The reciprocity principle and the pharmaceutical industry

When a Hari Krishna approaches you in an airport, he or she will give you a gift.

They will then solicit money.

And they get it.

When we are given something, there is a powerful need to reciprocate – a need which makes it very difficult to refuse a favour to someone to who we are indebted.

That’s why the Hari Krishnas have become so rich.

And it may well be the reason why the pharmaceutical industry has become so powerful.

The law of reciprocity

The Hari Krishnas are successful because they utilise the rule of reciprocity.

When someone gives you something, you feel you are in debt to them, you owe them something, and you need to do something back for them.

“The rule possesses awesome strength, often producing a “yes” response to a request that, except for an existing feeling of indebtedness, would surely have been refused,” explains Dr Cialdini, author of The Psychology of Persuasion.

Catching them young

The pharmaceutical industry starts wooing doctors before they have even graduated.

According to one article, gifts received include free lunches, pens, notepads and Viagra calculators. (These stand up when the on button is pressed!)

Meanwhile, an article in the British Medical Journal reveals that companies like Pfizer are now going into universities and providing free education.

Crucially, Pfizer refused any payment for the teaching – payment which would have removed the rule of reciprocity.

Small change?

It has been argued that the gifts are small change compared to the potential influence of the medical profession.

There are two points to consider.

According to Dr Caldiani, the size of the initial gift does not matter.

“A small initial favour can produce a sense of obligation to agree to a substantially larger return favour.”

Secondly, the cost of the industry’s favours is, in total, not so small.

One source (page since removed) estimates that the pharmaceutical industry spent over sixteen billion dollars in 2001 alone cultivating students and phsycians.


The UK government spent over a billion pounds of wasted money on useless flu vaccines.

The people who recommended it? According to the BMJ, it was big pharm scientists working for the WHO.

Pharmaceutical companies fund the FDA. Pharmaceutical companies fund the MHRA. Pharmaceutical companies fund WHO scientists.

And they fund the anti-smoking organisations who promote expensive nicotine cessation therapies with a 5% success rate, despite the fact that quitting cold turkey has been proven more effective.

And it’s those same anti-smoking organisations who oppose the electronic cigarette which threatens  pharmaceutical companies’ profits.


BMJ: Should drug industry staff teach students?

Robert B. Cialdini, PH.D. Influence: The Pyschology of Persuasion

Students start to rebel against drugmakers influence

World Health Organization Scientists Linked to Swine Flu Vaccine Makers


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