Reforming Pharmaceutical Industry-Physician Financial Relationships: Lessons from the United States, France, and Japan


  • Marc A. Rodwin

    1. Edmond J. Safra Research Lab Fellow at Harvard University and Professor of Law at Suffolk University Law School, is the author of Conflicts of Interest and the Future of Medicine: The United States, France and Japan (Oxford, 2011) and Medicine, Money and Morals: Physicians' Conflicts of Interest (1993).
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This article compares the means that the United States, France, and Japan use to oversee pharmaceutical industry-physician financial relationships. These countries rely on professional and/or industry ethical codes, anti-kickback laws, and fair trade practice laws. They restrict kickbacks the most strictly, allow wide latitude on gifts, and generally permit drug firms to fund professional activities and associations. Consequently, to avoid legal liability, drug firms often replace kickbacks with gifts and grants. The paper concludes by proposing reforms that address problems that persist when firms replace kickbacks with gifts and grants based on the experience of the three countries.