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  1. Medicine, Money, and Morals: Physicians' Conflicts of Interest.Marc A. Rodwin - 1993 - Oxford University Press.
    Conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest (40% of physicians in Florida invest in medical centers); for hospitals to offer incentives to physicians who refer patients (a practice that can lead to unnecessary hospitalization); or for drug companies to provide lucrative give-aways to entice doctors to use their "brand name" drugs (which are much more expensive than (...)
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  2.  16
    Conflicts of Interest, Institutional Corruption, and Pharma: An Agenda for Reform.Marc A. Rodwin - 2012 - Journal of Law, Medicine and Ethics 40 (3):511-522.
    Why do physicians have financial conflicts of interest? They arise because society expects physicians to act in their patients’ interest, while simultaneously, financial incentives encourage physicians to practice medicine in ways that promote their own interests or those of third parties. Because physicians’ clinical choices, referrals, and prescriptions affect the fortune of third parties, these third parties may offer physicians financial incentives to make income-driven clinical choices. In the past, physicians and scholars typically conceived of conflicts of interest as an (...)
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  3.  27
    Five Un‐Easy Pieces of Pharmaceutical Policy Reform.Marc A. Rodwin - 2013 - Journal of Law, Medicine and Ethics 41 (3):581-589.
    Improper dependencies slant policy over a drug's life span, biasing the development of new drugs, the testing and marketing approval for new drugs, and the monitoring of patient safety after drugs are marketed. This article examines five ways in which the public improperly depends on pharmaceutical firms that compromise the integrity of pharmaceutical policy. Today the public relies on pharmaceutical firms: (1) to set priorities on drug research and development; (2) to conduct clinical trials to test whether drugs are safe (...)
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  4.  18
    Conflicts of Interest and the Future of Medicine: The United States, France, and Japan.Marc A. Rodwin - 2010 - Oxford University Press.
    The heart of the matter -- The evolution of the French medicine -- Coping with physicians' conflicts of interest in France -- The rise of a protected medical market : the United States before 1950 -- The commercial transformation : the United States, 1950-1980 -- The logic of medical markets : the United States, 1980 to the present -- Coping with physicians' conflicts of interest in the United States -- The evolution of Japanese medicine -- Coping with physicians' conflicts of (...)
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  5.  8
    Five Un-Easy Pieces of Pharmaceutical Policy Reform.Marc A. Rodwin - 2013 - Journal of Law, Medicine and Ethics 41 (3):581-589.
    The federal government indirectly subsidizes the pharmaceutical industry by funding basic research, various tax credits and deductions, patent rules, grants of market exclusivity, and other means, in order to spur drug development, promote public health, and improve medical care. But today, the pharmaceutical industry often neglects these goals and sometimes even undermines them, due to what Lawrence Lessig refers to as institutional corruption — that is, widespread or systemic practices, usually legal, that undermine an institution’s objectives or integrity. A key (...)
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  6.  20
    Rooting Out Institutional Corruption to Manage Inappropriate Off‐Label Drug Use.Marc A. Rodwin - 2013 - Journal of Law, Medicine and Ethics 41 (3):654-664.
    Prescribing drugs for uses that the FDA has not approved — off-label drug use — can sometimes be justified but is typically not supported by substantial evidence of effectiveness. At the root of inappropriate off-label drug use lie perverse incentives for pharmaceutical firms and flawed oversight of prescribing physicians. Typical reform proposals such as increased sanctions for manufacturers might reduce the incidence of unjustified off-label use, but they do not remove the source of the problem. Public policy should address the (...)
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  7.  33
    Drug Advertising, Continuing Medical Education, and Physician Prescribing: A Historical Review and Reform Proposal.Marc A. Rodwin - 2010 - Journal of Law, Medicine and Ethics 38 (4):807-815.
    Through the 1960s, many people claimed that drug advertising was educational and physicians often relied on it. Continuing Medical Education (CME) was developed to provide an alternative. However, because CME relied on grants, industry funders chose the subjects offered. Now policymakers worry that drug firms support CME to promote sales and that commercial support biases prescribing and fosters inappropriate drug use. A historical review reveals parallel problems between advertising and industry-funded CME. To preclude industry influence and improve CME, we should (...)
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  8.  4
    Rooting Out Institutional Corruption to Manage Inappropriate Off-Label Drug Use.Marc A. Rodwin - 2013 - Journal of Law, Medicine and Ethics 41 (3):654-664.
    The Food and Drug Administration authorizes the marketing of a drug only for uses that the manufacturer has demonstrated to be safe and effective, based on evidence from at least two clinical trials. However, the FDA does not regulate the practice of medicine, so physicians may prescribe drugs in any manner they choose. Prescribing drugs in ways that deviate from the uses specified in the FDA-approved drug label, package insert, and marketing authorization is referred to as off-label prescribing. This occurs (...)
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  9.  8
    Drug Advertising, Continuing Medical Education, and Physician Prescribing: A Historical Review and Reform Proposal.Marc A. Rodwin - 2010 - Journal of Law, Medicine and Ethics 38 (4):807-815.
    Public policy tries to promote appropriate drug use by allowing firms to market drugs in interstate commerce only for uses that the Food and Drug Administration has found to be safe and effective. Because of their medical knowledge, physicians are authorized to prescribe drugs even for uses unapproved by the FDA. Nevertheless, physicians have relied on drug firms for information on appropriate prescribing despite the inherent tension between drug firm dissemination of information to promote sales and rational prescribing. In the (...)
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  10.  17
    Reforming Pharmaceutical Industry-Physician Financial Relationships: Lessons From the United States, France, and Japan.Marc A. Rodwin - 2011 - Journal of Law, Medicine and Ethics 39 (4):662-670.
    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 (...)
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  11.  10
    Reforming Pharmaceutical Industry-Physician Financial Relationships: Lessons From the United States, France, and Japan.Marc A. Rodwin - 2011 - Journal of Law, Medicine and Ethics 39 (4):662-670.
    Post-industrial societies confront common problems in pharmaceutical industry-physician relations. In order to promote sales, drug firms create financial relationships that influence physicians' prescriptions and sometimes even reward physicians for prescribing drugs. Three main types exist: kickbacks, gifts, and financial support for professional activities. The prevalence of these practices has evolved over time in response to changes in professional codes, law, and markets. There are certainly differences among these types of ties, but all of them can compromise physicians' independent judgment and (...)
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  12. Medical Commerce, Physician Entrepreneurialism, and Conflicts of Interest.Marc A. Rodwin - 2007 - Cambridge Quarterly of Healthcare Ethics 16 (4):387.
    Is medical commerce a recent phenomenon? Does it distort the patient–physician relationship? Are investor-owned firms the main source of medical commercialism? I contend that medicine has generally been commerce in the United States, that medical commerce is a problem when it creates or worsens physicians' conflicts of interest, and that these conflicts thrive in nonprofit organizations as well as in investor-owned firms. I provide a historical sketch to show that physician entrepreneurialism, rather than commerce generally, is the main source of (...)
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  13.  29
    The Metamorphosis of Managed Care: Implications for Health Reform Internationally.Marc A. Rodwin - 2010 - Journal of Law, Medicine and Ethics 38 (2):352-364.
    The conventional wisdom is that managed care's brief life is over and we are now in a post-managed care era. In fact, managed care has a long history and continues to thrive. Writers also often assume that managed care is a fixed thing. They overlook that managed care has evolved and neglect to examine the role that it plays in the health system. Furthermore, private actors and the state have used managed care tools to promote diverse goals. These include the (...)
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  14.  47
    Institutional Corruption and the Pharmaceutical Policy.Marc A. Rodwin - 2013 - Journal of Law, Medicine and Ethics 41 (3):544-552.
    Today, the goals of pharmaceutical policy and medical practice are often undermined due to institutional corruption — that is, widespread or systemic practices, usually legal, that undermine an institution's objectives or integrity. In this symposium, 16 articles investigate the corruption of pharmaceutical policy, each taking a different look at the sources of corruption, how it occurs, and what is corrupted. We will see that the pharmaceutical industry's own purposes are often undermined. Furthermore, pharmaceutical industry funding of election campaigns and lobbying (...)
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  15. Medicine, Money and Morals.Marc A. Rodwin - 1994 - Perspectives in Biology and Medicine 37 (2):308.
  16. Physicians' Conflicts of Interest.Marc A. Rodwin - 1994 - Perspectives in Biology and Medicine 37 (2):308.
  17.  4
    The Metamorphosis of Managed Care: Implications for Health Reform Internationally.Marc A. Rodwin - 2010 - Journal of Law, Medicine and Ethics 38 (2):352-364.
    Many writers suggest that managed care had a brief life and that we are now in a post-managed care era. Yet managed care has had a long history and continues to thrive. Writers also often assume that managed care is a fixed entity, or focus on its tools, rather than the context in which it operates and the functions it performs. They overlook that managed care has evolved and neglect to examine the role that it plays in the health system.This (...)
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  18.  14
    Vested Interests.Marc A. Rodwin - 1991 - Hastings Center Report 21 (6):43-43.