Ethics of pharmaceutical company incentives and gifts

Drug Company Perks

As a general rule, it is problematic to accept valuable gifts from people trying to solicit your business because it is believed that those gifts will influence decision-making. This influence is well understood by the sellers; they would not be offering gifts or perks if they did not have a sincere belief that doing so makes the sale more likely. However, that does not mean that they are believed to be bribes by the sellers. Instead, the sellers may simply believe that these perks help make the potential purchasers more amenable to the sale. In fact, the perks might actually be the only way that the salespeople have the opportunity to present their information to the clients. Therefore, I am not certain that it is always problematic to accept low-value gifts from people who are trying to solicit business, but I am certain that it would be problematic to accept high-level gifts from those people. Is the gift large enough to induce the buyer to give the seller time to make a presentation? If so, then I do not believe that the gift is necessarily unethical. However, if the gift is large enough to influence decision-making beyond allowing an opportunity for a presentation, I can see some ethical problems.

One of the main issues with pharmaceutical companies offering gifts or perks to physicians is that the physicians are not making purchasing decisions for their offices. if, for example, their supplier for scrubs or manila envelopes wanted to provide them with lunches and free sticky notes, it seems difficult to suggest that would be an ethical issue. However, when doctors are making decisions about prescribing medications, they are not making purchasing decisions for themselves; instead, they are making health decisions for their patients. Moreover, patients who receive prescriptions from their doctors believe that those doctors are prescribing medications based upon the symptoms and complaints presented by the patients combined with the doctor's underlying medical training. Therefore, the real ethical problem in this scenario is not so much that the doctors accept gifts from pharmaceutical company representatives, but the lack of disclosure by the doctors to their patients. Patients have a right to know if their doctor's decision to prescribe a certain medication has been influenced by free lunches or other perks, rather than that doctor's objective overview of prescribing information.

In fact, the real ethical issue presented in the underlying case is not that the doctors are accepting gifts from the pharmaceutical companies. Drug companies did decide to some degree of self-limit in their gifts to physicians. However, whether or not the drug companies offer gifts may not be the real ethical issue. The criteria for acceptability or unacceptability of gifts should actually rest on physician response, rather than an arbitrary financial limit of gifts for physicians. In other words, some of the currently prohibited practices, such as taking the physicians golfing, seem like a smart business practice for the sales people. The doctors, however, should have to maintain a database for patients to access, where they inform the patients of any gifts received by pharmaceutical companies, and give patients a copy of the list whenever they prescribe a medication that they have received a gift for it.