What economic approach would actually work?

[rory_20_uk]

There exists the suggestion that corporations "as persons" be held accountable to criminal law, possibly including the death penalty. One problem is that the individuals involved still have the opportunity to scatter and continue their bad behavior elsewhere.

If corporations were democratically built and controlled by the whole body of their workers, each individual would have a clearer liability and a corporate criminal penalty would impinge on the whole body responsible. If the offense was a small conspiracy concealed from oversight, then normal criminal statutes can also still apply (whereas the contemporary centralized structure gives executives the dodge that someone below them must have been at fault).

And I wonder just how British pharmaceuticals compare to others in "corruption". If they're big enough, then can't limited fines be accounted for as but one more operating cost, as long as the profits of rule-breaking exceed the costs? That seems to be the case across industries and countries. Cost-benefit analysis is supposed to estimate the costs and the benefits separately for each affected party, not just the corporation; forcing the inclusion of negative externalities on environment and society seems like a worthy approach.

If UK affiliate Pharma companies get in enough trouble, there is a track record of the entire senior management team getting sacked and replaced. Not parachuted out. Not paid off. But booted en masse. That sort of thing helps ensure senior interest on doing the right thing if only to keep their own career. If you keep breaking the rules, the PMCPA passes you over to the MHRA and there the pain really starts. They can send people to jail for jeopardizing patient safety, and even take away the Market Authority of a drug, or force companies to supply it to everyone for free. And the agencies talk - if the MHRA is not happy expect the EMA and especially the FDA to also take an interest enter the billion dollar fines.

I think that in the USA things are significantly different since there is no NHS and power is a lot more with Doctors. In the UK a company could be frozen out of the entire market for one or all of their drugs in essence for ever if that was decided. In the USA I don't think that this is possible - and there is so much more money in the system and more ways of bribing the players that they probably do in more cases accept the risk.

I don't for one minute think that those in the Industry are more honest or "nice" they just know that problems are generally quickly detected, and that fines are in essence infinite.

[Seamus Fermanagh]

...I think that in the USA things are significantly different since there is no NHS and power is a lot more with Doctors. In the UK a company could be frozen out of the entire market for one or all of their drugs in essence for ever if that was decided. In the USA I don't think that this is possible - and there is so much more money in the system and more ways of bribing the players that they probably do in more cases accept the risk.

Their is no direct mechanism for the removal of an entire top management team in such a fashion here in the USA. It would take an action/series of actions that were so morally or financially scandalous that stockholders demanded a special meeting of the board/shareholders and forced the resignations or firing of that top management team. Even then, unless the specific "we owe you nothing because of X condition" clauses in their contracts were triggered, they would receive whatever severance payments had be contracted.