“Agreements between not for profit research institutes and the pharmaceutical industry can be fraught with conflict, even if an iron clad contract is in place to ensure the independence of the parties involved. The recent case of Sanofi-Aventis contributing 25cents per pack of Plavix sold in Australia to the Baker Institute is an interesting case in point. Both parties are publically adamant that the funds are entirely ‘without strings’ and this is most probably true in the legal and contractual sense. However, it speaks volumes that the 25 cents per pack is derived from the Plavix marketing budget.
Pharmaceutical companies are past masters at managing and manipulating social obligations and reciprocity for their marketing benefit. Gifts engender a feeling of indebtedness on the recipient and a social obligation to reciprocate in some way to the giver of the gift. In this way, the phrase “much obliged” has become synonymous with “thank you”. Marketing expenditure in any industry is always associated with a quid pro quo for the ‘investing’ organisation – increased sales, as Ken Harvey highlights in his response.
In the case of the Baker Institute, this arrangement provides a guaranteed income stream, so the Institute would be commercially ‘mad’ to conduct any research that could jeapordise this arrangement. While the Institute, according to public statements, legally retains its right to research whatever it likes, conducting research that may be unpalatable to Sanofi may jeapordise renewal of this agreement or the development of future agreements (with Sanofi or other companies). Sanofi is a large pharmaceutical company with many commercially successful drugs, so the agreement using a ‘royalty’ from Plavix could provide leverage to reduce research in other areas such as diabetes that may adversely affect other drugs in its current portfolio or development pipeline.
Accountability would also be more complex with a corporation than the more well studied individual practitioner. A practitioner will face clients and may be asked awkward questions in a one to one situation which may reflect on the trust of a patient in their practitioner.
Corporations are faceless entities which are also charged with a different charter – looking after the corporate bottom line (and shareholders, if applicable). Therefore there is a different sense of public accountability for their actions.
In this case, it can be argued (and probably will be) that the Baker Institute was doing the best deal it could to generate research funds to improve medical research for the greater good of society. One wonders if the contract will be released publicly to demonstrate the transparent nature of the agreement?”