Google, Whole Foods, and … Big Pharma?

By Nadia N. Sawicki

Google’s informal corporate slogan is “Don’t be evil.”  Whole Foods is a Fortune 500 company with a net revenue of 10 billion dollar that prides itself on a commitment to social responsibility.  Both companies have pledged to do long-term good in the world, even at the expense of short-term gains, and both are wildly successful.

If corporations can be profitable as a result of their commitments to social justice and corporate ethics, why can’t this doctrine be extended to the pharmaceutical industry?  Someday, a company called GoodPharma might reach the Fortune 500 on the basis of a pledge to improve access to medicine, conduct international research trials in accordance with the highest standards of research ethics, engage in research on orphan diseases, publish negative research findings, promptly report information about adverse effects, and generally act as a model for ethical industry practices.  If this business model hasn’t been explored, it should be.

The 2012 Access to Medicines Index was released last week, and places GlaxoSmithKline, once again, as the industry leader in promoting worldwide access to medicine.  But the public view of big pharma as a moneymaking but essentially corrupt industry goes beyond a concern that pharmaceutical companies’ pricing and intellectual property policies restrict public access to drugs in impoverished countries.  Critics of big pharma’s business practices have challenged its abuse of vulnerable populations in international research trials, its unwillingness to report negative research findings, its use of ghostwriters, its use of detailers to persuade physicians to prescribe drugs off-label, and its focus on profit rather than public benefit.  Pharmaceutical companies defend their practices with the standard response about the need to maximize shareholder profit.  But perhaps it is time for a bold and innovative company to latch onto the idea of tying social responsibility to success in business.

Much of Whole Foods’ and Google’s success derives from the fact that their socially-conscious policies are widely publicized.  Whole Foods, in particular, benefits from growing public awareness of food-related issues, such as preserving traditional foodways, improving food safety, reducing the use of GMOs, increasing environment sustainability, defending the rights of migrant farmers, and emphasizing the importance of organic and local farming.  Today, people care about where their food comes from, and they are willing to pay a premium to ensure that their spending habits don’t contribute to troubling social practices.  Can we imagine similar public awareness and consensus developing around the practices of the pharmaceutical industry?  I believe that a consumer who is willing to pay $19.99 a pound for local, organic, grass-fed beef might be equally discriminating if offered the option of supporting a pharmaceutical company with a strong commitment to ethical practices.

Of course, there are significant differences between the pharmaceutical industry and others.  I may have a choice of where to buy beef, but the recommended treatment for my health problems may be produced by only one pharmaceutical company.  In that respect, the market is very different.  Nevertheless, where there are choices in treatment – as between two equally-effective drugs, or between a generic and a brand-name drug – physicians and consumers in the know may well choose the option that reflects their own commitment to social goals.

The key, of course, is that consumers must be aware of the ethical issues within the pharmaceutical industry, care about these issues, and have access to information about how various companies stack up.  Judging by the popularity of books like Carl Elliot’s White Coat, Black Hat and the increase in media reporting unethical research practices, consumer awareness seems to be rising.  Perhaps I’m being overly optimistic … or perhaps all that’s needed is for one company to step up and announce its commitment to ethical practices in developing and marketing new drugs for GoodPharma to become the new Google.

Nadia Sawicki

Nadia N. Sawicki is a Georgia Reithal Professor of Law at Loyola University Chicago, and Academic Director of Loyola’s Beazley Institute for Health Law and Policy. Her research focuses on patient decision-making and the informed consent process, particularly in the areas of end-of-life and reproductive care. Her work has been published in a variety of peer-reviewed journals - including the New England Journal of Medicine; Law & Policy; the Journal of Law, Medicine & Ethics; the American Medical Association Journal of Ethics; the Journal of Clinical Ethics; the American Journal of Bioethics; and the Journal of Legal Medicine – as well as in many academic legal journals. She has previously served as a member of the American Bar Association’s Special Committee on Bioethics and the Law, and was the co-chair of the American Society for Bioethics and the Humanities’ Law Affinity Group. Prof. Sawicki received her J.D. from University of Pennsylvania Law School, and her Masters in Bioethics from University of Pennsylvania School of Medicine. She is a graduate of Brown University, with a concentration in biomedical ethics. Prior to joining the Loyola faculty, Prof. Sawicki held the inaugural George Sharswood Fellowship at the University of Pennsylvania Law School, served as a lecturer in History and Sociology of Science at the University of Pennsylvania's School of Arts and Sciences, practiced law with Wolf, Block, Schorr & Solis-Cohen, and clerked for the Honorable J. Curtis Joyner of the U.S. District Court for the Eastern District of Pennsylvania.

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