Shouldn't all pharmaceutical professionals too take the Hippocratic Oath?

The news about the generic drug maker Ranbaxy Labs pleading guilty to felony charges related to drug safety and its acceptance of $500 million in civil and criminal fines created an unprecedented buzz in the world-wide web. The most incisive piece by far appears to be “the epic inside story of long-term criminal fraud at Ranbaxy.....” By Katherine Eban on CNN Money.

No horror story is complete without its share of seedy alleys, murky dealings & closed cup-boards that contain multitudes of hidden skeletons - this too has. Even as all the digging is indeed required towards a total expose’, the associated spill/ shoot-out of emotional rhetoric is threatening to harm the still-early but the strong trend of genericization of global medicare.

Can we raise above the rhetoric of branded drugs v/s generic drugs; first-world v/s third-world & address the core issue of why medical frauds happen & what can be done to plug these? 

My Comment on the above article:

---------------------------------------------------------------------------------

A very compelling narrative & an alarmingly scary proposition…. 

I fully agree with the majority opinion here that the consequences of a fraud this big should be equally big for the company in question. But again, I also endorse the opinion of a few others like Sam Werbalowsky, Dan Miller et al who have pointed out that Ranbaxy isn't a standalone case in the shameful history of pharmaceutical frauds & that the focus should be on ethical business of all Pharma & not just the generic players as Ranbaxy – It is important to underscore this particular aspect at this juncture since the tone & tenor of this otherwise brilliant piece makes it prone to being construed as a platform for demonizing the generic medicine vis-a-vis' branded drugs. 

A quick look at the list of infamy here & here establishes that the common thread running through all is the disturbing trend of the best-of-the-organizations taking a call of preferring earnings over ethics at critical decision points. Another common aspect among all is the seeming complicity of a vast number of employees at all levels of the organization to misrepresenting a fact or manipulating an outcome. This shows that the problem is not just at the top decision making levels but is endemic at all levels of hierarchy & there’s this shocking apathy all through to what amounts to ethical behavior of an average worker/ employee in a pharmaceutical organization.

Given the complete insulation of an average pharmaceutical employee to the consumer-end of the spectrum & hence insulation from the consequences of any wrong-doing, I'm a little sceptical as to what will motivate these people to be vigilantes of public health & safety at their work place, pardon my cheekiness here, whether or not that involves whistle-blower benefits – THIS apparent lack of ownership of public health & safety in pharmaceutical manufacturing world is what I believe is the real core problem.

While there may be much creative reasoning & some complex solutions to the above core problem, I’d like to keep it simple & say that the reason is a lack of any formal sensitization of a pharmaceutical industry worker prior to or during his/ her employment on her/ his own accountability to public health & safety in general & the solution I hence propose is to instil this accountability in all pharmaceutical employees by way of a Hippocratic Oath that unfortunately is currently merely confined to medical practitioners & decreasingly so.

Food for thought.

Ref: my earlier post at:

http://vishrasayan.blogspot.in/2013/03/factors-influencing-global-prospects.html

Nobody’s saying no to India’ – phew, that’s a relief...

The survey of a few global LPs by VCCircle that was intended to understand 'what a LP wants from Indian PE managers" but actually feels like "why a global LP wouldn't want to put his best bucks in Indian PE" threw up some expected & some strange surmises, but nevertheless makes an interesting read –

The link to the article is below & below that is a repro' of my own comment on the article;

http://www.vccircle.com/news/general/2013/05/20/what-do-limited-partners-want-indian-private-equity-fund-managers-results

My comment:

---------------------------------

Interesting surmises!

What makes the takeaways less validated however is the lack of disclosure or at least a categorization of the LPs surveyed**. This gap I felt more acutely for a few like the question # 9 the response pictorial of which indicates that 50% of LPs surveyed will put money in PE/ VCs that're focused on investing in growth-stage enterprises – this averaged-out response doesn't allow one to assess if this is the response of each LP sub-set falls within this range or if some LP sub-sets deviate from the mean significantly.

I also felt a lot of the questions were overtly leading & that could skew the responses in favor of the inherent bias/ prejudice in the question (for e.g. 10 & 11..)

And yeah, the sliver-lining… It warmed my cockles that LPs have acknowledged of the promise of Healthcare Industry in India & the candid confession that ‘no body’s saying no to India’ – phew, that’s a relief.

**I realize it’s possible this can be done still from the data available OR it has already been done… only I couldn’t see it in the downloaded report.  

Economists often ignore politics says Donald Marron! - wish we all could...

Mahatvakankshi...

That's what I thought I'm becoming when I dared comment on a blog dedicated to Economics!!.... and, on an article dwelling on how economists don't seem to be factoring-in how 'policy decisions might change the future balance of political power' at that!!! - 

Well, here's the link to the article & below's my comment on the same...

http://dmarron.com/2013/05/08/should-economists-pay-more-attention-to-politics/#comment-13844

My comment;

--------------

1. on May 14, 2013 at 8:26 am | ReplyMurali Apparaju

   Of course they should pay attention to politics… 

   The legacy of a theorem & assumption based scenario-building clubbed with the current trend of considering only the mathematical & econometric models as having scientific/ academic rigor I feel made economists predominantly quants… with very less patience and sensitivity towards the uncertainties that can be explained only qualitatively and never numerically……

   Guess some of the lost ART needs to put back in the SCIENCE of Economics 

Will the Indian Mobile makers pay a price for the judicial ambiguity (& their own..) on 'Essential Patents' & FRAND terms?

In his characteristic & incisive style, 'Spicy IP' Prashant Reddy unravels for debate, the ongoing litigation between Ericsson & Micromax Informatics Ltd. after Ericsson sued Micromax (and Mercury Electronics Ltd.) a few months ago for allegedly infringing 8 of its telecom patents for a range of wireless technologies, including 3G, AMR and Edge - read the artcile here @ http://spicyipindia.blogspot.in/2013/05/the-ericsson-micromax-patent-litigation.html 

Looking at the haste in which the Delhi High Court granted an ex-parte interim injunction against Micromax, I cannot but agree with the writer's initial assessment that Indian regulatory apparatus & companies are not geared up for fighting complex & strategic IP litigations.

I however don't share Prashant's (rather gloomy) view that "it is unlikely they (Indian companies) will take the extra-effort to counter-attack Ericsson in a bid to pre-empt future action by other patentees" - like i said earlier in a article of mine, commerce & the promise of it is a good enough reason for any company to learn the ropes of the trade. It also should be understood that, even if it makes immense sense, someone like Micromax may not really be able to go all proactive since they aren't exactly the Apple OR Samsung & their margins, I would expect, will be minimal.

The need is however crystal clear - It's about time Indian regulators, judiciary & indian tech-companies that have to mostly deal with dangerous dampeners like royalty-stacking et al take a crash course in what they need to expect & how they could make strategic litigation a part of their daily lexicon.

below is my comment posted on the above article on Spicy IP;

vishrasayan said...

Excellent insight Prashant!

It appears as though the displaced-vanguards of the mobile technology such as Motorola, Ericsson have re-strategized their revenue generation to monetizing their patents rather than depending on competitive selling :-)

I also see your point about the Indian regulatory, judicial apparatus & the companies themselves prepping way too less on litigations and that's bothersome – this lack of comprehension also resonates with the lack of precise articulation I wrote about some-time ago on my blog… hopefully this will change.

I do agree the potential for royalty-stacking in mobile technology makes it much complex and hence the need for a middle-path, but healthcare too comes with its own complexity of access to latest innovation - I have read your earlier post on compulsory licensing – it appears to me there’s a dichotomy in your justification of premium for innovation (patents) in healthcare and not applying the same yard-stick for the mobile technology…?

1:22 PM

Dear HBR, defend your research!

In the May 2013 issue of HBR that has a ‘spotlight on entrepreneurship’, Adi Ignatius observes in the very first paragraph of his editorial that the “IPO market has been soft for years” & on a closing note hoped for ‘a steadier flow of IPOs’ as the economy is on the path to recovery.

This angst I thought pretty much reinforces the dominant LP complaint of an ‘absent IPO market in venture backed firms’ these days. Given this, I expected the articles to focus on elucidating about scalability of an early enterprise to the entrepreneurs – which I realized wasn’t the case after reading through the same.

Each of the four articles & the one interview instead seemed standalone in content & interestingly anti-VC in tone & tenor – not sure why. Since an elaborate hypothesis on these already elaborate academic articles didn’t appeal to me, I felt capturing the essence of each article in a single line would make it crisper - but given the duality of the message in the articles/ interview, I decided that the take-away messages should be in two sets, one for the entrepreneur & one for VC.

Here goes;

FOR THE ENTREPRENEUR

Go the Lean-way or Fade away¹

Seek out the client, not just an investor²
To err is VC – YOU, be the driver³
Marry the VC if you must, just make sure the pre-nup is not one-sided!⁴
If you are good, a Top VC will find you / If a Top VC funds you, you must be good!⁵

FOR THE VC

Lean is in – Junk the flab (read: 5yr business plan et al.)¹
Failing early is a virtue, at times, most times²
Focus on great returns, not on large fees – Stay relevant³
VCs are good but dated – Brace up for the Gen-Y entrepreneur⁴
If you aren’t a top-quartile VC, tough luck!, great deals don’t happen to you⁵

Article reference:

Click link to access the article, (I pay for my Kindle edition tho’..)

1.        Article “Why the Lean Start-Up Changes Everything” by Steve Blank

2.        Article “What Entrepreneurs Get Wrong” by Vincent Onyemah, Martha Rivera Pesquera, and Abdul Ali

3.        Article “Six Myths About Venture Capitalists” by Diane Mulcahy

4.        Article “How to Negotiate with VCs” by Deepak Malhotra

5.        “In Search of the Next Big Thing, Interview of Marc Andreessen

Most of the above messages have been around for some time now, only this comes across as a tacit academic endorsement of the market grapevine - If I forget scalability for a moment, my summarized takeaway from the above is;

Whether or not there’s something basically and drastically wrong with the current VC model, the emerging new trends in the start-up strategies make it pertinent that the early investors, in particular the VCs, should evolve in tandem – This is important not only for sustaining the radically different new-gen start-ups but also for the sustenance of the VC domain itself.

I always liked the way the professors are called out to defend their research in “Idea Watch” section of HBR, So do I now say; 

Dear HBR, defend your research? 

Game on…


After thought:

Ponder the following exchange between Adi Ignatius (Editor HBR) and Mark Andreessen (Venture Capitalist) - ref: “In Search of the Next Big Thing

Adi:    You’ve developed a strong philanthropic focus. Is the next generation of investors thinking about social investment?

Marc:   No. [Laughs.]

Adi:    So much for my hopes for the next generation.

Marc:   Many younger entrepreneurs have a social mission or a philanthropic agenda. They start early. Investors, not so much.

Considering this is towards the end of the conversation, I thought Marc was pretty dismissive about another aspect that investors both big and small HAVE to eventually look at "Corporate Social responsibility" of financial organizations. I pondered on this in my earlier article titled "IRR v/s Social Impact: Do financial institutions necessarily go through this dilemma?" - No answers tho'.