Ethical Considerations in Selling Pharmaceuticals in Emerging Economies

Abstract

International research-based pharmaceutical companies are increasingly selling their products in less economically developed countries, commonly referred to as “emerging economies” or “emerging markets.” While the introduction of new drugs in these settings has the potential to bring significant health benefits for individuals and populations, it also raises a host of difficult ethical questions. For example, in countries without universal health insurance systems, is it ethically acceptable for companies to sell their products only to the relatively small segment of the population that can afford private insurance coverage or to pay for medications out of pocket? Are there certain drugs that companies should be expected to sell in emerging markets even if they are unable to do so profitably? What ethical responsibilities do companies have in settings where, because of lax regulatory controls, individuals are able to purchase virtually any medication they want without a prescription? This white paper is designed to help companies identify and respond to these and related ethical challenges. Developed with input from an international group of experts and stakeholders, the white paper begins by considering the sources of companies’ ethical responsibilities within emerging markets, as distinct from the responsibilities of national governments or the broader international community. It then provides guidance for thinking through specific ethical challenges that arise when making decisions about whether, and on what terms, to introduce a new drug into a particular setting.