Ethics of Offshoring: Novo Nordisk and Clinical Trials In Emerging Economies
Offshoring is a highly debatable topic throughout the country and the world. Many people base their opinions on different aspects of offshoring. Some people are against offshoring because they feel as if the working conditions in other countries aren’t up to par and are unethical. Some people are against offshoring because they feel it is taking jobs away from people within their own country. Some people are for offshoring because they feel there is greater profit involved or that they can get harder workers in other countries. No matter what side of the debate, everyone can agree on a few things like there ...view middle of the document...
The average American patient consumes nearly $7,000 in medical care each year; the average Indian's annual health care tally is $39. Nearly every American adult can read, but 39% of Indians are illiterate”. Also, the case mentioned how it costs so much more in the US to track the progress of a single person’s clinical trial than it does overseas. While the price of developing a single drug has raised substantially, it is easy to see why pharmaceutical companies increasingly are shifting clinical research to developing countries such as India. Economically, it does make sense for companies like Novo Nordisk to conduct clinical trials in places like India. Below is a table that shows an increase in offshoring pharmaceuticals (amednews).
| United States | Western Europe | Rest of World |
1997 | 86% | 9% | 5% |
1999 | 80% | 9% | 12% |
2001 | 77% | 10% | 13% |
2003 | 70% | 11% | 19% |
2005 | 62% | 13% | 25% |
2007 | 57% | 14% | 29% |
It is easy to see why economically a company would want to do their clinical testing by using offshoring, but what about ethically? Before reading this case and learning all of the facts, I would have said it was fine for clinical trials to be conducted in places like India. In the case it said that a mother in India with three children is not a good test subject. The woman needs money to feed her kids, so she would be unable to refuse the test. I can agree with that. Just that little bit of text alone was powerful enough for me to start thinking. Therefore I do not think it is ethically responsible to conduct trials in poor economies with poor people who cannot refuse. Like our case stated, these tests should be held for the people with the resources to say no if they wanted to. Unfortunately, like the table above shows, there has been a huge increase in offshoring. Novo Nordisk had everything in place, for example, they would not test in areas they were not thinking about selling their products. They also have adapted all guidelines and recommendations by all the professional bodies. Their tests are conducted on people with ailments the drug would be used for too. These are the types of principals that I think should guide the decision as to whether or not it is appropriate to offshore to places like India. Another question that needs to be addressed is if trials are conducted in an emerging economy, how should they be managed and which standards should apply? I think medical ethics is a big issue when it comes to trials being conducted in an emerging economy. One famous incident of this was the Tuskegee syphilis study. This study left 400 African Americans untreated in order to research how they obtained the disease. The cure for syphilis, penicillin, had already been found in the 1940s. To prevent this from happening again, professional medical organizations developed guidelines and principles of ethics to guide their research, notably the Helsinki Declaration. I believe Novo Nordisk does a great...