Skip to main content

Professional Ethics, Professionalization, and Regulation of Pharmaceutical Sales Representatives: Analyzing the Costa Rican Case

  • Chapter
  • First Online:
  • 285 Accesses

Abstract

The purpose of this essay is to present an argument in favor of a strong state regulation of sales representatives working for pharmaceutical companies, taking as an example the Costa Rican legislation, which can be used as part of a strategy to discourage the various incorrect practices that have created a climate prone to corruption in the relationship between prescribers and pharmaceutical companies. This regulation should include three basic mechanisms: (1) The professionalization of sales representatives as a legal requirement, (2) Affiliation to the pharmaceutical professional association in the country, as a mandatory requirement, (3) Creation of state laws or policies to regulate the conduct and practices of pharmaceutical sales representatives, including the necessary mechanisms for filing complaints about breach of such regulations and adequate penalties for both the sales rep and the company. These rules can go along with by transparency policies such as the Open Payments Act in the US, and international guidelines on the proper relationship between prescribers and pharmaceutical companies, such as those published by the WHO.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Notes

  1. 1.

    See, for example: Physician Motivations for Nonscientific Drug Prescribing, Rebecca Schwartz et al., 1989, Society Medicine, Vol. 28. No. 6, pp. 577–582; Scientific versus Commercial Sources of Influence on the Prescribing Behavior of Physicians, Avorn, Chen and Hartley, Medicine, Science and Society, 1982, Vol. 73.

  2. 2.

    Regarding the strategy of pharmaceutical companies to maximize their sales to the State, by using the legal system to force the purchase of medicines that are not included in the official list of medicines of the public health system, I recommend reading Angelina Godoy’s book: Of Medicines and Markets, published by Stanford University Press in 2013.

  3. 3.

    http://www.nogracias.eu/2012/06/04/medicos-sin-marca/.

  4. 4.

    http://www.nofreelunch.org/.

References

  • Bala-Miller, P., Macmullan, J., & Upchurch, L. (2007). Drugs, doctors and dinners. How companies influence health in the developing world. London: Consumers International.

    Google Scholar 

  • Brax, H., Fadlallah, R., Al-Khaled, L., Nas, H., El Jardali, F., & Akl, E. (2017). Association between physicians’ interaction with pharmaceutical companies and their clinical practices: A systematic review and meta-analysis. PLoS ONE, 12(4). Retrieved from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0175493.

  • Feldman, Y., Gauthier, R., & Schuler, T. (2013). Curbing misconduct in the pharmaceutical industry: Insights from behavioral ethics and the behavioral approach to law. Journal of Law, Medicine and Ethics, 41, 620–628.

    Google Scholar 

  • Gagnon, M., & Lexchin, J. (2008). The cost of pushing pills. A new estimate of pharmaceutical promotion. PLoS Med. Retrieved from https://www.medscape.com/viewarticle/571493_print.

  • Gagnon, M.-A. (2013). Corruption of pharmaceutical markets: Addressing the misalignment of financial incentives and public health. Journal of Law, Medicine and Ethics, 41, 571–580.

    Google Scholar 

  • Gagnon, M.-A., & Volesky, K. (2017). Merger mania: Mergers and acquisitions in the generic drug sector from 1995 to 2016. Globalization and Health, 13, 62.

    Google Scholar 

  • Gaudillière, J.-P., & Thoms, U. (2015). The development of scientific marketing in the twentieth century. New York: Routledge.

    Book  Google Scholar 

  • Grochowski-Jones, R., & Ornstein, C. (2016). Matching industry payments to medicare prescribing patterns: An analysis for propublica. Retrieved from https://static.propublica.org/projects/d4d/20160317-matching-industry-payments.pdf?22.

  • Groves, K., Sketris, I., & Tett, S. (2003). Prescription drug samples—Does this marketing strategy counteract policies for quality use of medicines? Journal of Clinical Pharmacy and Therapeutics, 28, 259–271.

    Google Scholar 

  • Habibi, R., Guénette, L., Lexchin, J., Reynolds, E., Wiktorowicz, M., & Mintzes, B. (2016). Regulating information of allowing deception? Pharmaceutical sales visits in Canada, Frances and the United States. Journal of Law, Medicine and Ethics, 44, 602–615.

    Google Scholar 

  • Hunt, P. (2008, August 11). Interim report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Geneva: United Nations General Assembly.

    Google Scholar 

  • Lakoff, A. (2006). High contact: gifts and surveillance in Argentina. In Global Pharmaceuticals. Ethics, Markets and Practices. Petryna, A., Lakoff, A., & Kleinman, A. (Eds). Duke University Press, 111–135.

    Google Scholar 

  • Larkin et al. (2017). Association between academic medical center pharmaceutical detailing policies and physician prescribing. JAMA, 317(17), 1785–1795. https://jamanetwork.com/journals/jama/fullarticle/2623607.

  • Liu, Q. (2007, October). The dynamics of competitive drug detailing. The Johnson School at Cornell University. Ithaca, USA. Retrieved 2017, from https://pdfs.semanticscholar.org/6055/3b04014857d9d7fdd5bdfa538bd9e5c2dc74.pdf.

  • Mintzes, B., Lexchin, J., Sutherlang, J., Beaulie, M. D., & Wilkes, M. (2013). Pharmaceutical sales representatives and patient safety: A comparative prospective study of information quality in Canada, Frances and the United States. Journal of General Internal Medicine, 28, 1368–1375.

    Google Scholar 

  • Mitchell, A., Winn, A., & Dusetzina, S. (2018). Pharmaceutical industry payments and oncologists. JAMA Internal Medicine, 178, 854.

    Google Scholar 

  • Norris, P., Herxheimer, A., Lexchin, J., & Mansfield, P. (2005). Drug promotion: What we know, what we have yet to learn. Reviews of materials in the WHO/HAI database on drug promotion. London: World Health Organization and Health Action International.

    Google Scholar 

  • Page, L. (2017, November 21). Sunshine act: Are doctors still enjoying free lunches from drug reps? Retrieved from Medscape. https://www.medscape.com/viewarticle/885792_2.

  • Parker, R. S., & Pettijohn, C. E. (2006). Pharmaceutical drug marketing strategies and tactics. Health Marketing Quarterly, 22, 27–43.

    Google Scholar 

  • Petryna, A., Lakoff, A., & Kleinman, A. (2006). Global pharmaceuticals. Ethics, markets, practices. Durham: Duke University Press.

    Google Scholar 

  • Ratanawijistrasin, S., & Wondemagegnehu, E. (2002). Effective drug regulation. A multicountry study. Geneva: WHO.

    Google Scholar 

  • Sismondo, S. (2006). Ghosts in the machine: Publication planning in the medical sciences. Social Studies of Science, 39, 171–198.

    Google Scholar 

  • Transparency International. Pharmaceuticals and Healthcare Programme. (2016). Corruption in the pharmaceutical sector. Diagnosing the challenges. London: Transparency International UK.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gabriela Arguedas-Ramírez .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Arguedas-Ramírez, G. (2020). Professional Ethics, Professionalization, and Regulation of Pharmaceutical Sales Representatives: Analyzing the Costa Rican Case. In: Çalıyurt, K. (eds) Integrity, Transparency and Corruption in Healthcare & Research on Health, Volume I. Accounting, Finance, Sustainability, Governance & Fraud: Theory and Application. Springer, Singapore. https://doi.org/10.1007/978-981-15-1424-1_6

Download citation

Publish with us

Policies and ethics