The Economic Driven By Politics As Values: The Case of Market Authorizations for Medicines

This paper confronts head on the deeply rooted understandings of both economics and politics which, by rendering the latter subservient to the former, dominate today’s world. To do so, it first critiques the definitions of politics deployed within existing theories of political economy and economic sociology (politics as politicians, policy or powering), then proposes a new, robust alternative which re-injects issues of morality into the forefront of analysis: the mobilization of values to change or reproduce the institutions that orientate, and indeed make possible, economic activity. Drawing upon constructivist strands of institutionalism, political sociology and industrial economics, this definition of politics is then used to build an analytical framework for understanding the ‘political work’ that constantly determines the directions taken by both firms and the public authorities charged with regulating and governing their activity. Specifically, using this approach, a fundamental tension within capitalism between the values of Freedom and Security is consistently examined. This is tackled by looking at conflicts within the definition of these two values during the regulation of specific industries, but also by examination of mobilizations of two other, and generally subordinate, values: Equality and Tradition. A hypothesis tested throughout my current research is that Equality and Tradition play either supporting, intervening or silent roles within the Freedom-Security relationships that structure the politics of contemporary economic activity.

The second part of the paper will put this analytical framework and these hypotheses to the test using empirical data from an ongoing research project upon the withdrawing of medicines from the French pharmaceuticals market. Fuelled by a number of health ‘scandals’, but also the rising cost of medicines, at least in France, such market withdrawls have recently become more frequent. Indeed, those in favor of such actions, particular regulatory agencies, are driven by two acceptations of the value of Security, one concerning patient safety, the other the very sustainability of national health systems. Not surprisingly, however, such actors constantly struggle against pharmaceuticals manufacturers and their allies who mobilize the value of Freedom in order to maintain medicines on the market and, thereby, support their Freedom to ‘innovate’, as well as that of doctors and patients to choose the treatments they prefer. As our research into the recent case of an anti-diabetic (pioglitazone) reveals, however, the French regulatory agency has often handicapped its work in this area by failing to combine their concerns for Security with ones that derive from an egalitarian conception of Equality. Little wonder then that by drawing instead upon Equality as simply equal access to opportunities, the defenders of Freedom have largely continued to dominate the regulation of the pharmaceuticals industry in France and beyond.

Overall, the paper argues not only that the materiality of economic activity is inextricably bound up in politics and thus morality. More specifically, it claims that the best means of capturing these relationships and their consequences is to place the mobilization and hierarchization of values at the center of theoretical development, research designs and analysis.