Intended for healthcare professionals


Is there a cure for corporate crime in the drug industry?

BMJ 2013; 346 doi: (Published 06 February 2013) Cite this as: BMJ 2013;346:f755
  1. Courtney Davis, senior lecturer in sociology,
  2. John Abraham, professor of sociology
  1. 1Department of Social Science, Health and Medicine, King’s College, London, UK
  1. courtney.davis{at}; J.W.Abraham{at}

Effective enforcement of regulations requires more resources and determination to impose robust sanctions

Nearly 30 years ago, Braithwaite’s Corporate Crime in the Pharmaceutical Industry showed that unethical and corrupt behaviour was endemic in the sector. Sadly, there is growing evidence that little has changed. Recent research suggests that violation of the law continues to be widespread. Most new medicines offer little or no therapeutic advantage over existing products, so promotion plays a huge role in achieving market share. In a crowded and competitive marketplace the temptation for companies to resort to misleading claims is great. According to Gøtzsche (doi:10.1136/bmj.e8462),1 as of July 2012, nine of the 10 largest drug companies were bound by corporate integrity agreements under civil and criminal settlements or judgments in the United States. The corporate activity that has led to recent government investigations has involved unethical and unlawful practices that are well beyond mere administrative offences.

Whistleblowers’ and other “insider” accounts in the US typically include allegations that companies systematically planned complex marketing campaigns to increase drug sales, which involved illegal and fraudulent activities. These included active promotion of off label, or otherwise inappropriate, use of drugs, despite company knowledge that such use could seriously harm patients.2 3

How successful, then, have governments responsible for protecting citizens been in curbing illegal activity by the transnational research based …

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