War, ethics, and market presence: policy shifts of global pharmaceutical companies in Russia following the 2022 invasion of Ukraine

Abstract Background In response to the 2022 Russian invasion of Ukraine, some scholars have advocated for pharmaceutical companies to voluntarily cease all operations and sales in Russia, including essential medicines. This proposal has been criticized on ethical and practical grounds. This study aims to understand the perspectives of global pharmaceutical companies regarding the provision of medicines following the Russian invasion of Ukraine. Methods We analyzed press releases and similar statements from the public websites of 19 global pharmaceutical companies following Russia’s invasion of Ukraine. Companies were selected based on third-party reports of top 20 global pharmaceutical companies by revenue. Data were analyzed using conventional content analysis. Two researchers with ethics expertise independently identified key concepts, assessed ethical justifications (consequentialist, deontological, or values-based), and categorized findings. Results Analysis of the press releases revealed two major themes: “scale-back” of non-essential operations in Russia (58% of companies) and a commitment to continuing to sell “essential products or medicines” (79% of companies). Companies scaling back operations often hinted at ethical justifications, including consequentialist, deontological, and values-based reasoning. The commitment to essential medicines was justified using consequentialist, deontological, and values-based reasoning, although values-based reasons were most common. Conclusion Global pharmaceutical companies have responded to the Russian invasion of Ukraine with a nuanced approach, characterized by scaling back non-essential operations while maintaining the supply of essential medicines. This approach reflects a complex interplay of ethical, practical, and geopolitical considerations. The findings highlight a shared understanding of the humanitarian imperative to ensure access to life-saving treatments, but they also raise questions about the variable articulation of ethical justifications and the potential influence of economic factors.