(Un)Ethical issues in the Pharmaceutical industry

1. (Un)Ethical issues in the Pharmaceutical industry

2. Unethical Issues in the pharmaceutical industry Source: Evaluation of CSE performance , Palazzo, G. et al, UNIL 2010

3. Increasing number of cases, increasing costs (1991-2012) Number of settlements Financial penalties TOTAL (1991-2012) 239 settlements, 30.2 billion $ Source: Pharmaceutical Industry Criminal and Civil Penalties: An Update, Public Citizen, September 27, 2012 (2012 figures limited to first Semester!)

4. Type of frauds Pharmaceutical industry falls under numerous rules and legislations, from the FDA’s regulations (Food and Drug Administration) to tax and competition laws. Their types of violations can be summarized according to the stakeholder who is directly harmed in the process: • Environment • FDA and federal/state government: overcharging government health programs, financial violations • Competitors: monopoly practices, kickbacks • Patients*: unlawful promotion, poor manufacturing practices, illegal distribution, concealing study findings • * Most violations have a final impact on patients since they result from a short term financial concern, regardless of global health concerns Source: Pharmaceutical Industry Criminal and Civil Penalties: An Update, Public Citizen, September 27, 2012

6. The Heat of Bribing Doctors in China Nov, 4, 2011: GlaxoSmithKline has reached a record $3bn (£1.9bn) settlement in principle with the US government over aggressive sales and marketing practices of blockbuster medicines, including its lung treatment Advair and the diabetes drug Avandia, over more than a decade. A year later, GSK was pleading guilty saying “the misconduct related to "a different era“”. • July 12, 2013: China has accused GlaxoSmithKline of being at the centre of a "huge" scheme to raise drug prices in three of the country's biggest cities and said the UK-based drugmaker's staff had confessed to bribing government officials and doctors • July 26, 2013: GlaxoSmithKline has replaced the head of its China operations with one of its top two European managers, as the UK-based drugs company seeks to battle a widening corruption probe . • August 12, 2013: Chinese authorities have launched an investigation into a whistleblower's claim that staff at Sanofi bribed hospital doctors, drawing the French pharmaceutical company into a widening probe of the industry • August 23, 2013: Eli Lilly became the latest western pharmaceutical group to be drawn into rising allegations of corruption in China , with media reports that it paid Rmb30m ($4.9m) in kickbacks to doctors to prescribe its products for diabetics. • Sept 13, 2013: Chia Tai Tianqing Pharmaceutical Group Beijing has taken the first step to extend its probe of pharmaceutical corruption in China to domestic drug companies, with state television broadcasting claims that a Chinese drug company bribed doctors with overseas trips. • Sept 24, 2013: Sales of GlaxoSmithKline's medicines in China are thought to have dropped 30 per cent since officials accused the UK pharmaceutical group of corruption , according to provisional analysts' estimates. Dec 17, 2013: GSK declares stopping all payments to doctors. Marketing forces are no more remunerated according to sales

7. The recent (heavy) hand of the Government (1)

8. The recent (heavy) hand of the Government(2)

9. The recent (heavy) hand of the Government(3)