1. What are the ethical issues in this case?
2. Who are the primary stakeholders in these incidents?
3. Is there any justification for the marketing tactics described in the case? Which are acceptable and which are questionable?
4. What is your evaluation of giving free promotional items to med students? What are the arguments for and against such practices?
5. What ethical principles may be violated by the marketing tactics described? Do any of these ethical principles support the companies’ actions?
6. Big Pharma needs enormous sums of money to conduct R&D and to advance its industry. Do the ends justify the means because our health is at stake?
7. What response do you think physicians should take when approached regarding some of the schemes presented in this case?

“Big Pharma” is the name the business press uses for the gargantuan pharmaceutical industry. Most of us are familiar with Big Business and Big Government. Now, Big Pharma is in the news and has been for several years regarding its marketing, advertising, and sales tactics. As Time magazine recently stated, it’s hard to empathize with the drug industry these days because of the high cost of our prescriptions. We either just emptied our wallets in paying for our latest prescription or just returned on a Greyhound bus from Canada where we bought our prescriptions for less. Public perceptions of the pharmaceutical industry add to its problems. In a 2007 poll, Big Pharma has been called greedy as well as shifty, and it was found that most people do not trust the industry to disclose bad news about its products.