The moral economy of the pharmaceutical industry: Legitimising prices

The practices of pharmaceutical companies have been widely criticised by researchers and investigative journalists, yet their conduct has mostly escaped significant moral opprobrium from the wider public, health professionals and governments. This article examines one reason for this by exploring the techniques companies use when seeking to justify and legitimise their conduct – legitimising techniques that help to render their failures to adhere to accepted standards less visible. It explores these techniques by examining four cases involving pricing where the companies’ conduct has, nonetheless, been questioned. It is divided into three parts. The first looks at the various publicly-stated standards that provide the moral context for the industry’s activities. The second examines four cases, each involving pricing, where companies’ prices have been challenged as morally unacceptable, each leading to a US Government investigation. These provide a means of exploring how companies seek to justify their actions in order to maintain the appearance of conformity to accepted moral standards. The third considers some reasons why the industry’s efforts at legitimation have considerable force. The analysis shows not only the character of the claims made by pharmaceutical companies in defence of their practices – claims about the health benefits of the medicine, access to it, and research and development costs, which are all often exaggerated. It also shows why the companies’ legitimising tactics are typically effective.