Donald Light — The Pharmaceutical Industry, Institutional Corruption, and an Epidemic of Harms

The October 3, 2012 Lab seminar was presented by Edmond J. Safra Lab Fellow, Professor Donald W. Light, whose research focuses on how institutional bias has led to an epidemic of harmful side effects in new drugs. In his recent work, Professor Light has been investigating the ways in which Big Pharma corrupts the research and development process, clinical trials, marketing, and prescribing of drugs. In the context of his ongoing investigation of the pharmaceutical industry, Professor Light characterizes institutional corruption as widespread or systematic practices that undermine the integrity of an institution. However, in the context of the pharmaceutical industry, Professor Light argued that further clarification and discussion of the concept of institutional corruption is needed, mainly because the term carries negative connotations, which can turn off reviewers and journals.

With this in mind, Professor Light's presentation focused on industry innovation and principles of integrity in the medical profession. Early on in the discussion, one seminar participant questioned if Professor Light's use of integrity in his definition of institutional corruption relating to the pharmaceutical industry was too vague. For instance, participants agreed that integrity should mean the balance between increasing profits and developing safe and effective drugs for patients. However, another participant was vocal in his skepticism of the idea of industry integrity, and questioned how trustworthy publically traded pharmaceutical companies can be with the pressure of profit incentives. For example, does the mere presence of profit motives foster a general distrust of the industry as a whole? Some participants disagreed, however, contending that there are many reputable drug companies that find it in their best interests to adhere to their mission statements of developing safe and efficacious drugs. On this note, there was much debate about how drug companies formulate, uphold, and work to ensure integrity, as outlined in their respective mission statements. Professor Light shared his concern and agreed that the idea of integrity, as it relates to institutional corruption in the pharmaceutical industry, is something that needs to be discussed further.

At this point in the presentation, the discussion shifted to the topics of innovation and research and development in the pharmaceutical industry. Professor Light argued that pharmaceutical companies often manipulate the word innovation for rhetorical purposes and seldom develop clinically superior drugs, thus corrupting the R&D process. He cited studies indicating that over the past 30 years, on average fewer than 2 major clinical advances and 7-13 superior drugs were developed each year, compared with the 85-90 drugs that are developed with few or no advantages. With 113,000 deaths a year caused by adverse drug reactions just in hospitalized patients and 2.5 million serious reactions, Professor Light believes there is an epidemic of harmful side effects from drugs that often have few offsetting advantages. At this point in the conversation, one Lab participant argued that minor improvements lead to important advances from time to time. What's more, he suggested that the "medicine chest" of effective drugs has only increased from this process over the years, and that the only real cause for concern would be if the process were responsible for undermining the development of superior drugs. Professor Light expressed his view that this could be plausible, but that it is usually not the case.

In summary, participants of the Lab seminar discussed how the term institutional corruption might be applied to drug development within the pharmaceutical industry. Finally, the notion of integrity was discussed at length, and there was much debate among participants about the veracity of pharmaceutical companies' mission statements, as well as whether profits were put above patients' safety.