The logic of strategic ignorance

Ignorance and knowledge are often thought of as opposite phenomena. Knowledge is seen as a source of power, and ignorance as a barrier to consolidating authority in political and corporate arenas. This article disputes this, exploring the ways that ignorance serves as a productive asset, helping individuals and institutions to command resources, deny liability in the aftermath of crises, and to assert expertise in the face of unpredictable outcomes. Through a focus on the Food and Drug Administration's licensing of Ketek, an antibiotic drug manufactured by Sanofi-Aventis and linked to liver failure, I suggest that in drug regulation, different actors, from physicians to regulators to manufacturers, often battle over who can attest to the least knowledge of the efficacy and safety of different drugs - a finding that raises new insights about the value of ignorance as an organizational resource.     

Transparency in Europe: A Quantitative Study

In recent years, European pharmaceutical regulators have increasingly committed to heightening access to raw safety‐related data as part of a wave of transparency initiatives (e.g., providing public Internet‐mediated access to clinical trials data). Yet, the regulators—who are under significant pressure—have not yet benefited from a systematic review of this new policy. In seeking to inject much needed evidence, this article explores the effects of new transparency policies designed to promote meaningful communication of risks and benefits to patients. Results of a cross‐national European survey with respondents from Great Britain, the Netherlands, Spain, France, Germany, and Sweden (N = 5,648) shed light on how patients and the public are likely to react to the regulators’ new transparency policies. The findings demonstrate clear national variations in how European citizens are likely to react and emphasize the need to develop evidence‐based, reasoned transparency policies that integrate benefit‐risk communication. The authors conclude by providing six specific recommendations, informed by the study, that seek to improve the European transparency model both within the medical field and across health, safety, and environmental policy domains.     

Pharmaceutical Intimacy: Sex,Death, and Methamphetamine

ABSTRACT

In this article, I draw from ethnographic work conducted among residents of an “in-house” drug and alcohol treatment center in Baltimore, Maryland, to discuss the relationships born of pharmaceutical (ab)use. By looking in close detail at the autobiographical accounts of one man in treatment for addiction to methamphetamine, I attempt to chart the way life and death are at times brought into close proximity, and at others wedged firmly apart, by such things as love and avoidance. My concern is with the ethics of care that emerge through the so-called “small events” in everyday relations; that so often define a life or a relationship as falling under the category “normal” or “pathological.” I ask how such things as the known demands placed on the body by the need to maintain or avoid relations, whether pharmaceutically mediated or not, come to bear on the decision to “let die” or the resurgence of moral worlds. I end by discussing the different aspects of relatedness revealed by the dependencies and alliances formed by the kinship between pharmaceuticals and humans.

In compliance with current ethical research standards, the names of all informants have been changed to assure their anonymity.     

College Students' Use of Widely Advertised Medications

Abstract

The authors describe college and university students' use of widely advertised pharmaceutical products. Four hundred seventy-one students from three institutions completed self-administered questionnaires that addressed the use of advertised medications, attention to magazine ads for medications, communications with physicians about medications, and the conditions the medications address. Results indicated that the majority of the students used at least one of the advertised products. Most students did not discuss the pharmaceutical products with their physicians or discuss the conditions for which they reported they were taking the drugs.     

Supply chain configuration conundrum: how does the pharmaceutical industry mitigate disturbance factors?

How a supply chain (SC) is configured can have a significant impact on the performance of global firms. More specifically, disturbance factors (i.e. those factors associated with uncertainty and risk) are increasingly important considerations. This paper focuses on endogenous, exogenous and environment-related SC disturbance factors and their relative importance when configuring global SCs. Three alternative scenarios of SC configurations for European-based pharmaceutical firms are identified – insource nearshore, outsource nearshore and outsource offshore. Through a multi-phase, mixed-methods approach we find that the top five disturbance factors managers should be aware of while configuring their SCs are quality defects, unforeseen and random interruptions in manufacturing processes, order processing difficulties, untimely delivery of products and a mismatch between market demand and supplier responsiveness. This study is able to provide insights into the impact of disturbance factors on the SC configuration strategy for Big Pharmas (BPs). We show that SC disturbances influenced the decision to bring production back home (reshoring) or to a closer location (nearshoring). To mitigate the effects of disturbances many BPs recalibrated their SC configurations by insourcing core products, outsourcing non-core products offshore and developing offshore insourcing capabilities through ‘captives’.     

Intimate tablets: digital advocacy and post-feminist pharmaceuticals

Since the enormous commercial success of Viagra, launched by Pfizer in 1998, large pharmaceutical conglomerates have sought to produce an analogous drug for women with low sexual desire. On August 18 2015, Sprout Pharmaceuticals obtained approval from the Food and Drugs Administration (FDA) for flibanserin, now marketed as Addyi. In the lead-up to the approval of Addyi, campaigns supporting the production of the drug were deployed through an extensive use of social and digital media platforms including Facebook and Twitter, which mobilised discourses of post-feminism to reconfigure narratives of intimacy to lobby the FDA. The lobbying for the approval of the tablet represents a unique instance of consumers reproducing discourses of medicalisation in order to demand gender equality. It strategically combines feminist rhetoric and digital media platforms to disseminate and coordinate such demands. The rhetoric of post-feminism constitutes both a reproduction of discourses of medicalisation and a challenge to medical orthodoxy. The success of the campaigns exemplifies a turn in the pharmaceutical industry where potential consumers are also producers of medical products, no longer passive but active agents in the commodification of pharmaceutical intimacy and the management of sexual desire.     

天然香豆素类物质的利用和研究进展

综述了香豆素在医药、化工以及农药方面的应用,介绍了目前香豆素植物提取和化学合成的方法,提出了目前香豆素研究的热点以及今后的研究重点.     

Therapeutic mobilities

ABSTRACT

This Special Issue expands mobilities research through the idea of therapeutic mobilities, which consist of multiple movements of health-related things and beings, including, though not limited to, nurses, doctors, patients, narratives, information, gifts and pharmaceuticals. The therapeutic emerges from the encounters of mobile human and non-human, animate and inanimate subjects with places and environments and the individual components they are made of. We argue that an interaction of mobilities and health research offers essential benefits: First, it contributes to knowledge production in a field of tremendous social relevance, i.e. transnational health care. Second, it encourages researchers to think about and through functionally limited, ill, injured, mentally disturbed, unwell and hurting bodies. Third, it engages with the transformative character of mobilities at various scales. And fourth, it brings together different kinds of mobilities. The papers in this Special Issue contribute to three themes key for the therapeutic in mobilities: a) transformations (and stabilizations) of selves, bodies and positionalities, b) uneven im/mobilities and therapeutic inequalities and c) multiple and contingent im/mobilities. Therapeutic mobilities comprise practices and processes that are multi-layered and mutable; sometimes bizarre, sometimes ironic, often drastically uneven; sometimes brutal, sometimes beautiful – and sometimes all of this at the same time.