typically allows courts to impose penalties—including fines and incarceration—on
convicted individuals and firms. The increasing wide-scale illegal conduct by pharmaceutical
firms and their employees over the last two decades prompts three questions. Are current
sanctions sufficient? Are stronger sanctions and enforcement policy possible? If so, would they
effectively deter harmful illegal conduct?

Rodwin, M. (2015). Do We Need Stronger Sanctions to Ensure Legal Compliance By

Pharmaceutical Firms? Food and Drug Law Journal, 70(3), 435-452. doi:10.2307/26661074

Gap – Does the government have any illegal and unethical practises in the legalization of
drugs in India?

Where Strategy and Ethics Converge: Pharmaceutical Industry Pricing

Policy for Medicare Part D Beneficiaries
Abstract

On January 1, 2006, Medicare Part D prescription drug coverage was initiated. Concern was
immediately voiced by the American Association of Retired Persons (AARP) and Families USA
that, in response to this program, the pharmaceutical industry may raise prices for drugs most
often used by the elderly. This article examines the ethical implications of a revenue-maximizing
pricing strategy in an industry in which third party financing mitigates an end product's true cost
to the user. The perspectives of three stakeholder groups are examined: the elderly, as
consumers of prescription drugs, the pharmaceutical industry, as product manufacturer and
beneficiary of derived profits, and the total U. S. population, as the ultimate payer for the program
via tax revenues. Key questions explored include the relationships among price strategy and
access to drugs at both the micro (Medicare cohort) and macro (total population) levels, and on
drug development or enhancement. The role of profit in a capitalism-based health care system is
also examined. Hospital industry impact on these same stakeholder groups in response to the
original 1965 Medicare law is used to compare and contrast possible outcomes of the new drug
program. It is predicted that pharmaceutical firms will mimic the hospital industry, adopting a
price maximizing strategy for drugs covered by the program. In the process, a utilitarian effect
occurs: the benefits of increased access and diffusion of drugs counterbalance inequities in
financing Medicare Part D.
Balotsky, E. (2009). Where Strategy and Ethics Converge: Pharmaceutical Industry Pricing
Policy for Medicare Part D Beneficiaries. Journal of Business Ethics, 84, 75-88. Retrieved April
15, 2020, from www.jstor.org/stable/40294774

Gap- Is the role of taxes really needed for a very essential products like medicine?

Violations of Exhibiting and FDA Rules at an American Psychiatric

Association Annual Meeting

Abstract

We conducted a cross-sectional study of all exhibit booths for the 24 pharmaceutical companies
at the 2002 American Psychiatric Association (APA) convention. We collected and categorized
one of each item distributed by the companies at each booth. A total of 268 items were collected
from 24 companies (median = 8). The most common categories of items were "reprints or
pamphlets" (37%) and "non-educational gifts" (27%), including music CDs and invitations to
dinners and museums. There were a total of 16 violations of the APA's own exhibit rules: eight
companies had one violation and two companies had four violations. Four companies engaged in
FDA-prohibited off-label promotion; one also violated the APA code. Over half of all companies
(54%) were in violation of either APA rules or FDA regulations. The APA's voluntary code has
failed to adequately reduce inappropriate promotional activity at the annual APA meeting.

Lurie, P., Tung Tran, Sidney Manuel Wolfe, & Goodman, R. (2005). Violations of Exhibiting and
FDA Rules at an American Psychiatric Association Annual Meeting. Journal of Public Health
Policy, 26(4), 389-399. Retrieved April 15, 2020, from www.jstor.org/stable/4125164

Gap- How a real time method can be implemented to find the people who are violating the rules.

Ethical Issues in Outsourcing: The Case of Contract Medical Research

and the Global Pharmaceutical Industry
Abstract

The outsourcing of medical research has become a strategic imperative in the global
pharmaceutical industry. Spurred by the challenges of competition, the need for speed in drug
development, and increasing domestic costs, pharmaceutical companies across the globe
continue to outsource critical parts of their value chain activities, namely contract clinical
research and drug testing, to sponsors across the globe, typically into emerging markets. While it
is clear that important ethical issues arise with this practice, unraveling moral responsibility and
the allocation of responsibility is not so clear, considering that contracts, by their very definition
transfer responsibility from the principal to the agent. This research provides a framework for
exploring some of the ethical issues, including attributions of moral responsibility associated with
Contract Medical Research. Using a theory of strategic and moral behavior, the research shows
that both clients and sponsors in contract research have individual and collective responsibility to
ensure that due care and diligence is exercised in the performance of clinical research. The
research suggests some guidelines for stakeholder action.

Adobor, H. (2012). Ethical Issues in Outsourcing: The Case of Contract Medical Research and
the Global Pharmaceutical Industry. Journal of Business Ethics, 105(2), 239-255. Retrieved April
15, 2020, from www.jstor.org/stable/41413258

Gap- how moral responsibility is assigned in CMR.

Ethical Transparency and Economic Medicalization

Abstract

This article introduces the concept of economic medicalization where non-medical problems are
transformed into medical problems in order to achieve the objective of corporate shareholder
wealth maximization. Following an overview of the differences in ethical norms applicable to
medical ethics and business ethics, the economic medicalization of medical research practice
and publication is examined in some detail. This motivates a general discussion of the problems
involved in the ethical approval process for medical research that balances the interests of both
business and government in the market for medical products and services.

Poitras, G., & Meredith, L. (2009). Ethical Transparency and Economic Medicalization. Journal of
Business Ethics, 86(3), 313-325. Retrieved April 15, 2020, from www.jstor.org/stable/40294892

Gap- how do companies have economic incentives to promote use of the drug for other
medical conditions

BIG PHARMA AND THE PROBLEM OF DISEASE INFLATION

Abstract

Over the course of the past decade, critics have increasingly called attention to the corrosive
influence of the pharmaceutical industry on both biomedical research and the practice of
medicine. Critics describe the industry's use of ghostwriting and other unethical techniques to
expand their markets as evidence that medical science is all-too-frequently subordinated to the
goals of corporate profit. While we do not dispute this perspective, we argue that it is imperative
to also recognize that the goals of medical science and industry profit are now tightly wed to one
another. As a result, medical science now operates to expand disease definitions, lower
diagnostic thresholds, and otherwise advance the goals of corporate profit through the
redefinition and expansion of what it means to be ill. We suggest that this process has led to a
variety of ethical problems that are not fully captured by current critiques of ghostwriting and
other troubling practices by the pharmaceutical industry. In our conclusion, we call for physicians,
ethicists, and other concerned observers to embrace a more fundamental critique of the
relationship between biomedical science and corporate profit.

Gabriel, J., & Goldberg, D. (2014). BIG PHARMA AND THE PROBLEM OF DISEASE
INFLATION. International Journal of Health Services, 44(2), 307-322. Retrieved April 15, 2020,
from www.jstor.org/stable/45140341

Gap- the task of formulating strategies for how the disease inflation along with price might be
disentangled
Extraordinary Pricing of Orphan Drugs: Is it a Socially Responsible
Strategy for the U.S. Pharmaceutical Industry?
Abstract

The PRIME Institute of the College of Pharmacy, University of Minnesota, recently released
preliminary research findings indicating a trend of extraordinary pharmaceutical industry pricing
of drug products in the United States (U.S.). According to researchers at the PRIME Institute,
such extraordinary price increases are defined as any price increase that is equal to, or greater
than, 100% at a single point in time. In some instances, PRIME Institute researchers found that
drugs exhibiting extraordinary price increases are categorized as "orphan drugs" (or blood-
related biologic treatments) and often life-saving or life-sustaining for treating the cause or
symptoms of diseases affecting fewer than 200,000 people in the U.S., or where there is
prevalence of less than 5 per 10,000 people afflicted with a disease or symptoms in the
community. Because of extraordinary price increases for orphan drugs — some exceeding
1000% at a single point in time -this article addresses two interrelated questions: Are
extraordinary orphan drug price increases socially responsible behavior? If so, are the
pharmaceutical industry's policies providing orphan drug access to American consumers in dire
need of available life-sustaining and life-enhancing pharmaceuticals considered "socially
responsible" behavior? The author concludes, after an interdisciplinary analysis of the legal,
economic, sociopolitical, and ethical dimensions of orphan drug pricing, that they are not socially
responsible – unless justified by cost and availability of health care marketplace/patient options.
Furthermore, the author recommends a socially responsible industry strategic approach to insure
that patients ultimately receive -regardless of cost -timely access to life-saving and life-sustaining
orphan drugs.

Hemphill, T. (2010). Extraordinary Pricing of Orphan Drugs: Is it a Socially Responsible Strategy

for the U.S. Pharmaceutical Industry? Journal of Business Ethics, 94(2), 225-242. Retrieved April
15, 2020, from www.jstor.org/stable/40784598

Gap- Are extraordinary price increases of orphan drugs socially responsible business
behaviour?

Patient- or Physician-Oriented Marketing: What Drives Primary Demand

for Prescription Drugs?
Abstract
The authors analyze primary demand effects of marketing efforts directed at the physician
(detailing and professional journal advertising) versus marketing efforts directed at the patient
(direct-to-consumer advertising). The analysis covers 86 categories, or approximately 85% of the
U.S. pharmaceutical market, during the 2001-2005 period. Primary demand effects are rather
small, in contrast with the estimated sales effects for individual brands. By using a new brand-
level method to estimate primary demand effects with aggregate data, the authors show that the
small effects are due to intense competitive interactions during the observation period but not
necessarily to low primary demand responsiveness. In contrast with previous studies, the
authors also find that detailing is more effective in driving primary demand than direct-to-
consumer advertising. A category sales model cannot provide such insights. In addition, a
category sales model likely produces biased predictions about period-by-period changes in
primary demand. The suggested brand-level method does not suffer from these limitations.

Fischer, M., & Albers, S. (2010). Patient- or Physician-Oriented Marketing: What Drives Primary
Demand for Prescription Drugs? Journal of Marketing Research, 47(1), 103-121. Retrieved April
15, 2020, from www.jstor.org/stable/20618958

Gap- What are the other independent factors which drives the demand between patient or
physician
The Rise and Fall of Gabapentin for Bipolar Disorder: A Case Study on Off-
Label Pharmaceutical Diffusion

Abstract

Context: Rising drug costs have increased focus on how new pharmaceuticals diffuse into the
marketplace. The case of gabapentin use in bipolar disorder provides an opportunity to study the
roles of marketing, clinical evidence, and prior authorization (PA) policy on off-label medication
use. Design: Observational study using Medicaid administrative and Verispan marketing data.
We examined the association between marketing, clinical trials, and prior authorization on
gabapentin use. Setting and Patients: Florida Medicaid, bipolar disorder -diagnosed enrollees
ages 18 to 64 for fiscal years 1994 to 2004. Results: Gabapentin prescriptions increased from
8/1000 enrollees per quarter in 1994 to a peak of 387/1000 enrollees in 2002. Its uptake tracked
marketing efforts towards psychiatrists. The publication of 2 negative clinical trials in 2000 and
the discontinuation of marketing expenditures towards psychiatrists were associated with an end
to the steep rise in gabapentin prescriptions. After these events gabapentin use remained
between 319/1000 and 387/1000 enrollees per quarter until the PA policy, which was associated
with a 45% decrease in prescriptions filled. After 1 year, scientific evidence and marketing
discontinuation were associated with a 5.4 percentage point decrease in the predicted probability
of filling a gabapentin prescription and the PA policy, a 7.1 percentage point decrease.
Conclusions: Pharmaceutical marketing can influence off-label medication prescribing,
particularly when pharmacologic options are limited. Evidence of inefficacy and/or the cessation
of pharmaceutical marketing, and a restrictive formulary policy can alter prescriber behavior
away from targeted pharmacologic treatments. These results suggest that both information and
policy are important means in altering physician prescribing behavior.

Fullerton, C., Busch, A., & Frank, R. (2010). The Rise and Fall of Gabapentin for Bipolar
Disorder: A Case Study on Off-Label Pharmaceutical Diffusion. Medical Care, 48(4), 372-379.
Retrieved April 15, 2020, from www.jstor.org/stable/27798458

Gap- No research gap

Pharmaceutical Trials In General Practice: The First 100 Protocols. An

Audit By The Clinical Research Ethics Committee Of The Royal College
Of General Practitioners

Abstract

Objective—To assess the outcome of 100 general practice based, multicentre research projects
submitted to the ethics committee of the Royal College of General Practitioners by
pharmaceutical companies or their agents between 1984 and 1989. Design—Analysis of
consecutive submitted protocols for stated objectives, study design, and outcomes; detailed
review of committee minutes and correspondence in relation to amendment and approval;
assessment of final reports submitted at conclusion of studies. Subjects—82 finally approved
protocols, embracing 34 523 proposed trial subjects and 1195 proposed general practice
investigators. Main outcome measures—Success at enrolling subjects and investigators;
commencement and completion data; validity of final report's assessment of efficacy, safety,
tolerability, and acceptability; and method of use and dissemination of findings. Results—18
studies were not approved and 45 had to be amended. Randomised controlled trials comprised
46 of the original submissions. Remuneration considerations, inadequate information or consent
sheets, pregnancy safety, the need to discontinue existing therapy, and suboptimal scientific
content were major reasons for rejecting studies or asking for amendments. Of the 82 approved
studies 8 were not started. Shortfalls of investigators (of 39%) and trial subjects (of 37%) and an
overall 23% withdrawal rate were responsible for a significant incidence of inconclusive results.
Within the six year follow up interval, only 19 of the studies had been formally published.
Conclusions—This audit identified substantial ethical concerns in the process of approving
multicentre general practice pharmaceutical research.

Wise, P., & Drury, M. (1996). Pharmaceutical Trials In General Practice: The First 100 Protocols.
An Audit By The Clinical Research Ethics Committee Of The Royal College Of General
Practitioners. BMJ: British Medical Journal, 313(7067), 1245-1248. Retrieved April 15, 2020,
from www.jstor.org/stable/29733503

No research gap

Product Names, Proper Claims? More Ethical Issues In The Marketing Of

Drugs
Abstract

Objectives—To analyse the explicit or implicit claims embodied in the proprietary names of
pharmaceutical products. Design—Linguistic and ethical analysis of proprietary names of
pharmaceutical products marketed in the UK and in Denmark. Results and conclusions—A
number of drugs have names that allude to their indication or actions. Such names may be
problematic, however, because they often promise more than the drug can deliver. Taking into
account, firstly, the type of allusion and its degree of sophistication, and, secondly, the
seriousness of the indication may help in identifying the most problematic drug names.

Holm, S., & Evans, M. (1996). Product Names, Proper Claims? More Ethical Issues In The
Marketing Of Drugs. BMJ: British Medical Journal, 313(7072), 1627-1629. Retrieved April 15,
2020, from www.jstor.org/stable/29733892

Gap- How to control that no drug with a misleading name

Marketing of the Life Sciences: A New Framework and Research Agenda

for a Nascent Field
Abstract
Although marketing scholars often seek to contribute new knowledge that is applicable across
industries, some industries have unique characteristics that require industry-specific knowledge
development. The authors argue that this requirement applies to the life sciences industry,
defined as companies in pharmaceuticals, biotechnology, and therapeutic medical devices.
Marketers in the life sciences industry face novel and unique challenges along eight decision
areas in therapy creation, therapy launch, and therapy promotion. In therapy creation, they face
therapy pipeline optimization, innovation alliance formation, and therapy positioning decisions. In
therapy launch, they face global market entry timing and key opinion leader selection decisions.
Therapy promotion mostly revolves around sales force management, communication
management, and stimulating patient compliance. The authors qualify these decision areas
according to their practical importance and academic potential. The article derives preliminary
generalizations and propositions from prior research and practice and steers further research in
specific directions. The authors believe that marketing of the life sciences offers a fertile area for
further research because, among other things, its potential impact transcends any problems
typically investigated by marketing scholars.

Stremersch, S., & Van Dyck, W. (2009). Marketing of the Life Sciences: A New Framework and
Research Agenda for a Nascent Field. Journal of Marketing, 73(4), 4-30. Retrieved April 15,
2020, from www.jstor.org/stable/20619031

Gap- Research on therapy positioning

Ghosts in the Machine: Publication Planning in the Medical Sciences
Abstract

Publication of pharmaceutical company-sponsored research in medical journals, and its

presentation at conferences and meetings, is mostly governed by 'publication plans' that extract
the maximum amount of scientific and commercial value out of data and analyses through
carefully constructed and placed papers. Clinical research is typically performed by contract
research organizations, analyzed by company statisticians, written up by independent medical
writers, approved and edited by academic researchers who then serve as authors, and the whole
process organized and shepherded through to journal publication by publication planners. This
paper reports on a conference of an international association of publication planners. It describes
and analyzes their work in an ecological framework that relates it to marketing departments of
pharmaceutical companies, medical journals and publishers, academic authors, and potential
audiences. The medical research described here forms a new kind of corporate science,
designed to look like traditional academic work, but performed largely to market products.

Sismondo, S. (2009). Ghosts in the Machine: Publication Planning in the Medical

Sciences. Social Studies of Science, 39(2), 171-198. Retrieved April 15, 2020, from
www.jstor.org/stable/27793288

Gap- to what extent the shift of marketing from traditional method to

modern methods affect the patients.

Releasing the Flood Waters: Diuril and the Reshaping of Hypertension

Abstract

This article narrates the development and promotion in the 1950s and 1960s of Merck, Sharp &
Dohme's Diuril (chlorothiazide), an antihypertensive drug, which played a significant role in the
redefinition of high blood pressure as a widespread target for chronic pharmaceutical
consumption. The joined careers of Diuril and hypertension in the late twentieth century
demonstrate the connections between the clinical research, clinical practice, and marketing
practices through which pharmaceuticals and disease categories come to define one another. By
examining a series of internal documents preserved in the Merck Archives alongside a careful
reading of the clinical literature and industry journals of the time, this article explores how the
ambitions of marketers, physicians, and public health advocates found convergence in the
expanding pharmaceutical prevention of chronic diseases.

GREENE, J. (2005). Releasing the Flood Waters: Diuril and the Reshaping of
Hypertension. Bulletin of the History of Medicine,79(4), 749-794. Retrieved April 15, 2020, from
www.jstor.org/stable/44449494

No research gap
A Simple Model of Pharmaceutical Price Dynamics
Summary
In this paper, we present a new explanation for this stylized fact. The key to our explanation
lies in the pharmaceutical company’s dynamic demand management problem. Pricing and
advertising strategies set today affect quantity demanded tomorrow. Patent expiry is an
important event in the dynamic program shaping the firm’s price and advertising path not
only at and after expiry but before that point as well.

Bhattacharya, J., & Vogt, W. (2003). A Simple Model of Pharmaceutical Price Dynamics. The
Journal of Law & Economics, 46(2), 599-626. doi:10.1086/378575

Gap- what level does the promotional gifts affects the physicians in prescribing the drugs

Characteristics of Patients Receiving Pharmaceutical Samples and

Association between Sample Receipt and Out-of-Pocket Prescription
Costs

Abstract

Background: Pharmaceutical samples are widely used for promotion and marketing, yet little is
known about who receives samples or how their use is associated with patient's prescription
costs. Objective: To examine the characteristics of those receiving samples and the relationship
between sample receipt and out-of-pocket prescription costs. Design, Subjects, and Measures:
We divided the 2002-2003 Medical Expenditure Panel Survey, a nationally representative, panel-
design longitudinal study, into baseline and analysis periods. We conducted logistic and
generalized linear regression analysis of 5709 individuals in the analysis period who did not
receive samples during the baseline period. The primary outcome measures were sample receipt
and prescription expenditures. Results: Fourteen percent of individuals received at least 1
sample during the analysis period. On multivariate analyses sample receipt was greater among
those who were younger and those not on Medicaid. In generalized linear regressions controlling
for demographic characteristics and health care utilization, the predicted 180-day out-of-pocket
prescription expenditures were $178 [standard error (SE), $3.9] for those never receiving
samples. Among those receiving samples, the corresponding out-of-pocket expenditures were
$166 (SE, $8.9) for periods before sample receipt (P = 0.16 for comparison with those not
receiving samples), $244 (SE, $9.2) for periods during sample receipt (P < 0.001 for comparison
with periods before sample receipt) and $212 (SE, $12.4) for periods following sample receipt (P
= 0.008 for comparison with periods before sample receipt). Results were qualitatively similar
when total prescription costs were examined. Conclusions: Individuals receiving samples have
higher prescription expenditures than their counterparts. These findings suggest that sample
recipients remain disproportionately burdened by prescription costs even after sample receipt.

Alexander, G., Zhang, J., & Basu, A. (2008). Characteristics of Patients Receiving
Pharmaceutical Samples and Association between Sample Receipt and Out-of-Pocket
Prescription Costs. Medical Care, 46(4), 394-402. Retrieved April 15, 2020, from
www.jstor.org/stable/40221674

Gap- Further work is needed to delineate these impacts across broader groups of patients,
clinicians, and health care setting
Poverty, Disease, and Medicines in Low- and Middle-Income Countries:
The Roles and Responsibilities of Pharmaceutical Corporations
Abstract

Providing access to medicines and health care is one of the most challenging issues facing
society today. In this paper the author highlights some of the complexities of the health value
chain as well as the problems that the world's poor have in terms of access to medical care and
medicines. He then attempts to delineate the roles and responsibilities of all stakeholders in
order to define the specific corporate responsibilities of pharmaceutical companies in the context
of the entire responsibility system—the strength of which is determined by its weakest link.
Finally, he looks forward to a transformational change being wrought for pro-poor health
development by forging new coalitions that cut across both the health and traditional
development stakeholders.

Leisinger, K. (2012). Poverty, Disease, and Medicines in Low- and Middle-Income Countries: The
Roles and Responsibilities of Pharmaceutical Corporations. Business & Professional Ethics
Journal, 31(1), 135-185. Retrieved April 15, 2020, from www.jstor.org/stable/41705473

Gap- How a medicine can be promoted at very minimal costs incurred and help medicines
reach the low and middle class people.

Let Them Eat (Genetically Re-Engineered) Cake and the Little Purple Pill:
A Rejoinder to Miles, Munilla and Covin

Abstract

This paper critiques a recent article in this journal in terms of its use of persuasive techniques.
The central issue of the original article by Miles, Munilla and Covin and this paper is whether
there should be a change in intellectual property rights to address the needs of impoverished
people who are HIV positive or have full blown AIDS and the countries that do not have the
means to buy AIDS medication in the absence of subsidies. This paper argues that patents are
state sanctioned monopolies that worked effectively for nearly a century. However, new
circumstances and a globally interdependent world represent a new environment calling for an
adjustment in the conventional public policy premises underlying patents. Most of the meaning
and complexity of this issue is lost to the persuasive techniques of the original article.

Ray, D. (2005). Let Them Eat (Genetically Re-Engineered) Cake and the Little Purple Pill: A
Rejoinder to Miles, Munilla and Covin. Journal of Business Ethics, 57(2), 111-119. Retrieved
April 15, 2020, from www.jstor.org/stable/25123460

Gap- How technology in pharmaceutical and biotechnology can be improvised and so that the
cost of marketing these products can be reduced and the price can be reduced than the other
products.
From Quid Pro Quo to Quid Pro Bono: Reshaping the Influence of
Industry on Health Care Epidemiologists
Abstract

Recent scrutiny of relationships between medical professionals and the pharmaceutical and
medical device industries has highlighted many opportunities for conflicts of interest and has
prompted calls for reforms in the way we conduct such business. This article reviews ways in
which industry influences health care epidemiologists and considers a range of strategies that
might be considered for reshaping these influences to preserve the benefits while eliminating the
conflicts of interest.

Kirkland, K. (2010). From Quid Pro Quo to Quid Pro Bono: Reshaping the Influence of Industry
on Health Care Epidemiologists. Clinical Infectious Diseases, 50(1), 93-97. Retrieved April 15,
2020, from www.jstor.org/stable/27799514

Gap- No research gap

Ethical Considerations in the Use of Direct-to-Consumer Advertising and

Pharmaceutical Promotions: The Impact on Pharmaceutical Sales and
Physicians
Abstract

The influence of direct-to-consumer advertising and physician promotions are examined in this
study. We further examine some of the ethical issues which may arise when physicians accept
promotional products from pharmaceutical companies. The data revealed that direct-to-consumer
advertising is likely to increase the request rates of both the drug category and the drug brand
choices, as well as the likelihood that those drugs will be prescribed by physicians. The data
further revealed that the majority of responding physicians were either neutral or did not feel that
accepting some types of gifts from pharmaceutical companies affected their ethical behaviors.

Parker, R. S., & Pettijohn, C. E. (2003). Ethical Considerations in the Use of Direct-to-Consumer
Advertising and Pharmaceutical Promotions: The Impact on Pharmaceutical Sales and
Physicians. Journal of Business Ethics, 48(3), 279–290. Retrieved from
www.jstor.org/stable/25075184

Gap- Does the promotional gifts affects the physicians in prescribing the drugs to the
patients.
Deadly Drugs and the Doctrine of Double Effect: A Reply to Tully
Abstract

In a recent contribution to this journal, Patrick Tully criticizes my view that the doctrine of double
effect does not prohibit a pharmaceutical company from selling a drug that has potentially fatal
side-effects and that does not treat a life-threatening condition. Tully alleges my account is too
permissive and makes the doctrine irrelevant to decisions about selling harmful products. In the
following paper, I respond to Tully's objections and show that he misinterprets my position and
misstates some elements of the doctrine of double effect. I also show how the doctrine
constrains some decisions about marketing drugs with potentially fatal side-effects.

Masek, L. (2006). Deadly Drugs and the Doctrine of Double Effect: A Reply to Tully. Journal of
Business Ethics, 68(2), 143-151. Retrieved April 15, 2020, from www.jstor.org/stable/25123903

Gap- No research gap

Perceptions of the Influence of Prescription Medicine Samples on

Prescribing by Family Physicians
Abstract

Background: The provision of free precription medicine samples is a common and traditional
marketing strategy used by pharmaceutical companies, but concerns have been raised about
their influence on physician prescribing behavior and patient safety. Objective: We sought to
investigate the knowledge, attitudes, and behaviors of Australian family physicians regarding the
use of sample prescription medications. Methods: Qualitative and quantitative techniques were
used, including (1) mailed questionnaires to family physicians, (2) semistructured interviews with
family physicians, and (3) sample cupboard inventories. Results: A number of issues about
samples were identified by the questionnaires (208) and interviews (17 doctors), including
insufficient labeling, poor record keeping, diversion of stock (personal use by doctors, their
families, practice staff and pharmaceutical representatives), and wasting of expired stock.
Prescription medicine samples also influenced prescribing behavior. Australian doctors were less
likely to provide samples to patients on financial grounds compared with a previous study in the
United States on medical residents. Six sample cupboards were inventoried. Median wholesale
value of sample cupboards was AUD $4959 (range $2395-$8709), with 6% of stock expired.
Very little generic medicine was included in the sample cupboards. Conclusions: Better methods
are needed to meet legislative requirements and to ensure quality use of medicines (and optimal
public health) with respect to prescription medicine samples. Doctors and practice staff require
training on the appropriate handling and storage of prescription medications. Alternative ways for
distribution of sample medications need to be investigated.

Hall, K., Tett, S., & Nissen, L. (2006). Perceptions of the Influence of Prescription Medicine
Samples on Prescribing by Family Physicians. Medical Care, 44(4), 383-387. Retrieved April 15,
2020, from www.jstor.org/stable/3768333

Gap- how Different methods of prescription drug sample distribution need to be developed so
that samples can still be available for their intended purpose without compromising patient
safety and public health.
The Anxieties of Globalization: Antidepressant Sales and Economic
Crisis in Argentina
Abstract

This paper describes the role of market research firms in shaping the actions of key players in
the pharmaceutical arena. It focuses on strategies for marketing novel antidepressants (selective
serotonin reuptake inhibitors, SSRIs) to doctors in Buenos Aires during the Argentine financial
crisis of 2001, posing the question of whether increased antidepressant sales were due to the
social situation or to promotional practices. This case demonstrates how 'pharmaceutical
relations' - interactions between doctors and pharmaceutical companies - are structured by a gift
economy whose effects are monitored through the sales numbers produced by database firms. It
suggests that the use of these numbers takes on special importance given the distinctiveness of
both the Argentine context and the antidepressant market. More generally, the case points to the
interpretive flexibility of psychotropic medication. In the Argentine setting, doctors' prescription of
SSRIs was dependent neither on a diagnosis of depression nor on a biological understanding of
mental disorder. These drugs found a different means of entering the professionally mediated
marketplace: doctors understood and used SSRIs as a treatment not for a lack of serotonin in the
brain, but for the suffering caused by the social situation - the sense of insecurity and
vulnerability that the economic and political crisis had wrought.

Lakoff, A. (2004). The Anxieties of Globalization: Antidepressant Sales and Economic Crisis in
Argentina. Social Studies of Science, 34(2), 247-269. Retrieved April 15, 2020, from
www.jstor.org/stable/3183044

Gap- How cost efficient marketing methods 'reinsertion' can be implemented in pharma
sector .

Critical Role of Leadership on Ethical Climate and Salesperson

Behaviors
Abstract

Leaders play a critical role in setting the tone for ethical climate in organizations. In recent years,
there has been an increased skepticism about the role played by corporate executives in
developing and implementing ethics in business practices. Sales and marketing practices of
businesses, particularly in the pharmaceutical industry, have come under increased scrutiny.
This study identifies a type of leadership style that can help firms develop an ethical climate.
Responses from 333 salespeople working for a North American subsidiary of an international
pharmaceutical company were used to analyze the impact of instrumental leadership on ethical
climate. We also examined the effect of ethical climate on effort, satisfaction with the supervisor,
and job satisfaction. Managerial implications are provided.

Mulki, J., Jaramillo, J., & Locander, W. (2009). Critical Role of Leadership on Ethical Climate and
Salesperson Behaviors. Journal of Business Ethics, 86(2), 125-141. Retrieved April 15, 2020,
from www.jstor.org/stable/40294880

Gap- Further research using experimental designs or longitudinal data is recommended to

investigate the causal links among the model constructs