Assessment Case Choice 4: Johnson and Johnson: Taking the pain away?

Background

The story of Johnson and Johnson’s huge fine in Oklahoma, which appeared over the summer, exposed how companies can be held liable for the effects of their products. In August this year a judge in Oklahoma ordered Johnson and Johnson to pay $572m to the state to mitigate the effects of the state having to deal with an opioid addiction crisis. You will find a selection of articles below to help you with the background to this. There are now many stories about America going through an ‘opioid crisis’. One report on CNN saying an estimated 1.7 million individuals in the United States suffered from substance use disorders related to prescription opioid pain relievers.  So what is the story here? For this assessment we are looking at Johnson and Johnson, but you will see from the stories below Johnson and Johnson were just one company for which opioids proved to be a very profitable product. But at what cost? The stories below point towards how drug companies used a marketing strategy based on the redefinition of pain. The thrust was that nobody needed to live with any pain when the company’s product could relieve it. But if a paracetamol would do why have something stronger? (Don’t forget opioids are based around opium). It seems that the suggestion that opioids would be better hinged on the idea that they would control the pain better and that they were not addictive. But these are questionable assumption. For many ailments opioids were probably not necessary, and it seems they are addictive. So how did the companies, including Johnson and Johnson, succeed in persuading doctors to prescribe so many opioid drugs? Read the articles below, they outline some questionable marketing practices, the manipulation of scientific findings on whether the drugs are addictive and how doctors were put in positions with clear conflicts of interest. Also below you will see an article suggesting that, having sold opioids so successfully in the US, companies went on to repeat the formula in other countries and India is mentioned.

You will also find below a link to a clip of the American show ‘Last Week Tonight’ with John Oliver. Be warned, he swears a bit, but the clip is funny and shocking. It is not about Johnson and Johnson but if you read the articles also you will see how what Oliver talks about is connected.

What should be the responsibility of a drug company? How should Johnson and Johnson have behaved? What are the ethical issues here – surely honesty, integrity, recognising conflicts of interest and impact on different stakeholder groups must be among them. So – a complex, but utterly fascinating case for you to examine.

Here are some articles:

The main one is

The Guardian 26^th August 2019 Johnson & Johnson to pay $572m for fueling Oklahoma opioid crisis, judge rules

Available at https://www.theguardian.com/us-news/2019/aug/26/johnson-and-johnson-opioid-crisis-ruling-responsibility-oklahoma-latest

These will also provide you with background and mush food for thought on the ethics of the issue

The Guardian 24^th July 2019 Capitalism gone wrong: how big Pharma created America’s opioid carnage[unique_solution]

Available at https://www.theguardian.com/us-news/2019/jul/24/opioids-crisis-big-pharma-drugs-carnage

The Guardian 27^th August 2019 How big pharma is targeting India’s booming opioid market

Available at https://www.theguardian.com/world/2019/aug/27/india-opioids-crisis-us-pain-narcotics

The Guardian 28^th August 2019 Opioid addiction rising in India as US Drugmakers push painkillers

Available at https://www.theguardian.com/world/2019/aug/28/india-opioids-addiction-us-drugmakers-push-painkillers

Parramore, L (2017) “Worse Than Big Tobacco”: How Big Pharma Fuels the Opioid Epidemic. Institute for New Economic Thinking

Available at https://www.ineteconomics.org/perspectives/blog/worse-than-big-tobacco-how-big-pharma-fuels-the-opioid-epidemic

Mansoor, S (2019) “ Johnson & Johnson Was Ordered to Pay %572 Million for Its Role in the Opioid Crisis. With Similar Lawsuits Across the Country, That Could Be Just the Beginning”. Time Magazine

Available at https://time.com/5662827/johnson-opioid-crisis-lawsuits/

The Johnson & Johnson stories are US focussed, there are stories linked here to India, but should we worry in the UK? Consider this:

BBC Health News 10^th September (2019) Too many hooked on prescription drugs – health chiefs

Available at https://www.bbc.co.uk/news/health-49639914

And for the impact:

BBC Business News 20 March 2019 National Portrait Gallery drops £1m donor. Available at https://www.bbc.co.uk/news/business-47636057

Finally – here is where you can see the John Oliver ‘Last Week Tonight’ show; and a final warning about the bad language!

https://www.youtube.com/watch?v=-qCKR6wy94U

These should help you with context, but you should also do your own research.

Your task now is to write a report to Johnson & Johnson senior managers on the ethical issues involved in the story.

Your assessment is in two parts with part 1 being further split into two. Read the requirements below and attempt all three parts:

Part 1

1. You are now required to write a brief report to senior managers at Johnson and Johnson from the perspective of an employee who has been asked to write a report for senior managers about the companies approach to marketing and selling opioids. You will need to explore and write about a number of factors including – Why should the company be looking at this issue from the perspective of ethics? What are the ethical challenges of marketing drugs and your thinking will probably include considerations of how scientific research is used and engaging with doctors as prescribers of the drug. You will need to consider how this issue influences the public image of the company and what alternatives ways are there to think about a business’ role in society (this is the material we covered in class 2 where we contrasted Friedman and Freeman); you should look at Who/what are the stakeholders impacted in the scenario you are reporting on and how are they impacted on? Are there examples of business that act responsibly and ones that do not? You should illustrate this by including research you have done e.g. Is there research that shows, for example, good choices benefit companies and bad choices have a negative impact? Finally you should conclude with some recommendations for what the company should do.

This part of your assessment should be written as a report, but should be referenced in the normal academic way using Harvard citations and referencing.

1. For this part you should again use the case study – but this time choose TWO ethical theories (using ones we have looked at in class) and demonstrate that you can apply these to the case to show how your chosen theories lead you to a view on the ethics of the case. For example, if you applied utilitarian thinking to the marketing and selling of opioids how might you consider what ‘the greater good’ is? Or, what if you apply Kant here, what might the three categorical imperatives look like? NOTE – you do NOT have to use ‘opposing’ ideas, we are interested most in how you use theory, if, when you apply two theories they seem to give the same answer that is fine, if they seem to give different outcomes that is fine too. This section is written in a more academic style than the report.

Part 2

Part 2 is NOT related to the case study. This section requires you to discuss what makes an ethical leader and how you would, as an ethical manager, manage your business and/or others to a high ethical standard.

You will need to think about personal ethics, about the conditions that bring about unethical organisations and practices, about organisational values and methods of compliance. This part can be written in a more reflective style, where the first person can be used.

WORD COUNT

The word limit for this assessment is 3,000 words. This does NOT include any title page or bibliography.

You are allowed 10% of the word count (i.e. submissions can be up to 3,300 words_, submissions exceeding this will be subject to a penalty.

How the word count is used across the submission is up to you. A suggestion would be

Part 1

1. 1200 words
2. 1000 words

Part 2

Approx. 800 words

The exact proportions will vary and this is part of your challenge to write informatively and concisely across the required tasks.

How will we support you with your assessment?

• Assessment briefing Week 1 (lecture)
• Briefing material and guides in addition to the assessment brief (Please make sure that you read these)
• Dedicated seminar session on your formative assessment  – see LTAF for the weeks
• Prompt feedback session on your formative assessment and tutorial session to support the development of your summative assessment.
• An assignment writing workshop in week 12
• Tutorial session to support the completion of your summative assessment in Week 13.

How will your work be assessed?

Your work will be assessed by a subject expert who will use the marking grid provided in this assessment brief.  When you access your marked work it is important that you reflect on the feedback so that you can use it to improve future assignments.

Referencing

You MUST use the Harvard System.  The Harvard system is very easy to use once you become familiar with it.

Assignment submissions

The Business School requires a digital version of all assignment submissions.  These must be submitted via Turnitin on the module’s Moodle site.  They must be submitted as a Word file (not as a pdf) and must not include scanned in text or text boxes.  They must be submitted by 2pm on the given date.  For further general details on coursework preparation refer to the online information via StudentZone http://studentzone.roehampton.ac.uk/howtostudy/index.html.

Mitigating circumstances/what to do if you cannot submit a piece of work or attend your presentation

The University Mitigating Circumstances Policy can be found on the University website – Mitigating  Circumstances Policy.

Marking and feedback process

Between you handing in your work and then receiving your feedback and marks within 20 days, there are a number of quality assurance processes that we go through to ensure that students receive marks which reflects their work. A brief summary is provided below.

• Step One – The module and marking team meet to agree standards, expectations and how feedback will be provided.
• Step Two – A subject expert will mark your work using the criteria provided in the assessment brief.
• Step Three – A moderation meeting takes place where all members of the teaching and marking team will review the marking of others to confirm whether they agree with the mark and feedback.
• Step Four – Work at Levels 5 and 6 then goes to an external examiner who will review a sample of work to confirm that the marking between different staff is consistent and fair.

Step Five – Your mark and feedback is processed by the Office and made available to you.