The Law and Ethics of the Pharmaceutical Industry - 1st Edition - ISBN: 9780444518682, 9780080459363

The Law and Ethics of the Pharmaceutical Industry

1st Edition

Authors: M.N.G. Dukes
eBook ISBN: 9780080459363
Hardcover ISBN: 9780444518682
Imprint: Elsevier Science
Published Date: 4th November 2005
Page Count: 422
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As one of the most massive and successful business sectors, the pharmaceutical industry is a potent force for good in the community, yet its behaviour is frequently questioned: could it serve society at large better than it has done in the recent past? Its own internal ethics, both in business and science, may need a careful reappraisal, as may the extent to which the law - administrative, civil and criminal - succeeds in guiding (and where neccessary contraining) it.

The rules of behavior that may be considered to apply to today's pharmaceutical industry have emerged over a very long period and the process goes on. Even the immensely detailed standards for quality, safety and efficacy laid down in drug law and regulation during the second half of the twentieth century have their limitations as tools for ensuring that the public interest is well served. In particular, national and regional regulatory agencies are heavily dependent on industrial data for their decision-making, their standards and competence vary, and even the existing network of agencies does not cover the entire world. What is more there are many areas of law and regulation affecting the industry, concerning for example the pricing of medicines, the conduct of clinical studies, the health protection of workers and concern for the environment. In some fields it is indeed hardly possible to maintain standards through regulation.

Professor N.M. Graham Dukes, a physician and lawyer with long term experience in industrial research management, academic study and international drug policy, provides here a powerfully documented analysis into the way this industry thinks, acts, and is viewed, and examines the current trends pointing to change.

Key Features

Provides a balanced picture of the current role of the pharmaceutical industry in society Includes indices of conventions, laws, and regulations; as well as judicial and disciplinary cases *This is the only book addressing the legal implications of big pharma activities and ethical standards


Pharmaceutical Industry, Government policy makers, Academic Health policy researchers

Table of Contents



  1. INTRODUCTION: THE PHARMACEUTICAL INDUSTRY AND ITS PRODUCTS 1.1. The concept of a pharmaceutical product
    1.2. The development of the pharmaceutical industry
    1.3. The unique nature of the pharmaceuticals field and the need for rules 1.4. The various roles of the pharmaceutical industry today 1.5. Types of firms engaged in the pharmaceutical field
    1.5.1. Research-based companies x 1.5.2. Generic manufacturers 1.6. The reputation of the pharmaceutical industry

  2. SOURCES OF STANDARDS FOR BUSINESS AND INDUSTRY 2.1. Grounds for defining and respecting business standards 2.1.1 General
    2.1.2. A basis in h uman rights
    2.1.3. The notion of business ethics
    (i) Ethics in daily practice? (ii) Individual and company standards (iii) The purpose of business (iv) The Friedman dogma (v) Loyalty to the Company (vi) Distance from society (vii) The attitude of management 2.2. Some laws and regulations relating to business generally
    2.2.1. Laws of contract and Sale of Goods 2.2.2. The law of tort and non-contractual liability 2.2.3. Consumer Protection Legislation 2.2.4. Intellectual property: trade marks, patents and data exclusivity (i) Property and Human Rights (ii) Trade Marks and Counterfeiting (iii) Patent Law (iv) The TRIPS Agreement (v) The "evergreening" of patents (vi) Claims of data exclusivity (vii) The ethics of data protection 2.2.5 Social and employment law 2.2.6 Environmental law
    2.3. Competitive and financial pressures 2.4. Political influences 2.5. The influence of litigation 2.6. Public opinion and the public image 2.7. The location of the company conscience 2.8. Company and industry codes of behaviour 2.8.1. Types of Codes 2.8.2. Style and content of codes 2.8.3. The usefulness of Codes
    2.9. Transnational corporations and influences 2.10. "Corporate social responsibility" and Governments

    3.2. Standards based on human rights in health
    3.3. Standards originating from pharmacy practice
    3.3.1. A basis in trust 3.3.2. Standards of knowledge
    3.3.3. Fields of knowledge 3.3.4. Trade interests versus professional interests 3.3.5. Codification of standards in pharmacy 3.3.6. Pharmacy standards in the Pharmaceutical Industry
    3.4. Standards originating from medical law and ethics 3.4.1. Primary duty to the patient
    3.4.2. Current medical expertise
    3.4.3. The duty of care 3.4.4. Confidentiality
    3.5. Standards set by pharmaceutical legislation and regulation 3.5.1. The evolution of modern drug regulation
    3.5.2. The scope of legislation and regulation 3.5.3. Issues of responsibility and liability
    3.5.4. Relationship of the applicant to the regulatory agency 3.5.5. The global coverage of law and regulation
    3.5.6. Old versus new products
    3.5.7. Criticism of regulatory developments 3 5.8. The emergence of deregulation 3.5.9. The adequacy of regulation today 3.5.10. The role of WHO 3.6. Self-regulation in the pharmaceutical industry


  1. THE INDUSTRY AS A DEVELOPER, MANUFACTURER AND SUPPLIER 4.1. Pre-marketing and Post-marketing Duties 4.2. Exactness of standards 4.3. The Quality of Drugs 4.4. The Safety of Drugs 4.5. The Efficacy of drugs

  2. THE INDUSTRY AS A SOURCE OF INFORMATION, PERSUASION AND EDUCATION 5.1. Basic information 5.2. Persuasion 5.2.1. Advertising to the health professions
    5.2.2. Advertising of prescription medicines to the public
    5.2.3. Non-explicit advertising
    5.2.4. Disease mongering
    5.2.5. Financial incentives
    5.3. Education
    5.4. Future Developments

  3. PHARMACEUTICAL PRICING AND PROFITS 6.1. Pharmaceutical Prices and Controversies 6.2. The Level of Spending
    6.3. The Manufacturer's costs 6.4. The ethics of pricing and profits 6.5. How does society control the prices of medicines? 6.5.1. Calculation of the "fair" price of a medicine
    6.5.2. Reference pricing 6.5.3. Economic evaluation of prices 6.5.4. Control of profits and expenses 6.6. Differential and equity pricing 6.7. Parallel Importation and Re-importation 6.8. Future approaches to pricing

  4. THE INDUSTRY AS INNOVATOR 7.1. Innovation and duty 7.2. The Innovation Controversy 7.3. Statistics and Analyses 7.3.1. The real cost of a new drug 7.3.2. Research expenditure within the company 7.3.3. Innovation trends over time 7.3.4. The spectrum of drugs reaching the market 7.3.5. The non-industrial role in drug innovation 7.4. Future trends and corrective measures 7.4.1. Should the innovation process change? 7.4.2. Can industry adapt?
    7.4.3. Is outside action necessary? 7.4.4. The DfND Initiative 7.4.5. Governments, Communities and Donors 7.4.6. Independent non-profit research centres
    7.4.7. Official incentives to true innovation 7.4.8. A total approach to innovation

  5. THE INDUSTRY AND THE DEVELOPING WORLD 8.1. Pharmaceuticals in developing countries
    8.2. Atttitudes of the industry to developing markets 8.3. Duties relating to exports 8.4. Access within the developing world 8.5. Other Duties within the developing world 8.6. Relationship to international organizations and donors 8.7. The industry in public-private partnerships

  6. SPECIAL SITUATIONS 9.1. Ethics of Animal Studies 9.2. Ethics of Human Studies Studies 9.3. Self Medication 9.4. Vaccine Manufacturing and Supply
    9.5. Blood and Blood Products 9.6. Controlled Substances 9.6.1. The Nature of risk and injury 9.6.2. Statutory and civil duties 9.7. Alternative and Complementary Medicines 9.8. Traditional Medicines 9.9. Borderline Products 9.9.1. Foods and medicines 9.9.2. Cosmetics as medical products 9.9.3. Contraceptives as health products 9.9.4. Medical devices with pharmacological activity 9.9.5. "Recreational substances" 9.10. Veterinary Products

  7. THE DUTIES OF THE GENERIC MANUFACTURER 10.1. The nature of the generic industry 10.2. The significance of the generic industry 10.3. Governments, laws and generics 10.4. Generic drugs in U.S. Law 10.5. Generic drugs in the European Union 10.6. Generic drugs in India
    10.7. Generic substutution
    10.8. Generic biologicals, biogenerics and biosimilars 10.9. The future status of the generic pharmaceutical industry




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© Elsevier Science 2006
Elsevier Science
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About the Author

M.N.G. Dukes

Affiliations and Expertise

Oslo, Norway


"...Although Dukes doesn't attempt to catalogue all relevant laws, he provides categories and examples that serve as a useful starting point for understanding the types of policies and laws that should be considered in particular cases. In addition, Dukes includes stories that led to the adoption of some of the laws and policies, which helps to make the process more accessible to the reader." - Jeremy Sugarman, M.D., M.P.H., Johns Hopkins University for THE NEW ENGLAND JOURNAL OF MEDICINE(2006) "...a measured walk through most of the beter-known public policy issues revolving around drug research, marketing and use." - (2006)

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