File this one under irony? In a bid to improve ethics, Novo Nordisk has teamed with the University of Copenhagen and a consulting firm to create a pair of tools they are calling Ethics Decision-Making and Ethics Dilemma, which are aimed at businesspeople, academics and students.
The Ethics Decision-Making tool uses questions and games to help the viewer improve their understanding of ethics and how to respond to situations that fall into a gray area. One question about a hypothetical decision: 'Would it be okay to see it on the front page of a newspaper?’ How about on a blog? Either way, that's a good test. Ethics Dilemma uses a questionnaire to show how differing views of ethics can influence decisions and lead to different outcomes (look here).
"Sometimes you find yourself in a ‘grey zone’ where there is no obvious right or wrong. The new tools aim at supporting you in navigating in such a grey zone by providing a better understanding of basic ethics and practical guidance on how to make sound decisions," Lise Kingo, a Novo Nordisk executive vp, tells InPharm. "The strength is that the tools combine academic knowledge with hands on experience from business and other practitioners.”
We wonder if Novo Nordisk ceo Lars Sorensen has taken these tests. You may recall that late last month, the Danish drugmaker pulled its diabetes product from Greece after the government instituted substantial price cuts of up to 25 percent on hundreds of medicines (see background). Why? Novo Nordisk claimed it would lose money on top of $36 million the government already owes. Sorensen reportedly wrote that "the irresponsible management of finances by the Greek government which puts both you and our company in this difficult position.”
This is a business decision, but given that Novo Nordisk is promoting this new exercise, this action begs a question - how ethical is it to pull a life-saving product used by thousands of people because their government is in financial straits?
14 Comments
AFAIK Novo is not the only manufacturer of insulin in the world. So what's the problem?
no problem - but is it ethical?
Oh come on! These people (and I have nothing to do with them) are trying to educate and train people on difficult decision-making. Yes, a lot of things are not black and white.
Shouldn't they be commended for doing this, with an external academic group? Instead the critique goes: "even when you do something good, we will try to slam you".
Balance please!!!
Hi Paul,
Thanks for the note. And I agree that any attempt to promote ethics is a good thing. Moreover, you're correct that I didn't commend Novo Nordisk explicity for this intiative, but I also didn't criticize the company for the effort. Two different things.
Rather I was trying to point out that, to some, there may be an irony here. As I wrote in the post, I understand there was a calculated business decision made to withdraw its diabetes product from Greece. Yet this will, no doubt, affect some diabetics. Hopefully another product is clinically and financially suitable, and obtainable.
That said, such a move does raise questions about the impact on patients and, perhaps, the need to stroll through the ethical decision making tool. In fact, this episode may be a perfect example of why and when such a tool can be useful. And that's a good thing, no?
So my apologies if it appeared I was not giving Novo Nordisk its due. I chose to focus on what, to my mind, appeared to be interesting timing, if nothing else, to release such a resource for making difficult decisions.
I hope this helps, ed
Ed, I think this is unbalanced. I've been through programs like this too, and surely no one is trying to say that PR is the final and only test of ethical decision-making.
If my tenant spends all his rent money on beer and hasn't paid me for 18 months, at some point I'm going to evict him. Am I ethically respsonsible for the fact that his family becomes homeless? I suppose you could run a story on the local news channel that makes me look pretty bad, depending on how the story was spun. In the present case, NN has offered the tenant less expensive accomodations for free.
Hi Pigs,
Thanks for your note as well. Again, I was trying to make the point that this is the sort of instance in which Novo's new ethical tool could be used.
Moreover, my last line in the post was deliberately composed in the form of a question. I was wondering whether others may be curious to know if, in fact, the Novo management should have taken the test.
I think it's a fair question to ask - the company's decision does have real implications for some Greek patients that are worth weighing and so why not undergo the exercise? In fact, Novo execs could have used this as an oppportunity to underscore that the tool can be useful in making decisions that may be justified, even if unpopular with some people.
By extension, perhaps this episode may also be worthwhile for others looking to learn from similar situations. Given the European financial crisis, such a move could happen again.
As an aside, I was not thinking strictly in terms of public relations. But since you mention it, I continue to have difficulty finding anything on the company's web site that mentions this decision.
In any event, I hope you have a better idea of how I came to write what I did.
Regards ed
I think it's good that NN cares enough to think about ethics! Most pharma companies don't!
As a person who is Type 2, I feel what NN did was ethically wrong. While there are several insulins on the market that can be prescribed for me, a few don't work as well while don't work at all. So to have to give up a product that is working just because the company can't make a dime may be a good business decision for the company, but a poor ethical decision for me. The company should practice what they preach.
Just to make the grey zone even greyer: is it ethically wrong to charge more money to US consumers for an Rx product in order subsidize its availability in an EU country that has spent itself into near bankruptcy? Because that's essentially how things would work out if NN reversed itself to make this product available in Greece again.
Ed, it is worth noting that Novo Nordisk has not withdrawn insulin from the Greek market, only it's proprietary, patent protected insulin analogues. It is still selling Novolin R and Novolin N in Greece, so even type 1 diabetes patients in Greece will have access to the synthetic hormone required to sustain life. The reality is that no patient requires Novo's patent-protected insulin analogues for life, millions of patients survived on regular old insulin before analogues were introduced in 1996.
Please look at Novo Nordisk's website, specifically the Triple Bottom Line. As a former employee, I am embarassed to know that my company treats their insulin like collateral and become a collection agency rather than a pharmaceutical company which formerly took pride in making the "ethical" decisions. If you read their own publications, it is evident that ethics is a thinly veiled attempt to cover up a collection of a debt. The scientific data supporting the use of analogs over human insulin has been consistent. And while I understand they are still providing them the human insulin (how big of them) They would have shown a great deal more character by having come to some other arrangement or just taken the hit as their competitors did.
Hmm, what's next? Asking Goldman&Sachs for cheap money for Greece? That's kind of bigoted discussion here...
its not about money, its about patients which novo nordisk claims to put first
Ed, I get that you're only asking the question and pointing out the possible irony here, but if these drugs are truly that important to Greek patients, isn't in unethical for their own government to say they won't pay fair market value for them? Why is NN cast as the bad actor here?
The REAL irony here is that people are asking Novo to do EXACTLY what got the Greek government in the dire straits its in.......give things to people who can't pay the bill.
Cheers to Novo for not being an enabler.