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Business ethics has rattling connectedness with present business world. It is concerned with how the company associates to the outside world. Business ethics is a class of practiced ethics that take stocks ethical rationales and moral or ethical troubles that happen in a business world. In painstaking marketplaces of this century, necessitate for more ethical business-marches and actions which is also called ethicism, is climbing.
Definition of Business Ethics:
Business Ethics calls for that a company analyze its behaviour towards the outside world. It takes into account Morality, Ethical reasoning and Application of Ethics. It means that the business manager's moral doctrine of any situation, do affect the manager's ethical feelings. Moral doctrine relates to the overall guiding belief arrangement behind the individual's perceptual experience of right or wrong. Important thing is to be familiarized with ethical reasoning, moral philosophy, and particularly the application of ethics to business and management. Concepts and theories of ethics are important to resolve moral troubles that the business is facing. These moral concerns must be incorporated in the businesses and each of their decision making process. Systematic explanation of morality, and ethics for business is required because business ethics clears up moral matters that would have been dismissed, and moral quandaries are being made to move through stringent ethical analytic thinking, intellectual argumentation, and ultimately results. By ethically settling moral problems dealing with business, business people are better able to realize and sort out their own moral feelings and better fitted to formulate a vital and brooding personal morality.
Viewpoint of Ethics in Pharmaceutical industry:
In classical Greek, the word "ethics" entails the "beliefs of the people" - the analyze of what is right and good in human conduct and the explanation of such claims. Already has applied to the complex and multifaceted world of healthcare, it is a formidable task to try and uncover the fundamental principles involved in "right and good conduct". It is rather a discussion, a process that helps to tease out the real issues and find ethical solutions to complex practical troubles. Ethical queries come up when the exercise of preference somehow affects the welfare of others. One of the problems for any business related issue is that they may not realize when choices about technical matters have moral significances. There are relationship between ethics and law and these are the issues can be legal as well as moral, or the issue can be legal and immoral or, the issues can be illegal and moral, or the issues can be illegal and immoral. So it is possible that the issue is illegal yet moral. In the argument on "selling banned drugs to overseas" is not really illegal if it is benefitted to the country citizen and it is a moral duty towards customers or business. In business world especially pharmaceutical companies, issues cannot be dealt in legislative ways. It is really complicated to deal with the pharmaceutical drugs cause sometimes drugs are useful for certain people while detrimental/costly to some people and sometimes it is not socially and religiously valid and sometimes it leads to crime. So there are always argument on these issues.
Progressively researchers, physicians, policymakers and the public face numerous dilemmas produced by advances in medicine and biology; the law is oftentimes ill-equipped to address these issues. Solution to one problem should not extend to new issues. There are always confliction of ideals or law about one ought to do. (Source: Biomedical Ethics in US Public Policy, 1993)
Major pharmaceutical companies in its industry
There are 15 multinational companies in pharmaceutical companies who are dominating the industry by a greater level of concentration.
Some big pharmaceutical companies are:
Johnson & Johnson
Source: Annual Reports of the companies they are listed as top ranking in the world.
Name of some drugs:
Sunitinib marked as Sutent was approved by the FDA on January 26, 2006. It is a cancer drug and it was an approved drug for both the renal cell carcinoma(RCC) and imatinib-resistant gastrointestinal stromal tumor(GIST) cancers.
Sunitinib is sold by Pfizer of UK pharmaceutical Company as Sutent which has been banned recently but it has the patent and market exclusivity till February 15, 2012.
Reason for banning Sutent:
Sutent is a very expensive drug. It is highly criticized due to its high cost and it does not cure cancer but it helps prolong the patient's life. In the US insurance companies refused to pay for this particular pharmaceutical drugs. This is burdensome financially and yet does not cure the patient that is why it is banned in the UK and the National Institute for health and Clinical Excellence(NICE) refused to recommend using this particular drug. Its estimated costs are around £72,000/QALY(Quality Adjusted Life Year) by NICE and around £29,000/QALY by Pfizer.
Why they are selling in Other Countries:
Pfizer Inc. is one of the largest research based pharmaceutical companies in the world. The reason why Sutent is banned in UK is due to the cost however in India, and China they have planned to develop country specific Sutent which will be lower in cost due to high demand. At the same time India's drug regulator Drug Controller General of India studied that there have been no adverse reactions reported in India due to using country specific-Sutent. While the figure is really more in the US, the victim of cancer is rising rapidly at higher rate in India and China, so the pharmaceutical company Pfizer is looking for developing plant in emerging countries like China, India, and Korea. Thus they strategically derailing its company from US centric to true global entity.
Despite some side effects like Fatigue, Diarrhoea, Nausea, Anorexia, Hypertension, a yellow skin discoloration, hand-foot skin reaction and stomatitis, yet with proper use of the drug it helps extend their lives of their patients who have cancer, diabetes, neurological disorders and inflammation, with special emphasis on the regional characteristics of the ailments. It also can be used for kidney cancers.
According to the theory of Consequentialism which says end justify the means. In here consequences of using this drug is morally justified as the ultimate result is good, the banned drug in UK is benefitting the citizens of India which is acceptable because it prolongs the life of the patients of cancer for whatever the costs.
According to the theory of Deontology, it emphasises on the rightness and wrongness of selling a banned drug in the emerging countries. As patient will not be cured by this drug, this will lead to burdensome for the families in India which is not acceptable in these emerging countries. However, Pfizer is planning to develop a country specific drug which will reduce the costs and at the same time it is higher moral absolute in terms of India. Moreover, Pfizer is the world biggest pharmaceutical companies in the world with economies of scale as such what they can offer with lower costs none else can provide. The problem here is which rule to follow because people follow different values and religious aspects.
According to the theory of situation ethics, it's more important to know on what basis Pfizer took the decision of selling banned drugs in emerging countries like India and China. Pfizer Inc. is a research based pharmaceutical company and heavily concentrated on pharmaceutical products. Getting a license for marketing and selling drugs costs them really high. To come into the breakeven they need to sell their existing products which is Sutent during this license period till 2012 or else financially they will be in deep trouble. From the history, there is a record that to keep the main goal of maximizing the shareholder's profit, these companies do unethical accounting shenanigans. Moreover, proper using of Sutent will abate the cancer growth of the patients. In the meantime, these type of research based companies get a chance to explore some new drugs to eliminate the cancer from the body of human being. As it is doing good in India and China, it should be viable to sell their products in those countries. In addition to it, in India, their cultural relativism conform with the selling of this drug from their religious and cultural point of view. As virtues are time and place sensitive, it is import to know how Indians take this drug and they take this drug as virtue because it halts the cancer. According to teleological theory selling banned drugs in India, China and Korea has intrinsic final causes by helping certain cancer patient to live for some moment and fulfil some of his or her unfinished job.
In Natural right theory, we know that every citizen has the right to live therefore by not letting banned drugs to be sold in certain countries will certainly violate the right of the patients in India, China, and other parts of the world. Problem with such case is that as science has not evolved in these particular countries in the world as much as in the UK and the USA, it would be hard for Pfizer to conduct those research in those countries and find out a way to reduce the costs.
In case of Utilitarian theory, human being ought to do something moral because it will ultimately make more happiness than doing anything else would. If Indians are getting benefitted by this particular drugs then it should not be stopped marketing and selling such banned drugs like Sutent. It has both positive intrinsic value and greater happiness which means that this drug is absolutely ready to be marketed in India, and other countries like China and Korea.
According to the Contractualism theory, all the government bodies from India, China and Korea are agreed upon to provide legal rights to have this drugs if it is demanding to their nationals. As the main problem with this drug is its costs then Government of India, China and Korea should support the company who market this drugs through subsidies, reduction of tax and by protecting their patents rights. The only problem with such legal rights is that it takes time for research on drugs that will be imported or manufactured in their own country so that their citizens' health are protected.
A drug named Lapatinib is an active drug for breast cancer and tumours. It interrupts the growth of cancer in the body. It also can be used as therapy. It has got its approval in triple positive breast cancer. Lapatinib got the approval from the US Food and Drug Administration(FDA).
Lapatinib, sold by GlaxoSmithKline of UK pharmaceutical Company as Tykerb(US) and Tyverb(mostly europe) has been banned in the UK.
Reason for banning Lapatinib:
Lapatinib cannot give the cure from the cancer but its only delay the cancer's progression as such NICE, UK is not happy to make them available in UK as this type of drug is not cost-effective use of National Health Service. According to NICE the estimated cost is around £70,000 a year and according to the pharmaceutical company the estimated cost is around £16000.
Why they are selling in Other Countries:
GlaxoSmithKline is the largest UK based pharmaceutical companies in the world. Other countries in which lapatinib is authorised for marketing include Australia, India, Brazil, Russia, Switzerland, Turkey, South Korea, Taiwan and others around the world.
There are some side effects like Fatigue, Diarrhoea, Nausea, Rashes and it provokes toxic hepatitis but yet it is well-tolerated drug. It helps to abate the growth of the cancer.
According to the theory of Consequentialism, using lapatinib drug is morally justified as the ultimate result is good in terms of India and other countries where they believe that slowing the cancer growth is essential part of their own religious that is the banned drug in UK is benefitting the citizens of India which is acceptable for whatever the costs.
Deontology emphasises on the rightness and wrongness of selling a banned drug in the aforementioned countries when it is benefitting these countries. However, the patient will not be cured by this drug, this would cost their family burden with expensive drugs which is not acceptable. The problem here is which rule to follow because people follow different values and religious aspects.
According to the theory of situation ethics, GSK decides to sell banned drugs in India on the basis of taking further research on how to evolve this drug so that they can resolve the cancer problem in future and thus sell all the drugs and come to a break-even or else their product would be dumped with no further exploration of the benefit in it. Moreover, proper using of lapatinib will abate the cancer growth of the patients. As virtues are time and place sensitive, it is import to know how Indians take this drug and they take this drug as virtue because it halts the cancer against such a huge costs.
According to teleological theory selling banned drugs in India, China and Korea has intrinsic final causes by helping certain cancer patient to live for some moment and fulfil some of his or her unfinished jobs.
In Natural right theory, we know that every citizen has the right to live. Not letting banned drugs to be sold in certain countries because it is banned in the UK then it will certainly violate the right of the patients in India, China, and other parts of the world. Problem with such case is that as science has not evolved in these particular countries in the world as much as in the UK, it would be hard for GSK to conduct those research in those countries and find out a way to reduce the costs.
In respect to Utilitarian theory, India and China alone constitute a huge market for selling lapatinib drugs. If Indians are getting benefitted by this particular drugs then it should not be stopped marketing and selling such banned drugs like lapatinib which has both positive intrinsic value and greater happiness means this drug is absolutely ready to be marketed in India, and other countries like China and Korea.
The only way to help marketing and producing lapatinib in India is through subsidizing. In this recession period, it would be a hard task for Indian Government to support these companies for producing and marketing such an expensive drug in these developing countries like India and China. However, the GDP growth for these two countries are really high in the world and in comparing to this figure, there are lesser number of women who are victimised by the cancer as such Government will be able to take step to help the patients of cancers.
It is traded as Avastin manufactured by Genentech/Roche a US based Pharmaceutical company. It is humanized monoclonal antibody that recognizes and blocks vascular endothelial growth factor A(VEGF-A) which stimulates the growth of new blood vessels thus help cancer and retinal proliferation of diabetes in the eye patients.
Reason for Banning Bevacizumab:
It is approved by FDA of the USA because it helps prevent spreading the cancers in other parts of the body and because it is good for the treatment of recurring glioblastoma multiforme. It only slowed tumor growth but cannot extend survival. After surgery it fails to prevent recurrences of non metastatic colon cancer. Bevacizumab slows the growth of blood vessels and thus heal and maintain the body. The problem with this drug is it interfere the normal process of wound healing and collateral circulation and thus leads to coronary artery disease and peripheral artery disease. The main side effects are hypertension, bowel perforation, lung cancer patients cannot get this treatment and heightened risk of bleeding. However, these effects can be avoided since the drug is injected directly into the eye and thus lowers other side effects. The main disadvantages of this drug is it is expensive drugs which only prolongs life to 2 years. Insurance companies do not like to pay on this drugs. Nice found out that it has low ratio of benefits to cost.
Why they are selling in other country:
In India, other available therapeutic modalities are quite expensive and unaffordacle for patients. Therefore, Bevacizumab can be used as the substitution for those expensive modalities. In addition to it, this drug is found to be well tolerated and there is no significant retinal toxicity present. It is therefore a cost-effective approach for the government of India to treat a variety of retinal pathologies. Genentech divided their drugs into 20 fractions from a single vial and thus decrease the cost of this drug to suit the GDP of India. Thus the drug is made affordable in single dosage and at the same time maintains sterility.
Life is priceless so putting a price tag on the life is not really appreciable. Many mothers are the victim of this cancer and they might have infant who needs the support of their mother at least till they start their school. Those infant are the future citizen of every countries and a world as a whole. Extending their life through using such expensive drugs is morally judged so according to Consequentialism theory it is right on penny. The way the clinical advisory board is helping the Indians people to fight against the cancer albeit with the higher costs is really complementing on their part so it is ethically permissible to sell banned drugs to India according to the Deontology theory. Theory of virtue ethics is country and time sensitive so it should be decided by the specialist in the clinical advisory board of India rather than the NICE of UK. According to teleological theory selling banned drugs in India, China and Korea has intrinsic final causes by helping certain cancer patient to live for some moment and fulfil some of his or her unfinished jobs. Every citizen has the right to live and of course infant should be treated well by their mothers who may happen to have the cancer so not letting banned drugs to be sold in certain countries because it is banned in the UK then it will certainly violate the right of the patients in India, China, and other parts of the world. According to Utilitarianism theory, after the drug is conformed with the GDP of India there should not be any barrier to subsidize this drug, reduce more tax and thus give the civil rights of the citizen of India.
It is traded as Vidaza with a generic name Azacitidine manufactured by the UK based pharmaceutical company called Celgene UK.
Reason for Banning of Vidaza:
According to NICE the relative to benefit of having this drug is not cost effective use of NHS. The cost is estimated to be £45,000 by NICE. NICE has further reasoning out that treating patient with range of blood and bone marrow including MDS, and other chronic leukemia would be harmful for the patient. Even with the proper use it can only treat limited number of patient due to its adverse effects.
Why it is sold in different countries:
As most MDS patients have to rely on frequent blood transfusions to manage anaemia and extreme fatigue and this drug is the only drug which can provide treatment to MDS albeit it is just a life extending drug. However, it is the only proven drug to provide Myelodysplastic syndromes, Chronic myelomonocytic leukaemia and acute myeloid leukaemia. It is sold in India, Germany, and Italy. It gives more life to MDS treatment than other drugs(15 months in compare to 24 months).
There may be some adverse effects of this drug but with the proper use of this drug and government regulations on proper dissemination of the useful information to the patients who have the right to live and get all the civil rights from their government, this drug can be used. Thus get a little more life so that they can fix out some existing business.
These companies argue that the benefit is worth the cost. These big pharmaceutical companies pay huge cost and conduct research to evolve and develop new drugs. It takes time to adjust the price for patients as they grow with economic of scales. As they get more chance of researching on the field and concurrently solve the temporary problems with the patients they will be able to find a way to resolve it for good in the long term or at least till they have the license for marketing and producing drugs. Recognizing the rules and conventions of science is not enough to assure responsible research conduct. Science may say this drug is not suitable for certain group of customers because of the clashes between their values, or even sometimes medication clashes with each other. However, the same drugs may be good for some other people from other country of the world. It is ethical to help every individuals rather than thinking cynically based on one particular case. Laws are not correctly adjusted with the advancement of technology, with the change in societal expectations, and with the evolving scientific disciplines. However, law will hold companies and their scientists responsible for their decisions. So regulators and companies are expected to come at morally defensible positions even on novel and unexampled issues. Regulators should maintain the issues with sensitive eyes of ethics, critically reason out the cases and habits to effectively resolve this situation. Knife can be used in both ways either by killing people and by cutting vegetables. However, banning the use of knife by restrictive law is not the solution. Government should aware people of the fact that knife should be used for cutting vegetables and that is the solution for humanity.