Michael A. Santoro

The ethics and economics of pharmaceutical pricing.

The cost of drugs is a major and rapidly rising component of health-care expenditures. We survey recent literature on the ethics and economics of skyrocketing pharmaceutical prices and find that advances in economic research have increased the sharpness and focus of the ethically based calls to increase access by modifying patent protection and reducing prices. In some cases, research supports ethical arguments for broader access. Other research suggests that efforts to broaden access result in unintended consequences for innovation and the medical needs of patients. Both ethicists and economists need to be more cognizant of the real clinical settings in which physicians practice medicine with real patients. Greater cross-disciplinary interaction among economists, ethicists, and physicians can help reduce the disjunction between innovation and access and improve access and patient care. This dialogue will impact private industry and may spur new multistakeholder paradigms for drug discovery, development, and pricing.

Business and Human Rights in Historical Perspective

BHR is both a multidisciplinary (and sometimes interdisciplinary) academic field drawing from, inter alia, business ethics, law and the social sciences, and a social, economic and political justice movement involving governments and inter-governmental institutions, as well as indigenous peoples, non-governmental organizations, and other civil society actors. The confluence of two broad historical shifts has shaped the contemporary BHR landscape. The first dates back nearly seven decades to the aftermath of the Nazi atrocities committed during World War II. The fledgling United Nations gave birth to the modern ideal of human rights without establishing an institutional framework for holding member states accountable for human rights violations against their own citizens. Over time, frustration over this state accountability void ineluctably led activists to shift their focus to a more easily (and too often justly) vilified and vulnerable target, i.e. multinational business, as the principal and sometimes exclusive pressure point for preventing and redressing human rights violations. Whether it is apartheid in South Africa, the rights of indigenous people in the Niger Delta, or political oppression and free speech rights in China, global civil society increasingly has shifted the immediate target of pressure to business, even when the fundamental problem is human rights violations by states. A second broad historical trend shaping the current BHR landscape has been the expansion, mostly in legal scholarship, of the range of BHR concerns beyond supply chain labor rights and the extractive industry to a broad array of issues ranging from the environment and access to affordable medicines to economic, cultural and social rights.From an academic perspective, the core BHR issues and controversies center around two sets of question: (1) fairness and justice, e.g. on what basis, if any, can business be said to owe moral duties regarding human rights? How extensive are the human rights duties of business in situations where business has no direct or indirect connection to human rights violations by states? and (2) implementation, public policy, and law, e.g. how might voluntary codes of conduct and other self-regulatory mechanisms serve to bring business behavior into greater alignment with their human rights duties?

The Application of Cost-Effectiveness and Cost–Benefit Analysis to Pharmaceuticals

Why economic analysis of pharmaceuticals is important Healthcare costs are continuing to escalate rapidly around the globe, reflecting aging populations, greater access to medical services, and improved medical technologies. In 2002 U.S. healthcare expenditures reached

Pay Now, Lose Later: The Role of Bonuses and Non-Equity Incentives in the Financial Meltdown of 2007-2009

1.6 trillion, 15 percent of that years gross domestic product, and

Pharmaceutical Policy In China

5,440 per capita. As shown in Figure 14.1, pharmaceutical expenditures have been escalating even more rapidly than overall healthcare expenditures over the past decade, reaching 10 percent of overall healthcare spending for the first time in forty years. In 1970, early in Medicare and Medicaid implementation, prescription drug spending was

Profits and Principles: Global Capitalism and Human Rights in China

43 per capita, and the lack of Medicare drug coverage was not a major political concern. By 2002, as political momentum for a Medicare prescription drug coverage program neared its peak, prescription drug expenditures reached

Ethics and the pharmaceutical industry

569 per capita, with the Medicare population spending nearly quadruple this amount. Drug spending and drug insurance coverage have become prominent U.S. economic and political issues. Similar concerns about drug spending are surfacing globally. Per capita drug expenditures vary widely internationally, reflecting differences in economic circumstances, pricing policies, government programs, and population characteristics. Nevertheless, drug expenditures are increasing rapidly in all industrialized countries (see Figure 14.2). Health economists vigorously debate whether healthcare costs generally and pharmaceutical costs specifically are rising too rapidly. Many say that healthcare is precisely the kind of superior good that people consume more of as their income and wealth rise.

Ahoy There! Toward Greater Congruence and Synergy Between International Business and Business Ethics Theory and Research

This paper draws attention to and raises questions about an area of executive incentive compensation, bonuses and non-equity incentives, which seems to have disproportionally rewarded executives while shareholders remain exposed to substantial ongoing economic risks. This area of focus has surfaced because, beginning in 2007 and continuing throughout 2008, financial services firms incurred massive losses, while in the years immediately preceding this deluge of losses many executives were awarded substantial bonuses and non-equity incentives. We assess the risks associated with such payments and build a framework for assessing how shareholder and executive interests diverge as a result of bonuses and non-equity compensation. Our analysis is also meant to serve as a building block for future empirical studies about the relationship between executive incentive compensation paid in cash (bonuses and non-equity incentives) and the financial misstatements and overstatements of income that were at the heart of the financial meltdown.