That first car had no air conditioning, radio, CD, or air bags. So what you're dealing with is the public's unwillingness
to come to terms with what's actually going on and a larger social irresponsibility in not making the public aware of what
all these advances have contributed. Some-body, sooner or later, is going to have explain to the public exactly what's going
on. If no one is going to take up that challenge, then the pharmaceutical industry ought to. If it doesn't, it's going to
be one of the biggest losers.
CLINTON: Everyone at this table, I trust, believes the pharmaceutical industry—for all its faults and problems—does a more effective
job of discovering life-saving and life-enhancing treatments than anything likely to be put in its place. Is there an ethical
dimension to defending the industry and making sure pharma and the companies within it survive and continue to do their work?
Louis says there often are big differences between doing what's legal and what's ethical.
CAPALDI: I think you just said it. The ultimate ethical goal of the pharmaceutical industry is to enhance health and save as many
lives as possible in the long run. The way in which that's done is through a market economy, and there is no alternative to
doing that. Ethics has three parts. The goal is to save lives and to enhance health to the maximum extent possible, and the
way that you do that is through incentives and the market system. The third piece is that you have minimal government regulation.
I don't see any reason for being ashamed of that.
SODEN: We tied our "doing good" too much to the market economy, though. Would stockholders in a pharmaceutical company say, "Doing
good is giving me my average 15 percent return," or would they say, "I'm willing to take 5 percent to do good for the rest
of the world?"
CAPALDI: That's easy. If I have a choice between a 5 percent return and a 15 percent return, I'm going to go for 15 percent. If your
intent is to do good by lowering the value to shareholders, you will soon find it impossible to raise money to do the kind
of research that is necessary. Charity doesn't solve the problem.
PEREA-HENZE: That depends on how you define charity. I think more and more investors are looking at social responsibility factors. So
if we believe there are different ways to get medicines to people—whether through programs that give bulk prices or philanthropic
programs that fund new models—and if you have the traditional insurance-reimbursed medicine programs, you build a continuum.
You can still maintain your profit and expand your reach.
Cohen asks what company policies ensure that ethical decisions are made throughout the organization.
CAPALDI: Differential pricing is a good capitalist principle. I sell for less in markets where the market price is necessarily going
to be lower. Doing that enables poor people to get things that they wouldn't otherwise be able to get. But once you start
to allow the reimportation of drugs, one of the things you're going to do is to force companies to have one set price for
If you call it charity, instead of good business, someone is going to figure out that you are making more money by doing it
this way and will say, "Aha, the ethics is a scam." I would go on the offensive and say, "This is the best way to help people.
I don't have to defend that. You have to show me that there's an alternative way." And every time they suggest an alternative,
you shoot it down rather than play into their hands or apologize.