29-08-2014, 03:46 PM
Retention of employees in pharmaceutical industry
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Introduction:
Lake Chemicals was established in 1992 in association with Micro lab Group (the fastest growing company among the top 20 companies in India as per the ORG rating). Lake primarily intends to capture the specialized quality Bulk Drugs market and envisages an enormous growth prospect in India and across the world. Lake Chemicals Pvt Ltd, a Bangalore based company situated in the southern part of India, popularly known as Silicon Valley of Asia. Lake is a leading manufacturer of psychotic API’s & its intermediates. Lake is highlighted on the market as one of the major producers of Benzodiazepine series. Lake has grown a long way to have a good presence in regulated markets. Lake intents to achieve a stronghold in the US & other regulated markets like Europe, Australia etc. Lake is gearing up for a US FDA approval for its range of Benzodiazepine series and has filed CTD to various health authorities of Europe and is in a final process of submission to EDQM. Lake has Global presence in Singapore, Hong Kong,Brazil,andalsoIsrael.
Lake has considerable strengths and a growing presence in the world's key pharmaceutical markets, equipped for product development with complex chemistry, a talented and dedicated workforce and a leading portfolio of products with many more in the pipeline. Lake continues to ensure that we have the right resources to produce the right quality of the niche products and projects that we have underway or will be bringing on board. Over the next few years, we intend to build on our strengths and launch successful products by constant researching to develop new products that deliver significant value to mankind.
Lake’s accomplishments over the past few years speak a great volume about its talented team of employees, who have firmly embraced the Company's vision. Growth is due to the management guidance & team contributions
with an ongoing support from both ends.
Our vision
To become a more globally focused and integrated company with a number of successful API to meet the needs of regulated markets like US, Europe & Australia
Silent feature:
Lake is a WHO GMP certified facility.
Having a finished goods handling area with a class 1,00,000 air handling.
We have been awarded the export house status based on our export performance by the Govt. of India.
Possesses a sophisticated manufacturing facility as we are gearing-up to enter the US Market in the near future
Registered at international recognized DUN & Bradstreet D&B D-U-N-S#65-047-6559.
Exporting to about 30 countries including regulated and non-regulated markets
Lake Intends to file CTD of 5 products to EQQM for grant of COS in the near future
An approved source of a couple of products [Lorazepam - Wyeth , Haloperidol- Searle & Clonazepam- (Roche- through Nicholas Primal )] by the originators for local & unregulated market supply
Facility is built as per ICH guidelines with a focus to get into the US market with the Benzodiazepine range of products
Equipped with an in-house jet-mill and can offer micro ionized grade with the finest particle size of 100% less than 10 microns
OGANISATIOZATION PROFILE:
Health care professionals who prescribe pharmaceutical products base their prescription decisions on many factors including effectiveness, safety, and cost. In an effort to influence practitioners’ prescribing practices, the pharmaceutical industry employs diverse marketing and promotional strategies, among them offers of free drug samples, educational materials, meals, and other forms of gifts. These efforts are both intensive and expensive. In 2001 the drug industry spent more than $16 billion on visits to physicians’ offices. In the last five years the number of pharmaceutical company sales representatives in the U.S. has increased from 42,000 to 88,000.1 Some 80% of physicians report having been offered cash or gifts from pharmaceutical industry representatives.2 Many physicians meet with pharmaceutical industry representatives four or more times per month.3 Serious ethical concerns have been raised about these contacts between the pharmaceutical industry and individual health care professionals, especially when gifts are involved.4-9 The practice of accepting gifts from pharmaceutical industry representatives risks compromising health care providers’ professional objectivity and integrity, and undermining their fundamental ethical commitment to putting the interests of patients first. Gift incentives to participate in continuing professional education programs are the wrong incentives for health care professionals and trainees, who should be independently motivated to participate in lifelong learning.7 And there are economic consequences when the costs of gifts are passed along to patients, health care institutions, and third-party payers in the form of higher prices for drugs. Escalating drug costs may ultimately result in limitations on access to care. Federal regulations (at 5 CFR, Part 2635) establish standards for conduct in relation to gifts for all federal employees. But anecdotal reports from the field indicate that beyond these mandated thresholds, local facilities’ policies about accepting gifts from the pharmaceutical industry vary widely within VHA. To address this state of affairs, new national policy limits the access representatives of the pharmaceutical industry may have to facilities and staff.* This national guidance provides a foundation for the development of more uniform local policies throughout the system. This report by the VHA National Ethics Committee examines the values at stake in relationships between practitioners and the pharmaceutical industry from the perspective of health care ethics. Its goal is to clarify the philosophical and professional concerns that underlie regulations and policy in this area. The report addresses gifts provided to individual health care professionals by representatives of the pharmaceutical industry. Often these gifts consist of items that are designed to enhance patient care (e.g., reflex hammers, anatomical models) or learning (e.g., meals at educational events, textbooks), but gifts may also be of a more personal nature (e.g., organizers, event tickets). The promotional nature of gifts may be subtle or obvious, depending on, for example, whether a sponsor or product name is prominently displayed. For this report gifts are distinguished from purely promotional items that have no intrinsic value to the recipient (e.g., product brochures) and from compensation for professional work (e.g., honoraria). The report discusses the definition of gifts, examines why gifts to health care professionals from the pharmaceutical industry may be ethically problematic in the health care setting, and reviews professional ethical guidelines and legal standards regarding acceptance of gifts. It offers practical recommendations to guide ethical policy within VHA. Although the analysis and recommendations offered here were developed specifically in reference to gifts from pharmaceutical representatives, they apply equally to gifts from representatives of medical manufacturers Gifts provided to institutions are beyond the scope of this report.* What Is a Gift? Webster defines a gift as: “something bestowed voluntarily and without compensation.”12 Although this definition captures our casual understanding of a gift as something given with no expectation that the recipient will reciprocate, it misses much of the social aspect of gifts that make gifts from pharmaceutical representatives to health care professionals ethically challenging. Gifts “have deep and sometimes contradictory cultural meanings.”13 Unlike contracts, in which parties set out clear, explicit expectations, gifts place people in binding personal relationships that generate vague, open-ended moral obligations. The importance of a gift lies in the personal relationship it generates, sustains, and signifies.14 Why Are Gifts Ethically Problematic? Because gifts create relationships, health care professionals’ acceptance of gifts from the pharmaceutical industry can be ethically problematic in several ways. Accepting gifts risks undermining trust. It may bias clinicians’ judgments about the relative merits of different medications. And it may affect prescribing patterns in ways that increase costs and adversely affect access to care. Undermining Patient & Public Trust. Health care professionals’ fiduciary, or trust-based, relationship with patients requires that practitioners explain the reasons for treatment decisions and disclose any potential conflicts of interest, including the influence of gifts. One study asked patients and physicians to rate how appropriate it would be for a physician to accept gifts (ranging from pens to trips) from the pharmaceutical industry, and whether they thought accepting gifts would influence the physician’s behavior.15 With the exception of drug samples, the patients considered gifts to be more influential than did the physicians. Almost half of the patients who participated had not been aware that physicians received gifts from pharmaceutical companies—and of those, 24% said that this new knowledge changed their perception of the medical profession. Similarly, a telephone survey of patients found that although 82% of respondents were aware that physicians received “office-use gifts” from the pharmaceutical industry, only about one-third were aware that physicians received personal gifts.16 Forty-two percent believed that personal gifts adversely affect both the cost and the quality of health care. On the basis of such data, the American College of Physicians has concluded that “[a] significant number of patients believe that industry gifts bias their physician’s prescribing practices and ultimately drive up medical costs.”17 Public awareness that health care professionals accept gifts from pharmaceutical representatives may undermine trust in the profession and lead to a perceived loss of professional integrity. VHA is a public agency and public service is considered a public trust. Consequently, the public rightly hold VHA to a higher ethical standard than they do private companies. As federal employees, health professionals appointed to VHA have an obligation to ensure that citizens can have complete
Brief history of lake chemicals:
The Mill Brook sub watershed and the Blackstone River Headwaters have been identified by the Massachusetts Executive Office of Environmental Affairs as key priority areas to improve water quality within the Blackstone River. The Blackstone River has been designated as a National and American Heritage River by the National Park Service. The Blackstone River Valley National Heritage Corridor was designated by an Act of Congress on November 10, 1986 to preserve and interpret for present and future generations the unique and significant value of the Blackstone Valley. In August 1998, President Clinton declared the Blackstone River an "American Heritage River". The National Park Service, two state governments, dozens of local municipalities, businesses, nonprofit historical and environmental
organizations, educational institutions, many private citizens, and a unifying commission all work together in partnerships to protect the Valley's special identity and prepare for its future.
Indian Lake is the largest body of water located completely within the City of Worcester, Massachusetts (population of 170,000+). The 193-acre Lake with a mean depth of approximately 10 feet offers many family activities including two public swimming beaches, picnic and recreation areas, a public boat launch and a tennis court. Indian Lake originally encompassed 40 acres and was surrounded by marshes and farmland. In the late 1820's during the industrial era, the Blackstone Canal was built to create a new transportation link between Worcester, Massachusetts and Providence, Rhode Island. The Mill Brook was dammed at Indian Lake to form the headwaters of the Blackstone Canal and Blackstone River to control the flow of water through the canal. In the late 1840's the Lake was used to harvest ice for local businesses. The Upper Mill Brook Watershed area is approximately 15 square miles and extends northerly into Holden. The main outlet from Indian Lake flows through a gated valve in a southerly direction into Salisbury Pond and eventually into the Blackstone River. The watershed area is heavily urbanized and the major tributary entering into the Lake is Ararat Brook entering at the northwest corner of the Lake.
Over the past 50 years, development within the watershed has increased dramatically which has caused increased water quality problems at Indian Lake and its tributaries and inlets. This development has attributed to rapid sedimentation from both upstream development and urban runoff. High phosphorous loading has also led to eutrophication and has resulted in severe impairment of water quality, primarily in the form of low dissolved oxygen, nuisance aquatic plants, turbidity and organic enrichment. This has been documented in numerous studies and routine water quality monitoring conducted by the Indian Lake Watershed Association (ILWA) through the Blackstone Headwater Monitoring Team (BHMT) Program and by the City Department of Public Health (DPH).
Existing conditions have substantially reduced the recreational potential of the Indian Lake. In 1978 the Indian Lake Improvement Association was formed and in 1985, the ILWA was incorporated as a non-profit 501(3c). The organization began as a group of concerned residents who wanted to monitor and revive the water body and has grown to be one of the strongest neighborhood groups in the City of Worcester, working in cooperation with both city officials and residents to combat the effects of development within the watershed. The ILWA now maintains a membership of 300+ members.
The ILWA has completed many major tasks to protect and restore the quality of the Lake in the recent years. These tasks include: sewered homes along Indian Lake, dredged a portion of Indian Lake; lobbied against major land taking for construction of Rte 190, lobbied City to repair sewer pumping station on Holden Street, periodic treatment of Indian Lake with chemicals to control weeds; construction of Morgan Park; completion of diagnostic feasibility studies of both lakes; coordination of the stenciling of almost 1,500 storm drains, which ultimately discharge into the waterbodies; gained support from the City for an annual drawdown of Indian Lake to combat weed growth; successfully lobbied City to pave a local roadway and long stretch of sidewalk that washed sediment into Indian Lake during rain events; worked with the City to repair a failing septic system at Shore Park, located on Indian Lake, coordinated funding weed control of 80% of Indian Lake to control weed and algae growth, and continuously identify and repair numerous illicit sanitary/storm sewer connections entering Salisbury Pond. The ILWA meets several times per year to discuss on-going issues and projects. The ILWA also keeps its membership of 300+ informed of important events through the distribution of a semi-annual newsletter and provides important event, project status and educational information.
CHARTER OF THE EMPLOYEE DEVELOPMENT AND RETENTION COMMITTEE OF MEDICIS PHARMACEUTICAL CORPORATION:
This Employee Development and Retention Committee Charter was adopted by the Board of Directors (the “Board”) of Medicis Pharmaceutical Corporation (the “Company”) on July 9, 2006.
I. Purpose
The purpose of the Employee Development and Retention Committee (the “Committee”) of the Board of the Company is to review and provide guidance concerning the recruiting, hiring, training, promotion and retention of employees and managers.
In addition to the powers and responsibilities expressly delegated to the Committee in this Charter, the Committee may exercise any other powers and carry out any other responsibilities delegated to it by the Board from time to time consistent with the Company’s bylaws. The powers and responsibilities delegated by the Board to the Committee in this Charter or otherwise shall be exercised and carried out by the Committee as it deems appropriate without requirement of Board approval, and any decision made by the Committee (including any decision to exercise or refrain from exercising any of the powers delegated to the Committee hereunder) shall be at the Committee’s sole discretion. While acting within the scope of the powers and responsibilities delegated to it, the Committee shall have and may exercise all the powers and authority of the Board. To the fullest extent permitted by law, the Committee shall have the power to determine which matters are within the scope of the powers and responsibilities delegated to it.
II. Membership
The Board will appoint the members of the Committee. There will be a minimum of two members of the Committee. Each member of the Committee will be a non-management member of the Board.
III. Meetings and Procedures
The Chairperson (or in his or her absence, a member designated by the Chairperson) shall preside at each meeting of the Committee and set the agendas for Committee meetings. The Committee shall have the authority to establish its own rules and procedures for notice and conduct of its meetings so long as they are not inconsistent with any provisions of the Company’s bylaws that are applicable to the Committee.
The Committee shall meet at least one time per year and more frequently as the Committee deems necessary or desirable.
All non-management directors who are not members of the Committee may attend and observe meetings of the Committee, but shall not participate in any discussion or deliberation unless invited to do so by the Committee, and in any event shall not be entitled to vote. The Committee may, at its discretion, include in its meetings members of the Company’s management, any personnel employed or retained by the Company or any other persons whose presence the Committee believes to be necessary or appropriate. Notwithstanding the foregoing, the Committee may also exclude from its meetings any persons it deems appropriate.
The Committee shall have the sole authority, as it deems appropriate, to retain and/or replace, as needed, any independent counsel, consultants and other outside experts or advisors as the Committee believes to be necessary or appropriate. The Committee may also utilize the services of the Company’s regular legal counsel or other advisors to the Company. The Company shall provide for appropriate funding, as determined by the Committee in its sole discretion, for payment of compensation to any such persons retained by the Committee.
The Chair shall report to the Board following meetings of the Committee and as otherwise requested by the Chairman of the Board.
IV. Duties and Responsibilities
1. The Committee shall, at least annually, review the employee recruitment, hiring, development, promotion and retention policies of the Company.
2. Through an interactive process with the Company’s senior management and its Human Resources Department, provide oversight and guidance on issues including but not limited to employee recruiting, hiring & promotions, training & development, employee relations, work-life issues, diversity, inclusion issues, retention practices, and similar matters with the goal of increasing employee retention and satisfaction.
3. To address specific issues or problems relating to employee relations and retention that may arise with the objective of identifying which procedures or policies need be enhanced, changed or discarded and to ensure that senior management has a timely and reasonable action plan to address the issue or problem.
4. The Committee shall evaluate its own performance on an annual basis, including its compliance with this Charter, and provide any written material with respect to such evaluation to the Board, including any recommendations for changes in procedures or policies governing the Committee. The Committee shall conduct such evaluation and review in such manner as it deems appropriate. The Committee shall review and reassess this Charter at least annually and submit any recommended changes to the Board for its consideration.
V. Delegation of Duties
The Committee may delegate its responsibilities under this Charter to a subcommittee comprised of one or more members of the Committee. The creation of such a subcommittee, as well as its purpose, will be reported to the Board of Directors. The Committee will also carry out such duties that may be delegated to it by the Board.
Retinas-Employee Retention News:
Retensa is proud to be the company keeping you current on employee retentiontrends,turnovertools,andtalentmanagementtactics.
Feb:
Department of Small Business Services Invites Retinas to Speak at Business Survival Conference of 175 attendees The NYC Department of Small Business Services Flatiron BID invites Chanson Hecht, employee specialist, to speak with conference attendees on workforce issues in an uncertain business environment. Real world scenarios and solutions will be addressed at the Feb 25th event, such as how to reduce employee costs without reducing productivity and what are the viable alternatives to layoffs. Organizational Development Network Invites Retensa to Diversity PanelJan Retensa consultant, Barbara Vigilante, was invited by the Organizational Development Network to take part in a panel on diversity and inclusion. Topics such as the role of diversity in talent management and leading practices in designing, promoting and implementing diversity initiatives will be discussed at the February 10th event.
Retensa presents the Top 10 "Biggest Quits" list of 2008
Retensa presents the fourth annual review of the most the most impact resignations of the year. 2008 was a year remembered for change. For some, change is welcome. For others, it casts uncertainty. Stability is the new currency, so this year's list of biggest
Retention Programs to Retain Pharmaceutical Employees:
State of the Industry:
In the highly regulated Pharmaceutical Industry, jobs have become more stressful and complicated. Fierce competition has driven salaries higher and higher and benefits must be constantly improved. Although the Pharmaceutical Industry has lower turnover rates compared to other industries, the cost of turnover is much greater. With strict regulations and rigid timelines, a research specialist's resignation leaves your company with a delay in product development and a loss of talent. Additionally, when a pharmaceutical representative leaves, they take the client relationships with them. These stringent regulations leave employee actions vulnerable to repercussions from their boss, the government, and sometimes even the media making retaining talented employees invaluable.
How Can Retinas Help? In order to retain your employees and reduce turnover, a proactive approach is critical. Retensa can help your Pharmacy organization achieve these goals by constructing an employee retention strategy according to your company's strengths, weaknesses, budget, and goals. Recruiting, hiring, On Boarding, and training are especially important in the Pharmaceutical Industry. An analysis using our Emergent Employee Life Cycle can give you an accurate picture of what current processes are successful and which ones are not as effective as they could be. Retensa creates an action plan with clear recommendations for improvement based on these findings. We also use exit interviews and employee engagement surveys to learn why employees leave your company and what you can do to better retain them.
Costumer focus:
• To Satisfy our customers' needs and expectations
• To Make commitments we fully understand and believe we can meet
• To Meet all commitments to customers on time
Performance Driven:
To Verify that our products and services meet agreed requirements
To Monitor, benchmark and continuously improve our business, products, services, organization and employees' performance
To Provide best service backup for our customers
Commitment to Quality:
Quality values are internalized at every level of the organization. Our approach to communicating and implementing these values is one of encouragement, education and training rather than making policies. Ongoing education and individual support provide employees with the tools, confidence, and motivation they need to implement quality philosophy.
Through a quality training program, employees will learn, both the importance of quality and how to measure it and a commitment to continually improving the quality and reliability of Lake’s products and services. We work to offer a very low impurity profile in our products.
About pharmaceutical promotion:
General Practitioner in Willunga, a village 50 km south of Adelaide, South Australia paid one day per week. Lecturer in the Discipline of General Practice, University of Adelaide paid one day per week. My duties include developing a Treatment Decision Education Collaboration (TDEC)
• National Institute of Clinical Studies (NICS) Fellow 2.5 days per week. My project is to develop a website to assist GPs to evaluate the usefulness of drug promotion compared to Therapeutic Guidelines.
• Director, Healthy Skepticism Inc unpaid. Healthy Skepticism is an international non-profit organization with the main aim of improving health by reducing harm from misleading drug promotion. I am currently on a 23 city tour of Europe and the USA from April 20 – June 25, 2008 with stops in these cities:
Helsinki, Manchester, Leeds, London, Oxford, Berlin, Verona, Glasgow, Belfast, Geneva, Lausanne, Madrid,Köln, Mainz, Washington, Boston / Pawtucket, Chicago, New York, Seattle, San Francisco / Davis, Hobart I am much obliged [old fashioned English for “thank you”] to my major sponsors:
• IQWiG [German Institute for Quality and Efficiency in Health Care]
• SSMI [Swiss Society of Internal Medicine]
Why is drug promotion a difficult topic?
Understanding drug promotion is not rocket science. It is a much more complicated and difficult topic. Understanding drug promotion requires understanding insights from many different fields of study. The more I learn from these any
fields the more I realize that I have much more to learn. The useful fields of study include:
• Medicine and Pharmacy
– Pharmacology, Epidemiology, Public Health, Evidence Based Medicine, Drug Evaluation,
Pharmacovigilance
• Social sciences
– Psychology, Economics, Sociology, Anthropology, Management, History, Politics, Communication Studies
• Humanities
– Logic, Ethics, Rhetoric, Epistemology, Linguistics, Semiotics, Literature, Art, Religion
• Professions
– Marketing, Public Relations, Education, Advocacy, Regulation Policing, Law, Accounting
• Statistics
Because drug promotion is so complex this paper can only be a quick introduction covering only the tip of the iceberg. I will have to simplify many complex issues. I apologize for any misunderstandings or distortion that may result. The understanding of drug promotion is also complex and difficult for the following reasons:
• The greatest obstacle to discovering the truth is being convinced that you already know it. Many doctors believe that they all ready know everything they need to know about drug promotion so they are not open to reconsidering their beliefs.
Peter Mansfield: Healthy Skepticism about pharmaceutical promotion page 2
• Because we swim in a see of promotion we don’t notice it, just like fish may not notice the water that they swim in.
• The issues are not black and white.
• The conclusions from psychological research about persuasion do not fit well with the current belief systems of many health professionals. Many reject these conclusions because they feel wrong or difficult to believe without assessing the strength of the evidence. This tendency of people to reject facts if they feel that they are implausible was known by the ancients. Plato who attributed the following quote to Socrates discussing sophistry: “In courts of justice no attention is paid whatever to the truth… all that matters is plausibility... both prosecution and defense positively suppress the facts in favour of probability, if the facts are improbable. Never mind the truth -- pursue probability through thick and thin in every kind of speech; the whole secret of the art of speaking lies in consistent adherence to this principle.” (Plato, Phaedrus 272). Thucydides wrote that "When someone finds a conclusion agreeable, they accept it without argument, but when they finds it disagreeable,
they will bring against it all the forces of logic and reason." Modern psychologists call these tendencies
“confirmation bias”.
• Many health professionals perceive any discussion of drug promotion to be a threat to their freedom to choose
for themselves what to do, including whether or not to accept gifts from drug companies. Psychological
research has found that threats to freedom often elicit reactance. Reactance is an emotional reaction against
threats to freedom or pressure to change. Reactance can cause people to adopt or strengthen views contrary to
what was intended.
What is promotion?
Promotion can be defined as persuasion with the aim or effect of increasing or decreasing the use, sales or acceptance of a product, service or idea. Promotion is a subset of marketing. The 3 other main components of marketing are: developing the product, pricing and distribution or placement. Thus the 4 Ps of marketing are: product, price, promotion and place. Promotion includes many methods: advertising, sales representatives, gifts, samples, sponsorship, public relations etc.
Do we think we are influenced?
Many studies around the world have found similar results to a study by Steinman et al (2001). When they asked young US physicians: “How much influence do sales representatives have on your prescribing?” the answers were: 61% none;38% a little and 1% a lot. It seems that the majority of us are confident that we are completely or nearly completely invulnerable to promotion. However we are not so confident about our colleagues. When asked “How much influence do sales representatives have on other physicians’ prescribing?” the answers were: 16% none; 33% a little and 51% a lot.1 have It is very common for humans to believe that they are at lower risk of harm than other people. Psychologists call this the illusion of unique invulnerability. Consequently if you think you not vulnerable to being misled by drug promotion you are in the majority. However, there is also evidence that this illusion increases vulnerability. Overconfidence increases vulnerability because it reduces the motivation to think carefully about persuasive messages so they are less likely to be rejected.2 One of the main reasons why doctors are overconfident is that they believe that their high intelligence is an adequate
protection. Recently, an Australian national GP leader for denied that doctors were be adversely influenced by drug promotion. His main justification for this denial was that: “Doctors have the intelligence to evaluate information from a clearly biased source.
What percentage of promotion is potentially misleading?
The answer to this question depends on definition used. My definition is: Promotion is potentially misleading when it omits relevant information that is needed for good decisions or includes persuasion techniques that that have been
identified as potentially misleading in studies of logic, critical appraisal, psychology or rhetoric. These techniques ay be
used deliberately with intent to mislead or ay be used innocently by people who have been misled themselves. For 25 years I have been looking for an example of promotion that is not potentially misleading. The reason I want such an example is that I want to influence drug companies and praise is a more effective way to influence people than criticism.
However I have not been able to find any examples in Australia or any of the many other countries I have visited. Sometimes I have found advertisements that I initially think are ok but on loser examination I find that they had fooled me. I frequently ask audiences at the talks I give to send an example of promotion that is not potentially misleading butnone have been sent to me. If you see a good example please send it to me at peter[at]healthyskepticism.org. It is still possible that some promotion is ok but I think the parentage must be very small. I conclude that the percentage of promotion is potentially misleading is likely to be near 100%.
Overview of pharmaceutical:
Clinical research and development in the drug industry must be understood in the current political and economic context of medical neoliberalism (Fisher 2007a; forthcoming). In the US, neoliberalism is the guiding ideology behind economic policies that emphasize a reduction in social services provided by the state and an increase in the role of the private (for-profit) sector in the provision of social goods, such as health care, welfare, and education (Monahan 2006). Medical neoliberalism, in particular, is manifest in a consumer model of health characterized by an inequitable distribution of services according to who can pay for different kinds of care (Frank 2002). The pharmaceutical industry
[attachment=67362]
Introduction:
Lake Chemicals was established in 1992 in association with Micro lab Group (the fastest growing company among the top 20 companies in India as per the ORG rating). Lake primarily intends to capture the specialized quality Bulk Drugs market and envisages an enormous growth prospect in India and across the world. Lake Chemicals Pvt Ltd, a Bangalore based company situated in the southern part of India, popularly known as Silicon Valley of Asia. Lake is a leading manufacturer of psychotic API’s & its intermediates. Lake is highlighted on the market as one of the major producers of Benzodiazepine series. Lake has grown a long way to have a good presence in regulated markets. Lake intents to achieve a stronghold in the US & other regulated markets like Europe, Australia etc. Lake is gearing up for a US FDA approval for its range of Benzodiazepine series and has filed CTD to various health authorities of Europe and is in a final process of submission to EDQM. Lake has Global presence in Singapore, Hong Kong,Brazil,andalsoIsrael.
Lake has considerable strengths and a growing presence in the world's key pharmaceutical markets, equipped for product development with complex chemistry, a talented and dedicated workforce and a leading portfolio of products with many more in the pipeline. Lake continues to ensure that we have the right resources to produce the right quality of the niche products and projects that we have underway or will be bringing on board. Over the next few years, we intend to build on our strengths and launch successful products by constant researching to develop new products that deliver significant value to mankind.
Lake’s accomplishments over the past few years speak a great volume about its talented team of employees, who have firmly embraced the Company's vision. Growth is due to the management guidance & team contributions
with an ongoing support from both ends.
Our vision
To become a more globally focused and integrated company with a number of successful API to meet the needs of regulated markets like US, Europe & Australia
Silent feature:
Lake is a WHO GMP certified facility.
Having a finished goods handling area with a class 1,00,000 air handling.
We have been awarded the export house status based on our export performance by the Govt. of India.
Possesses a sophisticated manufacturing facility as we are gearing-up to enter the US Market in the near future
Registered at international recognized DUN & Bradstreet D&B D-U-N-S#65-047-6559.
Exporting to about 30 countries including regulated and non-regulated markets
Lake Intends to file CTD of 5 products to EQQM for grant of COS in the near future
An approved source of a couple of products [Lorazepam - Wyeth , Haloperidol- Searle & Clonazepam- (Roche- through Nicholas Primal )] by the originators for local & unregulated market supply
Facility is built as per ICH guidelines with a focus to get into the US market with the Benzodiazepine range of products
Equipped with an in-house jet-mill and can offer micro ionized grade with the finest particle size of 100% less than 10 microns
OGANISATIOZATION PROFILE:
Health care professionals who prescribe pharmaceutical products base their prescription decisions on many factors including effectiveness, safety, and cost. In an effort to influence practitioners’ prescribing practices, the pharmaceutical industry employs diverse marketing and promotional strategies, among them offers of free drug samples, educational materials, meals, and other forms of gifts. These efforts are both intensive and expensive. In 2001 the drug industry spent more than $16 billion on visits to physicians’ offices. In the last five years the number of pharmaceutical company sales representatives in the U.S. has increased from 42,000 to 88,000.1 Some 80% of physicians report having been offered cash or gifts from pharmaceutical industry representatives.2 Many physicians meet with pharmaceutical industry representatives four or more times per month.3 Serious ethical concerns have been raised about these contacts between the pharmaceutical industry and individual health care professionals, especially when gifts are involved.4-9 The practice of accepting gifts from pharmaceutical industry representatives risks compromising health care providers’ professional objectivity and integrity, and undermining their fundamental ethical commitment to putting the interests of patients first. Gift incentives to participate in continuing professional education programs are the wrong incentives for health care professionals and trainees, who should be independently motivated to participate in lifelong learning.7 And there are economic consequences when the costs of gifts are passed along to patients, health care institutions, and third-party payers in the form of higher prices for drugs. Escalating drug costs may ultimately result in limitations on access to care. Federal regulations (at 5 CFR, Part 2635) establish standards for conduct in relation to gifts for all federal employees. But anecdotal reports from the field indicate that beyond these mandated thresholds, local facilities’ policies about accepting gifts from the pharmaceutical industry vary widely within VHA. To address this state of affairs, new national policy limits the access representatives of the pharmaceutical industry may have to facilities and staff.* This national guidance provides a foundation for the development of more uniform local policies throughout the system. This report by the VHA National Ethics Committee examines the values at stake in relationships between practitioners and the pharmaceutical industry from the perspective of health care ethics. Its goal is to clarify the philosophical and professional concerns that underlie regulations and policy in this area. The report addresses gifts provided to individual health care professionals by representatives of the pharmaceutical industry. Often these gifts consist of items that are designed to enhance patient care (e.g., reflex hammers, anatomical models) or learning (e.g., meals at educational events, textbooks), but gifts may also be of a more personal nature (e.g., organizers, event tickets). The promotional nature of gifts may be subtle or obvious, depending on, for example, whether a sponsor or product name is prominently displayed. For this report gifts are distinguished from purely promotional items that have no intrinsic value to the recipient (e.g., product brochures) and from compensation for professional work (e.g., honoraria). The report discusses the definition of gifts, examines why gifts to health care professionals from the pharmaceutical industry may be ethically problematic in the health care setting, and reviews professional ethical guidelines and legal standards regarding acceptance of gifts. It offers practical recommendations to guide ethical policy within VHA. Although the analysis and recommendations offered here were developed specifically in reference to gifts from pharmaceutical representatives, they apply equally to gifts from representatives of medical manufacturers Gifts provided to institutions are beyond the scope of this report.* What Is a Gift? Webster defines a gift as: “something bestowed voluntarily and without compensation.”12 Although this definition captures our casual understanding of a gift as something given with no expectation that the recipient will reciprocate, it misses much of the social aspect of gifts that make gifts from pharmaceutical representatives to health care professionals ethically challenging. Gifts “have deep and sometimes contradictory cultural meanings.”13 Unlike contracts, in which parties set out clear, explicit expectations, gifts place people in binding personal relationships that generate vague, open-ended moral obligations. The importance of a gift lies in the personal relationship it generates, sustains, and signifies.14 Why Are Gifts Ethically Problematic? Because gifts create relationships, health care professionals’ acceptance of gifts from the pharmaceutical industry can be ethically problematic in several ways. Accepting gifts risks undermining trust. It may bias clinicians’ judgments about the relative merits of different medications. And it may affect prescribing patterns in ways that increase costs and adversely affect access to care. Undermining Patient & Public Trust. Health care professionals’ fiduciary, or trust-based, relationship with patients requires that practitioners explain the reasons for treatment decisions and disclose any potential conflicts of interest, including the influence of gifts. One study asked patients and physicians to rate how appropriate it would be for a physician to accept gifts (ranging from pens to trips) from the pharmaceutical industry, and whether they thought accepting gifts would influence the physician’s behavior.15 With the exception of drug samples, the patients considered gifts to be more influential than did the physicians. Almost half of the patients who participated had not been aware that physicians received gifts from pharmaceutical companies—and of those, 24% said that this new knowledge changed their perception of the medical profession. Similarly, a telephone survey of patients found that although 82% of respondents were aware that physicians received “office-use gifts” from the pharmaceutical industry, only about one-third were aware that physicians received personal gifts.16 Forty-two percent believed that personal gifts adversely affect both the cost and the quality of health care. On the basis of such data, the American College of Physicians has concluded that “[a] significant number of patients believe that industry gifts bias their physician’s prescribing practices and ultimately drive up medical costs.”17 Public awareness that health care professionals accept gifts from pharmaceutical representatives may undermine trust in the profession and lead to a perceived loss of professional integrity. VHA is a public agency and public service is considered a public trust. Consequently, the public rightly hold VHA to a higher ethical standard than they do private companies. As federal employees, health professionals appointed to VHA have an obligation to ensure that citizens can have complete
Brief history of lake chemicals:
The Mill Brook sub watershed and the Blackstone River Headwaters have been identified by the Massachusetts Executive Office of Environmental Affairs as key priority areas to improve water quality within the Blackstone River. The Blackstone River has been designated as a National and American Heritage River by the National Park Service. The Blackstone River Valley National Heritage Corridor was designated by an Act of Congress on November 10, 1986 to preserve and interpret for present and future generations the unique and significant value of the Blackstone Valley. In August 1998, President Clinton declared the Blackstone River an "American Heritage River". The National Park Service, two state governments, dozens of local municipalities, businesses, nonprofit historical and environmental
organizations, educational institutions, many private citizens, and a unifying commission all work together in partnerships to protect the Valley's special identity and prepare for its future.
Indian Lake is the largest body of water located completely within the City of Worcester, Massachusetts (population of 170,000+). The 193-acre Lake with a mean depth of approximately 10 feet offers many family activities including two public swimming beaches, picnic and recreation areas, a public boat launch and a tennis court. Indian Lake originally encompassed 40 acres and was surrounded by marshes and farmland. In the late 1820's during the industrial era, the Blackstone Canal was built to create a new transportation link between Worcester, Massachusetts and Providence, Rhode Island. The Mill Brook was dammed at Indian Lake to form the headwaters of the Blackstone Canal and Blackstone River to control the flow of water through the canal. In the late 1840's the Lake was used to harvest ice for local businesses. The Upper Mill Brook Watershed area is approximately 15 square miles and extends northerly into Holden. The main outlet from Indian Lake flows through a gated valve in a southerly direction into Salisbury Pond and eventually into the Blackstone River. The watershed area is heavily urbanized and the major tributary entering into the Lake is Ararat Brook entering at the northwest corner of the Lake.
Over the past 50 years, development within the watershed has increased dramatically which has caused increased water quality problems at Indian Lake and its tributaries and inlets. This development has attributed to rapid sedimentation from both upstream development and urban runoff. High phosphorous loading has also led to eutrophication and has resulted in severe impairment of water quality, primarily in the form of low dissolved oxygen, nuisance aquatic plants, turbidity and organic enrichment. This has been documented in numerous studies and routine water quality monitoring conducted by the Indian Lake Watershed Association (ILWA) through the Blackstone Headwater Monitoring Team (BHMT) Program and by the City Department of Public Health (DPH).
Existing conditions have substantially reduced the recreational potential of the Indian Lake. In 1978 the Indian Lake Improvement Association was formed and in 1985, the ILWA was incorporated as a non-profit 501(3c). The organization began as a group of concerned residents who wanted to monitor and revive the water body and has grown to be one of the strongest neighborhood groups in the City of Worcester, working in cooperation with both city officials and residents to combat the effects of development within the watershed. The ILWA now maintains a membership of 300+ members.
The ILWA has completed many major tasks to protect and restore the quality of the Lake in the recent years. These tasks include: sewered homes along Indian Lake, dredged a portion of Indian Lake; lobbied against major land taking for construction of Rte 190, lobbied City to repair sewer pumping station on Holden Street, periodic treatment of Indian Lake with chemicals to control weeds; construction of Morgan Park; completion of diagnostic feasibility studies of both lakes; coordination of the stenciling of almost 1,500 storm drains, which ultimately discharge into the waterbodies; gained support from the City for an annual drawdown of Indian Lake to combat weed growth; successfully lobbied City to pave a local roadway and long stretch of sidewalk that washed sediment into Indian Lake during rain events; worked with the City to repair a failing septic system at Shore Park, located on Indian Lake, coordinated funding weed control of 80% of Indian Lake to control weed and algae growth, and continuously identify and repair numerous illicit sanitary/storm sewer connections entering Salisbury Pond. The ILWA meets several times per year to discuss on-going issues and projects. The ILWA also keeps its membership of 300+ informed of important events through the distribution of a semi-annual newsletter and provides important event, project status and educational information.
CHARTER OF THE EMPLOYEE DEVELOPMENT AND RETENTION COMMITTEE OF MEDICIS PHARMACEUTICAL CORPORATION:
This Employee Development and Retention Committee Charter was adopted by the Board of Directors (the “Board”) of Medicis Pharmaceutical Corporation (the “Company”) on July 9, 2006.
I. Purpose
The purpose of the Employee Development and Retention Committee (the “Committee”) of the Board of the Company is to review and provide guidance concerning the recruiting, hiring, training, promotion and retention of employees and managers.
In addition to the powers and responsibilities expressly delegated to the Committee in this Charter, the Committee may exercise any other powers and carry out any other responsibilities delegated to it by the Board from time to time consistent with the Company’s bylaws. The powers and responsibilities delegated by the Board to the Committee in this Charter or otherwise shall be exercised and carried out by the Committee as it deems appropriate without requirement of Board approval, and any decision made by the Committee (including any decision to exercise or refrain from exercising any of the powers delegated to the Committee hereunder) shall be at the Committee’s sole discretion. While acting within the scope of the powers and responsibilities delegated to it, the Committee shall have and may exercise all the powers and authority of the Board. To the fullest extent permitted by law, the Committee shall have the power to determine which matters are within the scope of the powers and responsibilities delegated to it.
II. Membership
The Board will appoint the members of the Committee. There will be a minimum of two members of the Committee. Each member of the Committee will be a non-management member of the Board.
III. Meetings and Procedures
The Chairperson (or in his or her absence, a member designated by the Chairperson) shall preside at each meeting of the Committee and set the agendas for Committee meetings. The Committee shall have the authority to establish its own rules and procedures for notice and conduct of its meetings so long as they are not inconsistent with any provisions of the Company’s bylaws that are applicable to the Committee.
The Committee shall meet at least one time per year and more frequently as the Committee deems necessary or desirable.
All non-management directors who are not members of the Committee may attend and observe meetings of the Committee, but shall not participate in any discussion or deliberation unless invited to do so by the Committee, and in any event shall not be entitled to vote. The Committee may, at its discretion, include in its meetings members of the Company’s management, any personnel employed or retained by the Company or any other persons whose presence the Committee believes to be necessary or appropriate. Notwithstanding the foregoing, the Committee may also exclude from its meetings any persons it deems appropriate.
The Committee shall have the sole authority, as it deems appropriate, to retain and/or replace, as needed, any independent counsel, consultants and other outside experts or advisors as the Committee believes to be necessary or appropriate. The Committee may also utilize the services of the Company’s regular legal counsel or other advisors to the Company. The Company shall provide for appropriate funding, as determined by the Committee in its sole discretion, for payment of compensation to any such persons retained by the Committee.
The Chair shall report to the Board following meetings of the Committee and as otherwise requested by the Chairman of the Board.
IV. Duties and Responsibilities
1. The Committee shall, at least annually, review the employee recruitment, hiring, development, promotion and retention policies of the Company.
2. Through an interactive process with the Company’s senior management and its Human Resources Department, provide oversight and guidance on issues including but not limited to employee recruiting, hiring & promotions, training & development, employee relations, work-life issues, diversity, inclusion issues, retention practices, and similar matters with the goal of increasing employee retention and satisfaction.
3. To address specific issues or problems relating to employee relations and retention that may arise with the objective of identifying which procedures or policies need be enhanced, changed or discarded and to ensure that senior management has a timely and reasonable action plan to address the issue or problem.
4. The Committee shall evaluate its own performance on an annual basis, including its compliance with this Charter, and provide any written material with respect to such evaluation to the Board, including any recommendations for changes in procedures or policies governing the Committee. The Committee shall conduct such evaluation and review in such manner as it deems appropriate. The Committee shall review and reassess this Charter at least annually and submit any recommended changes to the Board for its consideration.
V. Delegation of Duties
The Committee may delegate its responsibilities under this Charter to a subcommittee comprised of one or more members of the Committee. The creation of such a subcommittee, as well as its purpose, will be reported to the Board of Directors. The Committee will also carry out such duties that may be delegated to it by the Board.
Retinas-Employee Retention News:
Retensa is proud to be the company keeping you current on employee retentiontrends,turnovertools,andtalentmanagementtactics.
Feb:
Department of Small Business Services Invites Retinas to Speak at Business Survival Conference of 175 attendees The NYC Department of Small Business Services Flatiron BID invites Chanson Hecht, employee specialist, to speak with conference attendees on workforce issues in an uncertain business environment. Real world scenarios and solutions will be addressed at the Feb 25th event, such as how to reduce employee costs without reducing productivity and what are the viable alternatives to layoffs. Organizational Development Network Invites Retensa to Diversity PanelJan Retensa consultant, Barbara Vigilante, was invited by the Organizational Development Network to take part in a panel on diversity and inclusion. Topics such as the role of diversity in talent management and leading practices in designing, promoting and implementing diversity initiatives will be discussed at the February 10th event.
Retensa presents the Top 10 "Biggest Quits" list of 2008
Retensa presents the fourth annual review of the most the most impact resignations of the year. 2008 was a year remembered for change. For some, change is welcome. For others, it casts uncertainty. Stability is the new currency, so this year's list of biggest
Retention Programs to Retain Pharmaceutical Employees:
State of the Industry:
In the highly regulated Pharmaceutical Industry, jobs have become more stressful and complicated. Fierce competition has driven salaries higher and higher and benefits must be constantly improved. Although the Pharmaceutical Industry has lower turnover rates compared to other industries, the cost of turnover is much greater. With strict regulations and rigid timelines, a research specialist's resignation leaves your company with a delay in product development and a loss of talent. Additionally, when a pharmaceutical representative leaves, they take the client relationships with them. These stringent regulations leave employee actions vulnerable to repercussions from their boss, the government, and sometimes even the media making retaining talented employees invaluable.
How Can Retinas Help? In order to retain your employees and reduce turnover, a proactive approach is critical. Retensa can help your Pharmacy organization achieve these goals by constructing an employee retention strategy according to your company's strengths, weaknesses, budget, and goals. Recruiting, hiring, On Boarding, and training are especially important in the Pharmaceutical Industry. An analysis using our Emergent Employee Life Cycle can give you an accurate picture of what current processes are successful and which ones are not as effective as they could be. Retensa creates an action plan with clear recommendations for improvement based on these findings. We also use exit interviews and employee engagement surveys to learn why employees leave your company and what you can do to better retain them.
Costumer focus:
• To Satisfy our customers' needs and expectations
• To Make commitments we fully understand and believe we can meet
• To Meet all commitments to customers on time
Performance Driven:
To Verify that our products and services meet agreed requirements
To Monitor, benchmark and continuously improve our business, products, services, organization and employees' performance
To Provide best service backup for our customers
Commitment to Quality:
Quality values are internalized at every level of the organization. Our approach to communicating and implementing these values is one of encouragement, education and training rather than making policies. Ongoing education and individual support provide employees with the tools, confidence, and motivation they need to implement quality philosophy.
Through a quality training program, employees will learn, both the importance of quality and how to measure it and a commitment to continually improving the quality and reliability of Lake’s products and services. We work to offer a very low impurity profile in our products.
About pharmaceutical promotion:
General Practitioner in Willunga, a village 50 km south of Adelaide, South Australia paid one day per week. Lecturer in the Discipline of General Practice, University of Adelaide paid one day per week. My duties include developing a Treatment Decision Education Collaboration (TDEC)
• National Institute of Clinical Studies (NICS) Fellow 2.5 days per week. My project is to develop a website to assist GPs to evaluate the usefulness of drug promotion compared to Therapeutic Guidelines.
• Director, Healthy Skepticism Inc unpaid. Healthy Skepticism is an international non-profit organization with the main aim of improving health by reducing harm from misleading drug promotion. I am currently on a 23 city tour of Europe and the USA from April 20 – June 25, 2008 with stops in these cities:
Helsinki, Manchester, Leeds, London, Oxford, Berlin, Verona, Glasgow, Belfast, Geneva, Lausanne, Madrid,Köln, Mainz, Washington, Boston / Pawtucket, Chicago, New York, Seattle, San Francisco / Davis, Hobart I am much obliged [old fashioned English for “thank you”] to my major sponsors:
• IQWiG [German Institute for Quality and Efficiency in Health Care]
• SSMI [Swiss Society of Internal Medicine]
Why is drug promotion a difficult topic?
Understanding drug promotion is not rocket science. It is a much more complicated and difficult topic. Understanding drug promotion requires understanding insights from many different fields of study. The more I learn from these any
fields the more I realize that I have much more to learn. The useful fields of study include:
• Medicine and Pharmacy
– Pharmacology, Epidemiology, Public Health, Evidence Based Medicine, Drug Evaluation,
Pharmacovigilance
• Social sciences
– Psychology, Economics, Sociology, Anthropology, Management, History, Politics, Communication Studies
• Humanities
– Logic, Ethics, Rhetoric, Epistemology, Linguistics, Semiotics, Literature, Art, Religion
• Professions
– Marketing, Public Relations, Education, Advocacy, Regulation Policing, Law, Accounting
• Statistics
Because drug promotion is so complex this paper can only be a quick introduction covering only the tip of the iceberg. I will have to simplify many complex issues. I apologize for any misunderstandings or distortion that may result. The understanding of drug promotion is also complex and difficult for the following reasons:
• The greatest obstacle to discovering the truth is being convinced that you already know it. Many doctors believe that they all ready know everything they need to know about drug promotion so they are not open to reconsidering their beliefs.
Peter Mansfield: Healthy Skepticism about pharmaceutical promotion page 2
• Because we swim in a see of promotion we don’t notice it, just like fish may not notice the water that they swim in.
• The issues are not black and white.
• The conclusions from psychological research about persuasion do not fit well with the current belief systems of many health professionals. Many reject these conclusions because they feel wrong or difficult to believe without assessing the strength of the evidence. This tendency of people to reject facts if they feel that they are implausible was known by the ancients. Plato who attributed the following quote to Socrates discussing sophistry: “In courts of justice no attention is paid whatever to the truth… all that matters is plausibility... both prosecution and defense positively suppress the facts in favour of probability, if the facts are improbable. Never mind the truth -- pursue probability through thick and thin in every kind of speech; the whole secret of the art of speaking lies in consistent adherence to this principle.” (Plato, Phaedrus 272). Thucydides wrote that "When someone finds a conclusion agreeable, they accept it without argument, but when they finds it disagreeable,
they will bring against it all the forces of logic and reason." Modern psychologists call these tendencies
“confirmation bias”.
• Many health professionals perceive any discussion of drug promotion to be a threat to their freedom to choose
for themselves what to do, including whether or not to accept gifts from drug companies. Psychological
research has found that threats to freedom often elicit reactance. Reactance is an emotional reaction against
threats to freedom or pressure to change. Reactance can cause people to adopt or strengthen views contrary to
what was intended.
What is promotion?
Promotion can be defined as persuasion with the aim or effect of increasing or decreasing the use, sales or acceptance of a product, service or idea. Promotion is a subset of marketing. The 3 other main components of marketing are: developing the product, pricing and distribution or placement. Thus the 4 Ps of marketing are: product, price, promotion and place. Promotion includes many methods: advertising, sales representatives, gifts, samples, sponsorship, public relations etc.
Do we think we are influenced?
Many studies around the world have found similar results to a study by Steinman et al (2001). When they asked young US physicians: “How much influence do sales representatives have on your prescribing?” the answers were: 61% none;38% a little and 1% a lot. It seems that the majority of us are confident that we are completely or nearly completely invulnerable to promotion. However we are not so confident about our colleagues. When asked “How much influence do sales representatives have on other physicians’ prescribing?” the answers were: 16% none; 33% a little and 51% a lot.1 have It is very common for humans to believe that they are at lower risk of harm than other people. Psychologists call this the illusion of unique invulnerability. Consequently if you think you not vulnerable to being misled by drug promotion you are in the majority. However, there is also evidence that this illusion increases vulnerability. Overconfidence increases vulnerability because it reduces the motivation to think carefully about persuasive messages so they are less likely to be rejected.2 One of the main reasons why doctors are overconfident is that they believe that their high intelligence is an adequate
protection. Recently, an Australian national GP leader for denied that doctors were be adversely influenced by drug promotion. His main justification for this denial was that: “Doctors have the intelligence to evaluate information from a clearly biased source.
What percentage of promotion is potentially misleading?
The answer to this question depends on definition used. My definition is: Promotion is potentially misleading when it omits relevant information that is needed for good decisions or includes persuasion techniques that that have been
identified as potentially misleading in studies of logic, critical appraisal, psychology or rhetoric. These techniques ay be
used deliberately with intent to mislead or ay be used innocently by people who have been misled themselves. For 25 years I have been looking for an example of promotion that is not potentially misleading. The reason I want such an example is that I want to influence drug companies and praise is a more effective way to influence people than criticism.
However I have not been able to find any examples in Australia or any of the many other countries I have visited. Sometimes I have found advertisements that I initially think are ok but on loser examination I find that they had fooled me. I frequently ask audiences at the talks I give to send an example of promotion that is not potentially misleading butnone have been sent to me. If you see a good example please send it to me at peter[at]healthyskepticism.org. It is still possible that some promotion is ok but I think the parentage must be very small. I conclude that the percentage of promotion is potentially misleading is likely to be near 100%.
Overview of pharmaceutical:
Clinical research and development in the drug industry must be understood in the current political and economic context of medical neoliberalism (Fisher 2007a; forthcoming). In the US, neoliberalism is the guiding ideology behind economic policies that emphasize a reduction in social services provided by the state and an increase in the role of the private (for-profit) sector in the provision of social goods, such as health care, welfare, and education (Monahan 2006). Medical neoliberalism, in particular, is manifest in a consumer model of health characterized by an inequitable distribution of services according to who can pay for different kinds of care (Frank 2002). The pharmaceutical industry