Closing the Marketing Strategy-Tactics Gap: An Institutional Theory Analysis of Pharmaceutical Value Chain - Innovation and Marketing in the Pharmaceutical Industry - page 716

Future research can build on this stream of work to more fully articulate the coevo-
lutionary processes involved in an open systems theory of interdependence.
Viewing pharmaceutical value chain as an open system centers attention on the
recursive relationships among market actors (DiMaggio 1997 ; Giddens 1990 ). For
instance, Moore et al. ( 2006 ) discuss the implications of interdependencies within
the context of accounting organizations. Faced with legitimacy threats from persis-
tent confl icts between their auditing and consulting functions, accounting fi rms
aggressively pursued “cosmetic changes” that improved the appearance of auditor
independence and “skillfully masked rent seeking in the rhetoric of the public
good,” till the excesses of one organization (Enron) wrought a political and public
backlash for a new institutional order (Moore et al. 2006 , p. 20).
A particularly provocative insight from an open systems perspective is that the
dominant coordinating logic at any given point is not necessarily conducive for
preserving legitimacy. System theorists note that, akin to biological evolution,
socio-economic systems move in the direction of more differentiated mechanisms
that initially allow nuanced, fl exible and contingent resolution of confl icted logics
but later tend to be drawn into progressive mechanization as dominant market actors
assert “fi xed arrangements” to gain effi ciency and reduce complexity in market
interactions. However, progressive mechanization also tends to “gradually diminish
and eventually abolish the equipotentiality” of the system as a whole thereby inhib-
iting its capacity to solve emergent problems rooted in system confl ict (von
Bertalanffy 1968 ; Katz and Kahn 1966 ). Thus, an open system perspective broadens
current conceptualizations to include the dynamics of recursive relationships among
market actors and opens several avenues for future research as outlined in Table 24.3 .

24.6 Concluding Notes

This chapter is motivated by the strategy-tactics gap in the extant pharmaceutical
marketing literature. Much previous research appears preoccupied by modeling the
ROI of diverse marketing mix instruments while largely neglecting to study the
strategies that underlie these tactics. Using the aversive discourse of pharmaceutical
marketing strategies in the medical literature and public press as a point of depar-
ture, the chapter aims to systematically analyze the marketing strategies used in
practice by pharmaceutical industry using a unique data involving court discovery
documents unsealed in a recent litigation. Moreover, we adopt an institutional the-
ory perspective to analyze the disparate logics that characterize the value chain of
pharmaceutical markets. Lacking institutional and system perspectives, current
approaches are hard pressed to anticipate, much less explain, the persistent and
increasingly unfavorable assessments of pharmaceutical marketing by its value
chain partners including professional medicine and consumers. Our analysis sug-
gests that the pharmaceutical value chain evidences dynamics consistent with sev-
eral aspects of institutional theory: (1) system confl ict due to coexistence of
competing logics, (2) institutional failure in resolving confl ict of logics that are