Exploring the Role of Pharmaceutical Marketing on Physician Ethical Behaviors: A Grounded Theory Study
Abstract
This paper investigates the influence of pharmaceutical marketing strategies on
physicians’ behaviors. It is argued that physicians are compelled into unethical
behavior which is detrimental to the patients as well as the environment in
general. Patients are unnecessarily exposed to high doses of antibiotics that is
giving rise to globally threatening phenomenon like “superbug”. Data is
collected and analyzed by following grounded theory method. It is found that
pharmaceutical marketing practices have led to physicians’ loose adherence to
ethics that exploits their materialistic approach. The pharmaceutical companies
use personalized services, product incentivization and even sometimes
misleading and partially proven scientific claim as marketing strategies. As a
result, physicians are compelled into over prescription leading to the
development of antibiotic resistance in patients. It is recommended that ethical
standards should be enforced through personal, organizational and institutional
wide mechanisms for both pharmaceutical companies and physicians.
References
Alanis, A. J. (2005). Resistance to antibiotics: are we in the post-antibiotic era? Archives of medical
research, 36(6), 697-705.
AMA. (1903). Principles of medical ethics of the American Medical Association: American Medical
Association Press.
AMA. (2016). AMA code of medical ethics: American Medical Association.
AMA. (2017). AMA code of ethics 2004. Editorially revised 2006. Revised 2016. Australian Medical
Association. ama. com. au/position-statement/ama-codeethics-2004-editorially-revised-2006.
Accessed April, 22, 2017.
APA. (2001). The principles of medical ethics: With annotations especially applicable to psychiatry:
Amer Psychiatric Pub Incorporated.
Ariely, D. (2000). Controlling the Information Flow: Effects on Consumers' Decision Making and
Preferences. Journal of Consumer Research, 27(2), 233-248. doi: 10.1086/314322
Atif, M., Ahmad, M., Saleem, Q., Curley, L., & Qamar-uz-Zaman, M. (2017). Pharmaceutical policy in
Pakistan Pharmaceutical Policy in Countries with Developing Healthcare Systems (pp. 25-44):
Springer.
Audet, A.-M., Greenfield, S., & Field, M. (1990). Medical practice guidelines: current activities and
future directions. Annals
of Internal Medicine, 113(9), 709-714.
Babchuk. (1997). The rediscovery of grounded theory: Strategies for qualitative research in adult
education.
Baker, R. A. (1999). The American medical ethics revolution: how the AMA's code of ethics has
transformed physicians' relationships to patients, professionals, and society: JHU Press.
Bauchner, H., Pelton, S. I., & Klein, J. O. (1999). Parents, physicians, and antibiotic use. Pediatrics,
(2), 395-401. Bentham, J. (1996). The collected works of Jeremy Bentham: An introduction
to the principles of morals and legislation: Clarendon Press.
Buller, P. F., & McEvoy, G. M. (1999). Creating and sustaining ethical capability in the multi-national
corporation. Journal of World Business, 34(4), 326-343. doi: https://doi.org/10.1016/S1090-
(99)00022-X
Buren, H. J. (1999). If Fairness is the Problem, Is Consent the Solution? Integrating ISCT and
Stakeholder Theory. Paper presented at the Academy of Management Proceedings.Caamaño, F.,
Figueiras, A., & Gestal‐Otero, J. J. (2002). Influence of commercial information on prescription quantity
in primary care. The European Journal of Public Health, 12(3), 187-191.
Cabana, M. D., Rand, C. S., Powe, N. R., & et al. (1999). Why don't physicians follow clinical
practice guidelines? Aframework for improvement. JAMA, 282(15), 1458-1465. doi:
1001/jama.282.15.1458
Carmona, R. H. (2003). The obesity crisis in America. Surgeon General’s Testimony before the
Subcommittee on Education Reform, Committee on Education and the Workforce, United
States House of Representatives, 16.
Carroll, A., & Buchholtz, A. (2014). Business and society: Ethics, sustainability, and stakeholder
management: Nelson Education.
Cassell, C., & Symon, G. (2004). Essential guide to qualitative methods in organizational research:
Sage.
Charmaz, K. (2008). Constructionism and the grounded theory method. Handbook of constructionist
research, 397-412.
Chassin, M. R. (1990). Practice guidelines: best hope for quality improvement in the 1990s. Journal
of occupational medicine.: official publication of the Industrial Medical Association, 32(12),
-1206.
Chou, S.-Y., Rashad, I., & Grossman, M. (2008). Fast-food restaurant advertising on television and its
influence on childhood obesity. The Journal of Law and Economics, 51(4), 599-618.
Chren, Landefeld, & Murray. (1989). Doctors, drug companies, and gifts. JAMA, 262(24), 3448-3451.
Chretien, J. H., McGarvey, M., & Esswein, J. G. (1975). Abuse of antibiotics: a study of patients
attending a university clinic. Archives of internal medicine, 135(8), 1063-1065.
Corbin, & Morse. (2003). The unstructured interactive interview: Issues of reciprocity and risks when
dealing with sensitive topics. Qualitative Inquiry, 9(3), 335-354.
Czinkota, M. R., & Ronkainen, I. A. (2013). International marketing: Cengage Learning.
Dana, J., & Loewenstein, G. (2003). A social science perspective on gifts to physicians from industry.
JAMA, 290(2), 252- 255.
Davis, J. J. (1992). Ethics and environmental marketing. Journal of Business Ethics, 11(2), 81-87. doi:
1007/bf00872314
DeAngelis, C. D., & Fontanarosa, P. B. (2008). Impugning the integrity of medical science: the adverse
effects of industry influence. JAMA, 299(15), 1833-1835.
DeJong, C., Aguilar, T., Tseng, C., Lin, G. A., Boscardin, W., & Dudley, R. (2016). Pharmaceutical
industry–sponsored meals and physician prescribing patterns for medicare beneficiaries. JAMA
Internal Medicine, 176(8), 1114-1122. doi: 10.1001/jamainternmed.2016.2765
Devitt, R., & Hise, J. (2002). Influences in ethical dilemmas of increasing intensity. Journal of Business
Ethics, 40(3), 261-274.
Dholakia, N., & Nason, R. W. (1984). Research Issues in Macro‐Marketing: A Blueprint for Progress.
European Journal of Marketing, 18(1), 41-55. doi: doi:10.1108/EUM0000000004720
Dogramatzis, D. (2015). Pharmaceutical marketing: a practical guide: Taylor & Francis US.
Donaldson, T., & Dunfee, T. W. (2008). Integrative Social Contracts Theory: A Communitarian
Conception of Economic Ethics. Economics and Philosophy, 11(1), 85-112. doi:
1017/S0266267100003230
Dunfee, T. W., Smith, N. C., & Ross, W. T. (1999). Social Contracts and Marketing Ethics. Journal of
Marketing, 63(3), 14-32. doi: 10.2307/1251773
Ferrell, O. C., Gresham, L. G., & Fraedrich, J. (1989). A Synthesis of Ethical Decision Models for
Marketing. Journal of Macromarketing, 9(2), 55-64. doi: 10.1177/027614678900900207
Fischer, M. A., Keough, M. E., Baril, J. L., Saccoccio, L., Mazor, K. M., Ladd, E., . . . Gurwitz, J. H.
(2009). Prescribers and Pharmaceutical Representatives: Why Are We Still Meeting?
Journal of general internal medicine, 24(7), 795-801. doi: 10.1007/s11606-009-0989-6
Gilbert, D. U., & Behnam, M. (2009). Advancing Integrative Social Contracts Theory: A Habermasian
Perspective. Journal of Business Ethics, 89(2), 215-234. doi: 10.1007/s10551-008-9995-6
Gillon, R. (1994). Medical ethics: four principles plus attention to scope. BMJ : British Medical Journal,
(6948), 184- 188.
Glaser, & Strauss. (1967). The discovery of grounded theory Chicago. Adeline, USA.
Goulding, C. (2002). Grounded theory: A practical guide for management, business and market
researchers: Sage.
Greenhalgh, T. (1987). Drug prescription and self-medication in India: an exploratory survey. Social
science & medicine,25(3), 307-318.
Hadland, S. E., Rivera-Aguirre, A., Marshall, B. L., & Cerdá, M. (2019). Association of pharmaceutical
industry marketing of opioid products with mortality from opioid-related overdoses. JAMA
Network Open, 2(1), e186007. doi: 10.1001/jamanetworkopen.2018.6007
Harris, J. L., Bargh, J. A., & Brownell, K. D. (2009). Priming effects of television food advertising on
eating behavior. Health psychology, 28(4), 404.
Hunt. (1994). On Rethinking Marketing: Our Discipline, Our Practice, Our Methods. European Journal
of Marketing, 28(3), 13-25. doi: doi:10.1108/03090569410057263
Isaman, V., & Thelin, R. (1995). Standard operating procedures (SOPs): reason for, types of, adequacy,
approval, and deviations from and revisions to. Quality assurance (San Diego, Calif.), 4(3),
-171.
Jo, R. (2009). Abduction: The Logic of Discovery of Grounded Theory.„. Paper presented at the Forum
Qualitative Sozialforschung/Forum: Qualitative Social Research.
Jofre, S. (2014). GSK faces accusations of bribing doctors in Poland. BMJ, 348, g2768.
Johnson, R. (2008). Kant’s moral philosophy. Stanford encyclopedia of philosophy.
Jones, Felps, W., & Bigley, G. A. (2007). Ethical Theory and Stakeholder-Related Decisions: The Role
of Stakeholder Culture. Academy of Management Review, 32(1), 137-155. doi:
5465/amr.2007.23463924
Jonsen, A. R. (2000). A short history of medical ethics: Oxford University Press.
Katz, D., Caplan, A. L., & Merz, J. F. (2010). All gifts large and small: toward an understanding of the
ethics of pharmaceutical industry gift-giving. The American Journal of Bioethics, 10(10), 11-
Krefting, L. (1991). Rigor in qualitative research:
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