Annotated Bibliography 7

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Annotated Bibliography 7 Brielle West Akbar, Yusaf H. “Biden’s Antitrust Turn: The 2021 Antitrust Executive Order and Its Implications for Firms and Their Executives.” California Management Review, October 4, 2021. https://cmr.berkeley.edu/2021/10/biden-s-antitrust-turn-the-2021-antitrust- executive-order-and-its-implications-for-firms-and-their-executives/ . “Biden’s Antitrust Turn: The 2021 Antitrust Executive Order and Its Implications for Firms and Their Executives” by Dr. Yusaf H. Akbar is a paper that analyses the potential impacts of President Biden’s Executive Order 14036 on antitrust policy. The author points out the three key implications in the EO and how it affects business; the implications being a more rigorous merger review and antitrust process, consumer protection is broadly defined, and it changes restrictive employment practices. The author also highlights the thinking of three leading antitrust scholars and their takes on the current antitrust legislation in the country. The paper served as a guide for businesses and how to respond to the order, but is also highlights the significant changes that are being made in enforcements and procedures of US antitrust. While this paper may not be focused on pharmaceutical monopolies it does show the impact of the order on businesses and how this can be a good thing for consumers. Edje, Louito, Carlos Casillas, and Jennifer K. O’Toole. “Strategies to Counteract Impact of Harmful Bias in Selection of Medical Residents.” Academic Medicine 98, no. 8S (July 21, 2023): S75–85. https://doi.org/10.1097/acm.0000000000005258 . This article by Louito Edje, Carlos Casillas, and Jennifer K. O’Toole the authors define the diversity and bias in residency programs in the U.S, they explore the process of selecting medical residents, the impact of history on demographics in the medical field, and propose solutions that work toward equity in the practices that are used when
selecting medical residents. The article begins by giving a brief overview of the history of bias in the medical resident selection process and then moves on to look at the factors that have contributed and continue to contribute to this bias. However, the bulk of the article focuses on the steps that can be taken to eliminate bias and promote equity in the resident selection process. The authors first start with the disclaimer that in order for there to be a change, efforts need to start well before student make a decision of a medical specialty they would like to pursue, or well before the student applies for residency programs. They suggest that a more holistic review is implemented in when looking at applicants. Recommended by national organizations and accredited bodies, this method allows for the applicants experiences, attributes, and academic metrics align with the residency program. When done correctly the holistic review pushed program directors to consider the whole person and not focus on a metric that has historically been biased against those who are underrepresented in the medical field. The authors also encourage residency programs to remove the photos of applicants to avoid any bias that is based on appearance, consider the interview, and for residency program representatives to be transparent of their recruitment. Gurgula, Olga. “Strategic Patenting by Pharmaceutical Companies – Should Competition Law Intervene?” IIC - International Review of Intellectual Property and Competition Law 51, no. 9 (October 28, 2020): 1062–85. https://doi.org/10.1007/s40319-020-00985-0 . This paper discusses the negative effects of strategic patenting by pharmaceutical companies, the author argues for the intervention of competition authorities. The first half of the paper serves as an explanation of what strategic patenting is, how it is done, and how it goes against the goal of patent and competition laws. The second half of the paper
is the authors suggestions, in which he argues that strategic patenting should be subject to scrutiny under competition law, in order to prevent the negative consequences affecting consumers. If the U.S. were to apply the principle of EU competition law, competition authorities would have the ability to investigate strategic patenting. As this was written during the COVID-19 pandemic, the author highlights how important it is for consumers timely access to affordable medications. He argues that strategic patenting hinders competition and stifles innovations for both generic and brand-name drug companies, and that involvement of competition authorities is necessary to ensure that consumer are given fair access to prescription drugs, as well as promote innovation within the pharmaceutical industry. Lexchin, Joel, Jillian Clare Köhler, Marc‐André Gagnon, James Crombie, Paul D. Thacker, and Adrienne Shnier. “Combating Corruption in the Pharmaceutical Arena.” Indian Journal of Medical Ethics , March 15, 2018. https://doi.org/10.20529/ijme.2018.022 . “Combating Corruption in the Pharmaceutical Arena” focuses on the four areas of corruption in the pharmaceutical arena. These include legislative/regulatory, financial, ideological/ethical, and communications. The article then proposes solutions and recommendations for reducing corrupt practices in these four areas. The authors suggest that in order for to reduce the current corrupt practices occurring in the pharmaceutical arena, we must delink profits from drug sales. This would make it so that the financial incentives for the pharmaceutical companies are structured in a way that align with the desired social outcomes of the drugs. One suggestion is value-based pricing. While the authors acknowledge that this proposal has many obstacles to overcome, it provides the financial incentives for research that is less focused on “me-too” drug and more on
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breakthrough drugs that improve health outcomes significantly. They also address that this model in high-income countries, like the US may need to be accompanied with other strategies, they suggest price-volume agreements. Another proposed idea is the “sequestration thesis” which separated researchers from the process of commercialization, this would involve the complete isolation of industry from clinical trial data. A strong version of this thesis would see the National Institute of Health organize and manage clinical trials, the resulting data would be funded from taxes collected from the pharmaceutical industry and/or general tax revenue. Scientists instead of working for the pharmaceutical company would work for the testing agency. Corruption has meant that instead of medicine being the means to advance healthcare in the U.S. it has become a means to increase corporate profits. The suggestions of the authors would combat this. William V. Padula, "State and Federal Policy Solutions to Rising Prescriptions Drug Prices in the U.S.," Journal of Health Care Law and Policy 22, no. 1 (2019): 15-24 “State and Federal Policy Solutions to Rising Prescription Drug Prices in the U.S.” by William V. Padula examines current policy primarily at the state level and other policy proposals. He highlights that in the past three years, because of the lack of fluidity in D.C. much of the federal legislation to address the rising costs of prescription drugs, majority of actionable items have been state-level. In which states are addressing drug prices in two ways, the first being by targeting drug prices directly, both generic and name brand and the second being exploring topics in drug price transparency. Many states have presented legislation to prevent price gouging, the author uses the example of Massachusetts who implemented legislation enacting a price gouging protection law that
does not only apply to brand-name drugs, but also generics, and it has seen some success. States are also introducing bills for price transparency, as these bills would help consumers where prices are being manipulated. Later in the paper the author discusses how the U.S. is the only western country to not have price regulation at a national level and highlights the proposal for “external reference pricing” by the Trump administration in 2018. What this would do essentially is “reference prices calculated by other countries using methods in health technology assessment to determine the price of the drug by its target outcome.” Due to the lack of progression in D.C. states have introduced and passed laws aimed at lowering prescription drug prices in the U.S. Summary The goal for all these articles was to look at alternatives to current root causes in healthcare in the U.S. The first article "Biden’s Antitrust Turn: The 2021 Antitrust Executive Order and Its Implications for Firms and Their Executives" by Dr. Yusaf H. Akbar discusses the potential impacts of President Biden’s EO on antitrust policy. The second article "Strategies to Counteract Impact of Harmful Bias in Selection of Medical Residents" by Edje, Casillas, and O'Toole look at the bias in medical resident selection and propose solutions to promote equality, one solution they propose is a more holistic review on applicants. "Strategic Patenting by Pharmaceutical Companies" by Olga Gurgula argues for competition authorities to intervene and counter the negatives of strategic patenting in the pharmaceutical industry and its impact on consumers. The final article Combating Corruption in the Pharmaceutical Arena" by Lexchin et al. looks at corruption in the pharmaceutical arena and suggests that we must delink profits from drug sales as well as proposes possible solutions like implementing value-based pricing.
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