Changing the ethical culture of pharma

The last five years, said Arthur Caplan, Ph.D., have seen the demonization of the pharmaceutical industry. Conflicts of interest, censored scientists, flawed drugs and devices placed on the market, and the failure to protect subjects of clinical trials, have been “flat-out ethical disasters,” said Caplan, chair of the Department of Medical Ethics at the University of Pennsylvania School of Medicine.

Nevertheless, he told an audience at the School of Management in September, this demonization is irresponsible. “The pharmaceutical industry is not the tobacco industry,” he said. “The pharmaceutical industry produces medicines that relieve pain, save lives and cure patients. The pharmaceutical industry does do a lot of good.”

How, he asked, can the industry change its ethical culture? He called for mandatory registries of all clinical trials that would make data—and reports of adverse events—public. Epidemiology, he said, must trump marketing. He also called for tougher Food and Drug Administration monitoring of Phase IV, when drugs are in the marketplace.

“I think pharmaceuticals need to commit to the scientific foundations of the industry,” he said.